Peripheral Artery Disease
Sources consulted
This article is original patient-education content.
- WHO—Health topics A–Z(2024)
- NHS—Health A to Z(2024)
- CDC—Health topics(2024)
Based on international clinical guidelines
Overview
Peripheral artery disease (PAD) is when the blood vessels in your legs become narrow or blocked. This usually happens because fatty deposits, called plaque, build up on the inside walls. It’s the same process that can cause heart attacks and strokes. The narrowed vessels cannot deliver enough oxygen-rich blood to your leg muscles, especially when you walk, which causes pain.
Key facts
- PAD is common, affecting around 1 in 5 people over 60.
- The main symptom is a cramping pain in the legs during activity that goes away with rest.
- Stopping smoking, exercising, and working with your healthcare team are the best ways to manage the condition and avoid serious problems.
Yes, it is quite common – about 1 in 5 adults over 60 have some degree of PAD, though many do not notice symptoms.
It mostly affects people over 50 years old, especially those who smoke, have diabetes, high blood pressure, or high cholesterol. Younger people with these risk factors can also develop it.
Symptoms
- Sudden, severe pain in a leg that turns pale, cold, or numb – this could be a sudden blockage (acute limb ischaemia) and needs immediate help.
- An open sore on your foot or leg that is spreading, red, hot, or has pus, especially if you also have a fever – this could be a severe infection.
- ⚠Leg pain that develops while you are resting, particularly at night.
- ⚠A new sore or wound on your foot that hasn’t started healing within a few days.
Common symptoms
- A cramping pain in the calf, thigh, or buttock when walking or exercising that fades soon after you stop (this pattern is called intermittent claudication).
- Coldness, numbness, or a pale or bluish colour in one foot or lower leg.
- Weak or absent pulses in the feet.
- Skin changes such as shiny skin, hair loss on the legs, or thickened toenails.
- Slow-healing sores or ulcers on the toes, feet, or legs.
Symptoms in children
- PAD is extremely rare in children. Leg pain in a child is usually due to other causes such as growing pains, muscle strain, or normal activity. If your child’s leg pain concerns you, see a doctor.
Symptoms in older adults
- The symptoms are the same as in adults, but they may be mistaken for arthritis or just ‘getting older’. It is important not to ignore leg pain that comes on with walking and eases with rest, as it may be a sign of PAD.
Causes
Main causes
- Atherosclerosis – a gradual build-up of fatty plaques inside the artery walls (the same process that narrows arteries to the heart and brain).
Risk factors
- Smoking – the most powerful risk factor.
- Diabetes (high blood sugar can damage blood vessels).
- High blood pressure.
- High cholesterol.
- Being overweight or obese.
- Not being physically active.
- A family history of heart or circulation problems.
- Increasing age, especially over 50.
When to see a doctor
See a doctor urgently if:
- You have leg pain when resting, particularly at night, or a new foot sore that doesn’t seem to be healing – see your doctor the same day.
Book a routine appointment if:
- You often get a crampy leg pain during walking that goes away within minutes of resting.
- You notice your feet are often cold, your leg hair is thinning, or you can’t feel a pulse at your ankle.
- You have risk factors like smoking or diabetes and want a check-up.
Diagnosis
Your doctor will ask about your symptoms, check your pulses in your feet and groin, and look at your skin. They may then arrange a few simple tests.
Tests that may be done
- Ankle-brachial index (ABI): a painless test that compares the blood pressure in your ankle with that in your arm. A lower pressure at the ankle can signal narrowing.
- Doppler ultrasound: uses sound waves to show the blood flow through your leg arteries.
- More detailed scans such as CT or MR angiography may be used if your doctor needs a closer look.
What to expect at your appointment
The tests are not painful. The ABI test feels like having your blood pressure taken. You usually get the results soon afterwards, and your doctor will explain what they mean.
Treatment
Treatment aims to relieve your symptoms, help you walk farther, and stop the condition from getting worse. It usually includes lifestyle changes, medications to control underlying health problems, and sometimes a procedure to improve blood flow.
Self-care at home
- Stop smoking completely – this is the single most important thing you can do.
- Take up a regular walking programme – gradually increasing how far you walk can train your muscles to use oxygen better and reduce pain.
- Check your feet every day for cuts, blisters, or colour changes, and keep them clean and moisturised.
- Eat a balanced diet that is low in saturated fats, salt, and added sugars.
Medical treatments
Your doctor may prescribe medicines to help lower your cholesterol, control your blood pressure and blood sugar, and prevent blood clots. Often a low-dose medicine to keep the blood flowing more easily (sometimes called a blood thinner) is recommended. Always talk to your doctor about which treatments are suitable for you.
When is surgery considered?
If your symptoms are severe and do not improve with other treatments, or if you develop pain at rest or non-healing wounds, you may need a procedure to open the blocked artery. Options include angioplasty (a tiny balloon that widens the artery, sometimes with a small mesh tube called a stent) or bypass surgery (using a vein or a synthetic tube to create a detour around the blockage). Your vascular surgeon will discuss the best approach for you.
Living with this condition
With good management, you can continue most daily activities. The key is to pace yourself, take breaks if you get pain, and slowly build up your walking tolerance. Keep an eye on your feet and let your doctor know if anything changes.
Lifestyle tips
- Stay as active as you can – supervised exercise programmes are particularly helpful.
- Stop smoking and avoid being around second-hand smoke.
- Work with your healthcare team to keep conditions like diabetes and high blood pressure under good control.
- Maintain a healthy weight.
Diet and exercise
A heart-healthy diet is best: plenty of vegetables, fruits, whole grains, lean protein, and healthy fats (such as olive oil). Try to limit processed foods, red meat, sugar, and salt. Aim for 30 minutes of walking most days, but start gently and increase slowly. Supervised exercise therapy can help you walk farther without pain.
Mental health and emotional wellbeing
Living with a long-term condition can feel frustrating or worrying. You may feel anxious about your mobility or your future. These feelings are completely normal. If you are struggling, speak to your doctor or ask to see a counsellor. Support groups can connect you with others who understand. If you ever feel in crisis, reach out to a mental health helpline (see Find Support below).
Prevention
You can greatly lower your risk by not smoking, keeping active, eating healthily, and controlling conditions like diabetes, high blood pressure, and high cholesterol. Even if you already have some narrowing, these steps can stop it from getting worse.
Screening programmes
If you are over 50 or have risk factors such as smoking or diabetes, ask your doctor about a simple check for PAD. This may include a foot pulse check and an ankle-brachial index test.
Complications
If left untreated
- Increasing leg pain that eventually occurs even at rest (critical limb ischaemia).
- Chronic wounds on the feet or legs that do not heal and can become infected.
- Gangrene (death of body tissue), which may require surgery or, in severe cases, amputation of a toe, foot, or leg.
- A higher risk of heart attack or stroke, because the same fatty plaques can affect arteries elsewhere.
Long-term outlook
With the right treatment and lifestyle changes, most people with PAD can manage their symptoms well, walk more comfortably, and significantly lower the risk of serious complications. By working closely with your healthcare team, you can stay active and healthy.
Find support
International organisations
Local organisations
Helplines
External links open third-party websites. Ruqelo Health is not responsible for external content. Listing an organisation does not imply endorsement.
Always verify with your doctor
Health guidelines vary by country and region. The information in this article is based on international clinical guidelines but may not reflect the specific guidelines, medications, or practices in your country. Always discuss your health concerns with your own doctor or healthcare provider, and refer to your local national health guidelines where available.
Important notice This information is for educational purposes only. It does not replace professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider about your specific situation. If you are experiencing a medical emergency, call your local emergency services immediately.