Recognizing and Managing Peripheral Artery Disease

Peripheral artery disease occurs when one or more of the peripheral arteries—the blood vessels carrying oxygenated blood to the arms, hands, legs, and feet—become blocked or narrowed. Reduced blood flow to these areas can cause a variety of symptoms, ranging from discomfort to significant mobility issues.

PAD most commonly affects the legs, where plaque buildup in the arteries—a condition known as atherosclerosis—is the primary cause. Contributing factors include a sedentary lifestyle, obesity, smoking, high cholesterol, and diets high in saturated fats or processed foods.

Claudication refers to pain in the buttocks, thigh, or calf triggered by walking. This symptom occurs due to reduced blood flow which prevents the muscles from receiving enough oxygen during physical activity.

Initially, the pain appears during longer walks and subsides with rest, but as PAD advances, it can occur during shorter walks or even at rest. In severe cases, walking becomes nearly impossible due to pain.

Insufficient blood flow can lead to poor oxygenation, causing numbness or weakness in the affected limb. This lack of sensation or strength may make everyday tasks, like climbing stairs or entering the shower, increasingly difficult.

To manage PAD, consider strengthening daily habits that support circulation. Engaging in regular physical activity, monitoring your diet to reduce cholesterol intake, and quitting smoking can help reduce the progression of symptoms like numbness and weakness in the legs.

Poor circulation and inadequate blood flow to the legs can also cause the affected extremities to feel cool. Because PAD can affect only one leg, someone with this condition may notice one foot or leg feels cold while the other remains warm.

To manage this symptom, consider wearing compression socks to promote circulation, staying physically active with light walking or stretching, and keeping your legs warm with insulated clothing.

Reduced blood flow to the legs and feet can impair the body’s ability to heal wounds, making even minor cuts or ulcers on the legs, feet, or toes a potential concern. If you notice wounds that are not healing, it’s important to act quickly.

To support healing, keep the affected area clean and covered, avoid putting pressure on the wound, and ensure you’re consuming a nutrient-rich diet to aid tissue repair. Unhealed wounds are also at risk of infection, particularly if sensation in the limb is diminished, which can delay detection.

PAD can cause changes in the skin's appearance. The skin can appear pale in the early stages due to insufficient blood flow.

As the disease progresses, skin symptoms may get worse. When PAD becomes severe, the skin on the affected limb may appear dark and blue or tight and shiny. These changes result from poor circulation, which causes decreased delivery of oxygen and nutrients.

Hair loss on the legs and feet is a common symptom of poor circulation. When blood flow to these areas is restricted, the hair follicles no longer receive the oxygen and nutrients needed for growth. This can result in noticeable thinning or complete loss of hair in the affected regions.

While hair loss itself is not harmful, it serves as a visible indicator of underlying vascular issues that may require further evaluation.

Because PAD reduces blood flow to the feet and legs, detecting pulses in the lower extremities can become challenging, particularly in the feet. In some cases, pulses may be completely absent. Healthcare professionals often assess this symptom using a diagnostic method known as the ankle-brachial index (ABI), which measures the perfusion of the arteries in the lower extremities.

This test provides valuable information about the severity of blood flow restriction. An absent or weak pulse during a physical exam is a key indicator of PAD and may warrant further investigation.

Walking can be a highly effective form of exercise for managing PAD. Research shows that home-based walking programs improve pain-free walking distances and help individuals walk farther over time.

Structured walking plans are recommended for people with PAD. Studies indicate that walking to the point of moderate pain may be necessary for improvement. Programs such as the University of Michigan PAD Walking Program emphasize a systematic approach. This plan suggests warming up with two to three minutes of slow walking, followed by walking at a moderate pace until leg pain reaches a level 3 or 4 on a 5-point scale.

After resting for three to ten minutes to allow the pain to subside, participants repeat the cycle, finishing with a five-minute cooldown and stretching of the calf and thigh muscles. Over time, the goal is to build up to 30-minute sessions and gradually incorporate hills or stairs.

Walking for PAD requires a more structured approach than casual strolls but offers significant benefits for mobility and pain management.

People with PAD are at an increased risk for cardiovascular diseases. Effective treatment often involves addressing underlying risk factors, such as managing diabetes and hypertension, lowering cholesterol levels, and quitting smoking. These measures help reduce the progression of atherosclerosis, which contributes to PAD and other vascular conditions. In some cases, medications are prescribed to promote vasodilation, enhance blood flow, and improve oxygen delivery to affected areas.

For individuals who do not respond to lifestyle changes and medications, surgical intervention may be required. Options include angioplasty to widen narrowed arteries, bypass grafts to redirect blood flow around blockages, or procedures to remove plaque obstructions. These treatments aim to restore proper circulation and alleviate symptoms when other approaches are insufficient.

If you experience persistent leg pain, wounds or sores that won’t heal, or severe coldness in one or both extremities, it’s essential to seek medical advice promptly. These symptoms may indicate PAD or other underlying vascular issues that require professional evaluation.

Early detection is crucial; with timely diagnosis, lifestyle changes, and appropriate treatment, PAD can often be managed effectively. If you notice any symptoms of PAD or have risk factors for the condition, consult a healthcare provider to explore the best steps for your care.