7 Peripheral Artery Disease Symptoms (PAD) & How To Manage Them

• Peripheral artery disease (PAD) is caused by plaque buildup in the blood vessels that carry blood away from the heart to other parts of the body, such as the legs.
• According to the Centers for Disease Control and Prevention (CDC), approximately 6.5 million people age 40+ in the United States have PAD.
• While there isn’t a cure for PAD, there are ways to treat and manage the condition’s symptoms.

Peripheral artery disease (also known as peripheral arterial disease or PAD) occurs when the narrowing of arteries or blockages in the arteries occurs, usually in the legs or lower extremities of the body. This reduces blood flow from the heart to other areas of the body. The most common reason for this reduction in blood flow is plaque buildup in blood vessels that supply blood to other parts of the body (also called atherosclerosis).

While PAD can occur in other areas of the body, such as the arms, it is more common for it to happen in the legs. 

Peripheral Artery Disease (PAD) Vs. Coronary Artery Disease (CAD)

While peripheral artery disease deals with blockages and narrowed blood vessels that carry blood to other parts of the body, coronary artery disease involves blockages and narrowed arteries in the heart, which can lead to heart disease or heart attack.

These two conditions are different, but they are often related. If you are diagnosed with PAD, you are at higher risk for CAD, and vice versa.

Types of Peripheral Artery Disease

There are a few different forms of peripheral artery disease.

• Lower Extremity Peripheral Artery Disease: Lower extremity PAD is the common form of PAD, which affects the legs, feet, and other lower extremities.
• Upper Extremity Peripheral Artery Disease: Upper extremity PAD affects the upper body, usually the arms and the hands, and is far less common than other types.

The cause of peripheral artery disease is atherosclerosis. This is when plaque buildup occurs in the arteries, causing them to narrow or become blocked, thus preventing blood flow. When blood is restricted from PAD, it can’t move from the heart to other areas of the body through the peripheral arteries. 

The most common symptoms of peripheral artery disease include:

1. Burning or aching pain in feet and toes
2. Numbness or weakness in legs or feet
3. Redness or other color changes on skin
4. Toe and foot sores that don’t heal
5. Coldness of skin on lower leg or foot
6. No pulse or weak pulse in legs or feet
7. Leg pain or foot pain when resting or sleeping

Often, these symptoms go unnoticed for a significant period, as PAD can develop over the course of years or even decades.

Risk factors for PAD include:

• Age: Those over the age of 65 are more likely to develop PAD, (althoughPAD can occur at any age).
• Chronic conditions: Those with type 2 diabetes, chronic kidney disease, blood clotting conditions such as thrombocytosis, high blood pressure, or high cholesterol, are more likely to develop PAD.
• Family history: Those with a family history of PAD, heart disease, stroke, etc. are predisposed to develop PAD.
• Weight: Those who are overweight or obese are at greater risk of developing peripheral artery disease.
• Race: African Americans are predisposed to developing PAD.
• Poor lifestyle habits: Those who smoke, vape, or use tobacco products are more likely to develop PAD.

If you start to experience severe pain in the legs, numbness or weakness in the legs, or notice other symptoms of PAD, it’s best to make an appointment with your doctor immediately.

If you experience chest pain, pain that spreads to the shoulder, sudden dizziness or lightheadedness, or cold sweats, please call 911 immediately or head to the nearest hospital as you could be having a heart attack.

To diagnose PAD, a doctor will first perform a physical exam followed by additional tests.

Physical Exam

To diagnose coronary artery disease, your primary care physician will perform a physical exam that typically includes:

• Asking about your lifestyle
• Asking about your family and medical history
• Measuring your blood pressure
• Listening to your heart with a stethoscope
• Asking about symptoms you’re experiencing

Tests

There are a few tests that a healthcare provider may run to try and diagnose/​determine the severity of PAD. These include:

• Ankle-brachial index (ABI)
• Blood tests
• Pulse volume recording
• Vascular ultrasound
• Angiogram

If a diagnosis of PAD is determined, your provider will help create a treatment plan.

Lifestyle changes and medications are the most common ways of treating peripheral artery disease. In some cases, surgery or other medical procedures may be involved.

Lifestyle changes

Your healthcare provider will likely have you initiate lifestyle changes as a first step to treating and managing PAD symptoms. Some of these changes may include:

• Eliminating tobacco: No longer smoking, vaping, or using tobacco products
• Changing your diet: altering your diet to focus on foods that are high-fiber and low in fat, cholesterol, and sodium
• Staying physically active: exercising for about 30 minutes daily, five days a week. Walking, jogging, or other physical activities count towards this goal.
• Lowering stress levels: Keeping stress levels low can help with PAD symptoms. Yoga, meditation, and other relaxing activities can all help manage stress levels.
• Intentional foot/​leg care: If you haven’t already, caring for your legs and feet by washing, drying, moisturizing, and immediately treating any infections or issues that arise can help keep PAD symptoms from worsening.

Medications

Your doctor may prescribe certain medications to treat other conditions that affect PAD, including blood pressure, cholesterol, or leg pain.

• Medications for high blood pressure, such as ACE inhibitors or calcium channel blockers
• Medications for high cholesterol, such as Statins or PCSK9 inhibitors
• Medications to help prevent blood clots, such as blood thinners
• Medications to help with leg pain, such as cilostazol

Surgery or Procedures

In some cases, surgery or certain medical procedures may be necessary to treat PAD.

• Angioplasty: This procedure involves reopening a blocked artery to allow better blood flow. Sometimes, a stent may be placed to keep the artery open.
• Bypass surgery: This procedure involves creating a path around the blocked artery using a new artery. This may be a healthy blood vessel from somewhere else in the body or a synthetic one created for the surgery.
• Thrombolytic therapy: This procedure is used specifically if there is a blood clot in the artery. A medication to dissolve the clot is administered to the blocked artery.

If you have high-risk factors for peripheral artery disease, there are some steps you can take to potentially help prevent the disease, including:

• Eliminating tobacco usage
• Managing and maintaining a healthy weight
• Eating a well-balanced, healthy diet
• Exercising 30 minutes per day, five days a week

Complications of untreated peripheral artery disease include:

• Ischemia/​Gangrene
• Amputation
• Infection
• Ulceration
• Heart attack
• Stroke
• Blood clots
• Erectile Dysfunction

Currently, there is no cure for PAD. However, the prognosis for managing symptoms and slowing the progression of the disease is still hopeful.

Slowing the progression will highly depend on your age, risk factors, and other health conditions, as well as if caught early and treatment protocols given by your doctor, such as medication and lifestyle changes, are followed. 

What are three signs of peripheral artery disease?

Some signs of peripheral artery disease include leg pain that doesn't go away, even while sleeping, a decrease in temperature of the lower leg or foot, and sores on the feet or legs that won't heal.

What is the average age for someone to develop PAD?

PAD can occur at any age, but it's most common in adults ages 50 and above.

What foods should I avoid if I have PAD?

Foods to avoid if you have PAD include items high in saturated fat, trans fat, sodium, and added sugar, as these can contribute to heart disease and other risk factors associated with PAD.

Do compression socks help with PAD?

No, compression socks are usually not recommended for those with PAD, as the socks typically fit tightly and don’t allow great blood circulation from the heart to the legs.

What is the best position to sleep in if I have PAD?

The most recommended sleeping position for those with PAD is on your back with legs elevated. If this isn’t an option, then side sleeping with a pillow between the legs is also recommended.