Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Poor circulation is often a cause of chronic pain. Poor circulation is usually caused by
tobacco use, diabetes, or various autoimmune diseases (diseases where the body makes antibodies that fight against itself) such as lupus or rheumatoid arthritis.
Partial blockage of arteries by fatty deposits called plaques (arteriosclerosis) is also a common cause of poor circulation. The reason for the pain of poor circulation is that the part of the body that does not get good blood circulation becomes short of oxygen and nourishment. The lack of oxygen and nutrition causes damage to that part of the body, and the damage causes pain.
Pain from poor circulation may be treated by surgery to bypass the clogged arteries with artificial arteries in order to improve the blood circulation. Sometimes this is not possible, and blood thinners or opioids may be needed to control the pain.
Another common cause of poor circulation is reflex sympathetic dystrophy (RSD), also known as complex regional pain syndrome (CRPS). This is a problem of both circulation and nerve transmission because painful nerve transmissions cause the blood vessels to
become narrower. The narrowing prevents enough oxygen and nourishment from getting to the part of the body that is affected. RSD can sometimes be treated with a surgical sympathectomy, an operation to stop the nerve impulses from causing a narrowing of the blood vessels. Often, non-opioid medication, either with or without surgery, is needed. Sometimes opioids are needed.