Getting older means new aches and pains. You might now have a twinge in your back or a creaky knee on cold mornings. You may even have some pain in your legs. But if it flares up while you walk or exercise and goes away when you rest, it could be a sign of peripheral artery disease, or PAD. Left untreated, this vascular disease can cause serious complications and even amputations.
How PAD Affects Your Legs
Hardening of the arteries causes peripheral artery disease by fatty plaque. PAD is most common in the hips, legs and feet. PAD often causes pain or cramping in your calf, thigh or hip muscles when moving around. This pain is called claudication.
Unlike joint pain in your hip or knee, claudication occurs when your muscles don't get enough oxygen because the arteries are too narrow for blood to flow normally to your leg. When you stop moving, your muscles don't need as much oxygen, and the pain disappears.
Signs and Symptoms of Peripheral Artery Disease and Claudication
If your leg pain is happening near one of your joints, it can be easy to confuse it with arthritis. But arthritis pain often still aches when you rest, while claudication pain does not. Usually, the pain goes away about as fast as it comes on. If it takes 10 minutes of walking before your leg pain starts, it will take 10 minutes of rest before it goes away.
Other symptoms of PAD include:
- Blueish color in your legs
- Cold feeling in your legs
- Numbness or weakness in the legs
- Slow hair growth on the legs or hair loss
- Slow toenail growth
- Sores on your feet or legs that won't heal
- Weak pulse in your legs or feet
Men may also experience erectile dysfunction.
Are You at Risk for PAD?
Although anyone can develop PAD and claudication, some are at a higher risk. The biggest risk factors include:
- Age
- Diabetes
- Family history of PAD
- Heart disease
- High blood pressure
- High cholesterol
- Previous history of heart attack or stroke
- Smoking
Most people diagnosed are 50 or older. Smokers are at a very high risk of developing PAD.
How PAD Is Diagnosed
If you have any risk factors for PAD, you should discuss them with your primary care provider even if you aren't experiencing symptoms. They can perform a simple test to compare the blood pressure in your leg to that in your arm. If the results are abnormal or borderline, you will need additional tests to determine if PAD is the source of the problem.
Confirmation of a PAD diagnosis can be done using advanced non-invasive imaging, such as:
- Angiogram, which uses contrast dye and X-rays
- CT angiography, where contrast dye shows your blood vessels during a CT scan
- Duplex ultrasound, which shows your blood vessels via sound waves
- MRI angiography, which provides imaging without radiation
Treatment for PAD
Peripheral artery disease does not have a cure, but successful treatment can prevent it from worsening. For less severe PAD, treatment may involve:
In fact, quitting smoking is one of the best ways to prevent PAD and improve your claudication symptoms. Another way is to get 30 to 60 minutes of brisk walking at least four times a week.
If the PAD is more advanced, you may need a procedure called an angioplasty, which opens the affected artery for better blood flow. If the artery is extremely damaged, you may need surgery to bypass that part with a different blood vessel.
In extreme cases, severe PAD can lead to gangrene in your toes, foot or leg. This situation could require amputation.
Talk to a UMMS Vascular Provider about PAD
If you are experiencing leg pain and aren't sure why, talk to a physician right away. Early diagnosis of PAD can make treatment easier and can also lower your risk of heart attack and stroke.
Sometimes it can be hard to diagnose peripheral artery disease. But the vascular specialists at the University of Maryland Medical System have expert training in diagnosing and treating PAD. Our advanced imaging technology ensures accurate diagnosis to speed up your treatment and recovery.
Listen to a Podcast about PAD
Listen to a podcast about Peripheral Artery Disease with Drs. Charles Fox and Nathanael Dayes:
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