Physical Therapy for Vascular Pain?
vascular pain

Vascular problems can lead to leg pain, discomfort during walking, and/or muscle cramps. Often times, people who experience this type of pain and limitation do not know what kinds of treatment are available. Hopefully, this article will answer some common questions and help you make the best informed decision about how to address leg cramps or pain from vascular problems.


Now, many factors influence leg pain, particularly when walking. Especially with peripheral vascular disease (PVD), leg cramps that stop at rest (claudication) cause real functional limitations as well as pain. As with many other medical diagnoses, conservative management can provide real benefits without the risks associated with more invasive treatments for patients with PVD and claudication [1].


Under the supervision of a qualified clinician (physical/occupational therapy), patients can participate in individualized exercise programs based on their function & ability. These programs aim to increase cardiac efficiency, leading to improved blood flow and peripheral oxygen utilization [1].


Frequently Asked Questions (FAQs) About Physical Therapy for Vascular Pain

We’ve included the list below to help answer some common questions about the types of treatment available for vascular pain. It’s always important to speak with your doctor or provider about the options available and what may be the best fit for your individual situation. 


Why would my physician refer me to therapy as a treatment for cardiac or vascular problems?


Your doctor may refer you to physical or occupational therapy to address pain, weakness or decreased function resulting from a cardiac or vascular problem. Research shows that PT/OT treatments can help reduce pain related to cardiac or vascular issues. It can also help increase endurance & strength which may be limited due to cardiac issues.


Conservative management can provide real benefits without the risks associated with more invasive treatments for patients with cardiac issues, peripheral vascular disease (PVD), and claudication. These therapy programs include supervised exercise treatment (SET) and aim to increase cardiac efficiency, leading to improved blood flow and peripheral oxygen utilization. This can lead to improved endurance & strength as well as decreased leg pain. [1]


Aquatic therapy has also been shown to be helpful in reducing pain and cramps related to vascular problems.


What are the benefits of therapy treatment for cardiac or vascular conditions?


There have been great developments in recent years in the treatment guidelines and programs for patients experiencing leg pain due to vascular issues as well as other problems related to cardiac and vascular diagnoses. Here are a few treatment programs available through physical & occupational therapy: Treadmill Exercise Training, Pain-Free Walking Exercise Therapy, Lower Extremity Cycling Training, & Aerobic Upper Body Exercise Therapy [1].


These therapy programs all aim to help improve strength, endurance,  & blood flow to help decrease pain or muscle cramps that may result from vascular issues or cardiac problems.


Does Medicare cover this type of treatment?


In short, the answer is “yes”. Medicare does cover physical/occupational therapy treatment as a way to address peripheral artery disease. This is taken from a statement in 2017: “The Centers for Medicare & Medicaid Services (CMS) proposes that the evidence is sufficient to cover supervised exercise therapy (SET) for beneficiaries with intermittent claudication (IC) for the treatment of symptomatic peripheral artery disease (PAD).” CMS proposes that Medicare Administrative Contractors (MACs) have the discretion to cover SET beyond 36 sessions over 12 weeks and may cover an additional 36 sessions over an extended period of time with a new referral if patients continue to be symptomatic.


So Medicare will pay for this type of treatment, which also means that many other third-party or commercial insurance plans will cover this at some level. If you have any questions about your insurance coverage, and whether this type of service is covered, feel free to reach out to us at the office and we’d be happy to help you out.



[1] Treat-Jacobson, PhD, RN, FSVM, FAHA, FAAN, D. (2019). Supervised Exercise Therapy for Peripheral Artery Disease (PAD). Lecture presented at American Heart Association in University of Minnesota.

Are you dealing with chronic pain?

We understand that struggling with the stress and strain of chronic pain can be tough…Whether it’s waking up feeling stiff or severe tension after walking, running, or playing, no one wants to spend each day dealing with the soreness that chronic pain brings. While many people choose surgery or injections for pain relief, at ProActive Rehabilitation & Wellness, we offer non-surgical therapies which prevents patients from going under the knife.


If you’d like to book a chronic pain consultation now, with one of our top clinicians, click here or have your provider fax over a referral. We only book a limited amount of these consultations each month, so act quickly before they’re gone.

Rafi Salazar OT

Rafael E. Salazar II, MHS, OTR/L (Rafi) is the CEO & President of Proactive Rehabilitation & Wellness, as well as the Principal Owner of Rehab U Practice Solutions and the host of The Better Outcomes Show. He has experience in a variety of rehab settings, working with patients recovering from a variety of injuries and surgeries. He worked as the lead clinician in an outpatient specialty clinic at his local VA Medical center, where he worked on projects to improve patient & employee engagement and experience throughout the organization. He also has experience as a faculty member at Augusta University’s Occupational Therapy Program, as a Licensed Board Member on the GA State OT Board, has served on several committees for the national OT Board (NBCOT), and as a consultant working for the State of Georgia’s DBHDD. He is also on the Board of Directors for NBCOT.