Pain Management for Arterial Ulcers: Understanding and Alleviating Discomfort

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1533 E 4th St,

Santa Ana, CA 92701

kennedy ulcer wound careWhen it comes to relieving the pain of arterial ulcers, you’ll need to take your time, pay attention, and take a special, yet effective approach. Because these ulcers are often caused by Peripheral Arterial Disease (PAD), they happen when the flow of blood is reduced or restricted. A reduction of blood flow leads to two main problems: tissue ischemia and persistent pain – though, there are other side effects of arterial ulcers. The latter we’ll talk about throughout this article. On the other hand, tissue ischemia happens when the tissue isn’t given enough oxygen and nutrients. Over time, tissue ischemia can lead to pain, especially when coupled with inflammation. So, getting back to the main point of this article, why are ulcers painful? Let’s get into it. 

Ulcer Pain 

Ulcers are often associated with pain – but why is that? Let’s explore three reasons why ulcers cause pain, including reduced blood flow, chronic inflammation, and neuropathy. 

Reduced Blood Flow

When blood flow is reduced, it means the tissues aren’t getting enough oxygen and nutrients. The body’s natural response is to send out pain signals. Think of these pain signals as your body’s natural alarm system: something went wrong and your body is letting itself know. For this reason, the best way to manage ulcer pain is to improve blood flow. This can be done through procedures like revascularization, which we’ll discuss later in the article. 

Chronic Inflammation

kennedy ulcer wound care ocOftentimes, ulcers cause ongoing inflammation. We call this “chronic inflammation,” because it’s inflammation that never seems to stop. Inflammation isn’t good for the body for a number of reasons, but in this article we’ll discuss the pain-related reasons inflammation is bad. Inflammation causes the body to release chemicals that make discomfort and pain even worse. Plus, these chemicals can actually hinder tissue healing, making them a double-whammy in the pain department. They not only cause pain, they also make it so the pain continues on a chronic level. 


Neuropathy makes ulcer pain even more intense and challenging. Neuropathy is a condition that happens when there is severe damage to the peripheral nerves and it can be caused by a number of different conditions, including diabetes. When it comes to ulcers, neuropathy can make the pain even worse for a few different reasons. First, by lowering the threshold for pain perception. In other words, neuropathy makes it so you don’t feel pain. It’s often compared to an overall numbness. Secondly, neuropathy gets in the way of the pain modulation and healing processes. Again, because it causes numbness or numbing sensation, neuropathy makes it so the body can’t put up natural defenses for dealing with pain. And lastly, because neuropathy can coexist with other pain-inducing factors, it often exacerbates pain and inflammation. 

Pain Relief for Arterial Ulcers in Orange County, Ca

kennedy ulcer wound care orange countyTo relieve arterial ulcer pain and help the ulcer heal as quickly as possible, we use a range of strategies:

  • Revascularization: As discussed above, revascularization is a great way to get blood flowing optimally again. This can be done through a few different types of procedures, including angioplasty and bypass surgery, which are two tried-and-true revascularization surgeries. Once revascularization is achieved, patients feel reduced pain and heal better and more easily, overall. 
  • Medication: When it comes to pain, medication is always an option but it is an option many don’t like to take. There are over-the-counter (OTC) pain-relief and anti-inflammatory drugs that can truly help – narcotics are not the only solution. Though, when people think of pain-relieving medicine, they often think of narcotics. If pain is severe, narcotics are prescribed; but if pain is moderate, doctors usually stick to OTCs like aspirin and tylenol. Even creams and ointments that contain pain-relieving qualities are great for pain reduction and inflammation reduction. 
  • Proper Wound Care: Proper wound care means a few different things. It means keeping the wound clean, stopping the spread of infection, removing dead tissue, changing dressings often, and monitoring the wound for changes. These simple steps help reduce pain greatly. They also help speed up the healing process. 

Offloading for Arterial Ulcer Care and Pain Relief

Offloading is a category of its own when it comes to ulcer care and pain relief. It’s a very simple tool but can mean a world of difference for ulcer sufferers. Offloading works because arterial ulcers often start in the lower extremities, feet, and toes. Pressure to these areas is made worse by body weight and improper footwear. In other words, standing on the wound is what makes it worse, and worse. When you offload, you’re taking pressure from the area and allowing the ulcer to heal better. Redistributing pressure works wonders for pain, inflammation, and healing in general. 

There are a few different ways to offload, let’s discuss them 

Techniques for Offloading

skin damage wound careSpecial Footwear

Special shoes, orthotic devices and/or custom-fitted footwear do wonders for ulcer care. Orthotic devices often come as insoles or inserts that are put directly into shoes. Special shoes are built to reduce the risk of pressure and tissue damage in the affected area. 

Casts and Total Contact Casting (TCC)

When it comes to ulcer care, your doctor or wound care specialist may suggest a technique called Total Contact Casting (TCC). TCC is essentially a special cast that adheres to the shape of the foot, extending from the toes to the knee. TCC offloads pressure in a unique and effective way. It is particularly beneficial for ulcers that are chronic and difficult to heal.


Elevation is inexpensive, easy, and effective. By elevating the affected leg you’ll reduce pain and pressure on the ulcer while at the same time you’re getting rest (which is much-needed for proper healing). How high should you elevate your leg? Bring it to a level above the heart. This will not only help improve blood flow to the area, but it also alleviates discomfort.

Understanding Arterial Ulcers

Wound care specialist Dr. Faried BanimahdWhat is an Arterial Ulcer? 

Arterial ulcers are usually found on the lower limbs, feet and toes. They are the result of lowered blood flow, caused by Peripheral Arterial Disease (PAD) and atherosclerosis. In appearance, these ulcers are shallow, punched-out wounds that have pale tissue and produce minimal exudate. Sometimes these wounds are necrotic

In conclusion, arterial ulcers are caused by a reduction in blood flow that often stems from Peripheral Arterial Disease (PAD).

Ulcers are often painful for a variety of reasons, including reduced blood flow, chronic inflammation, and neuropathy. Knowing the reasons behind ulcer pain is a crucial first step in effectively addressing it. Strategies like revascularization procedures, medication management, and proper wound care can alleviate pain, reduce inflammation, and promote healing. Another way to manage ulcerative pain is offloading, which involves redistributing pressure away from the affected area. Offloading is a critical component of care that significantly contributes to pain relief and healing.

Contact Wound Care OC for wound treatment in Orange County, CA

Dr. Faried Banimahd is a board-certified physician specializing in emergency medicine, wound care, and pain management. Our team at WoundCare OC will work with you to create an individualized treatment plan that meets your needs and unique conditions. Our clinic includes highly trained and experienced physicians, registered nurses, and certified medical staff who work together to provide you with the highest standards of wound care treatments.

To make an appointment

1533 E 4th St,

Santa Ana, CA 92701

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