artery that comes and goes

Overview

Peripheral artery disease (PAD) is a condition where the arteries that carry blood to your legs become narrowed or blocked. This can cause pain or cramping in your legs when you walk, which goes away when you rest. It is sometimes called 'claudication' — a Latin word meaning 'to limp.' The narrowing is usually caused by a build-up of fatty deposits inside the artery walls.

Peripheral artery disease is fairly common, especially in people over 50. It affects about 1 in 5 people over that age, though many have mild or no symptoms.

PAD is more common in people who smoke, have diabetes, high blood pressure, high cholesterol, or are overweight. It also becomes more likely as you get older. Men and women can both be affected, but it appears more often in men.

Symptoms

Common symptoms

• Pain, ache, cramp, or heaviness in your calf, thigh, or buttock muscles when you walk or climb stairs. This goes away after a few minutes of rest.
• Numbness or weakness in your legs.
• A feeling of coldness in your foot or lower leg, especially compared to the other side.
• Sores or ulcers on your feet or toes that heal slowly.
• A change in the colour of your leg — paler than usual or bluish.
• Toenails that grow more slowly or become thick.
• Hair loss on your legs.

Causes

Main causes

• Atherosclerosis — the build-up of fatty deposits (plaque) inside artery walls. This narrows the arteries and reduces blood flow.
• Inflammation of the blood vessels, which can also narrow them.
• Blood clots that partially block an artery.

Risk factors

• Smoking or using tobacco products.
• Diabetes.
• High blood pressure (hypertension).
• High cholesterol.
• Being over 50 years old.
• Being overweight or obese.
• Not being physically active.
• Family history of atherosclerosis or PAD.

When to see a doctor

See a doctor urgently if:

• Sudden, severe leg pain that makes you unable to walk or move your foot.
• A leg that is very pale, cold, and without any feeling or movement — this could be a blocked artery.
• A dark or black area on your foot or toe (gangrene) or a deep, infected sore.

Book a routine appointment if:

• You have leg pain or cramping when walking that goes away when you rest.
• You notice a sore on your foot or leg that is not healing.
• Your legs feel cold or look different colours for no obvious reason.
• You have a family history of PAD and are over 50.

Diagnosis

Your doctor will ask about your symptoms, medical history, and risk factors. They will examine your legs, check your pulses, and listen to your arteries with a stethoscope. A simple test called the ankle-brachial index (ABI) is often used to compare blood pressure in your ankle and arm. A lower pressure in your ankle suggests PAD.

Tests that may be done

• Ankle-brachial index (ABI) — a painless test using blood pressure cuffs.
• Doppler ultrasound — sound waves create images of blood flow in your arteries.
• Angiography — a dye is injected into your arteries and X-rays are taken to see blockages.
• Blood tests to check for diabetes, high cholesterol, and other conditions.

What to expect at your appointment

Most tests are non-invasive and painless. The ABI takes about 15 minutes. You may be asked to walk on a treadmill for a short time to see how your symptoms respond. If a blockage is found, your doctor will discuss treatment options, which often start with lifestyle changes and medication.

Treatment

Treatment for PAD focuses on relieving symptoms, improving blood flow, and preventing the condition from getting worse. The main goals are to reduce the risk of heart attack and stroke, and to help you walk without pain. Treatment usually starts with lifestyle changes and medication, and sometimes involves procedures to open blocked arteries.

Self-care at home

• Quit smoking — this is the most important step you can take.
• Walk regularly — a structured walking programme can help build up the distance you can walk without pain.
• Keep your feet clean and dry, and check them daily for any cuts or sores.
• Manage your weight through healthy eating and activity.
• Control diabetes, high blood pressure, and high cholesterol as advised by your doctor.

Medical treatments

Your doctor may prescribe medications to lower blood pressure or cholesterol, or to reduce the risk of blood clots. Some medicines can help widen the arteries and improve blood flow. Always take any medications exactly as prescribed and discuss all options with your healthcare provider.

When is surgery considered?

If lifestyle changes and medications do not help, or if you have severe symptoms or complications, your doctor may recommend a procedure. This could be angioplasty (where a balloon widens the artery, often with a stent to keep it open) or bypass surgery (where a healthy vein or artificial tube is used to route blood around the blockage). Surgery is only considered for more serious cases.

Living with this condition

Living with PAD means being consistent with healthy habits. You may need to plan your day around walking breaks, but regular activity is key. Pay close attention to your feet — check them every day for any injuries, and see a podiatrist (foot specialist) regularly. Keep your feet warm and avoid extreme cold or heat.

Lifestyle tips

• Quit smoking — get help from stop-smoking services.
• Walk for at least 30 minutes every day, even if you have to stop and rest.
• Eat a healthy, balanced diet low in salt, saturated fat, and sugar.
• Stay at a healthy weight.
• Manage stress through relaxation techniques or hobbies.
• Take all medications as prescribed.

Diet and exercise

A healthy diet can help control your weight, blood pressure, and cholesterol. Focus on fruits, vegetables, whole grains, lean proteins, and healthy fats like those in fish and nuts. Exercise is crucial: a supervised walking programme or even regular short walks can improve your symptoms over time. Start slowly and rest when you need to.

Mental health and emotional wellbeing

Living with a chronic condition like PAD can be frustrating or worrying. You may feel anxious about your health or limited in what you can do. It is normal to feel this way. Talk to your doctor or a counsellor if you feel low or anxious. Support from family and friends also helps.

Prevention

You cannot always prevent PAD, but you can lower your risk by not smoking, keeping active, eating well, and managing conditions like diabetes, high blood pressure, and high cholesterol. If you already have PAD, these steps can keep it from getting worse.

Screening programmes

There is no routine screening test for PAD in the general population. However, if you have risk factors such as diabetes, smoking, or a family history, your doctor may recommend a one-time ABI test even without symptoms. Talk to your doctor about whether screening is right for you.

Complications

If left untreated

• Critical limb ischemia — severe blockage causing pain at rest, non-healing sores, or gangrene, which may lead to amputation.
• Higher risk of heart attack or stroke, because the same fatty deposits can affect arteries in the heart and brain.
• Poor wound healing and increased risk of infection in the legs and feet.
• Loss of mobility and independence due to pain.

Long-term outlook

With proper treatment and lifestyle changes, most people with PAD can improve their symptoms and prevent serious complications. The outlook is very good for those who stop smoking, increase physical activity, and manage their health. Many people are able to walk without pain and continue their normal activities. Even if you need a procedure, results are often excellent.

Find support

Local organisations

• NHS (UK) – Peripheral arterial disease (PAD) information ↗ · United Kingdom

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