Leg-Up-PAD-ts

Get a Leg Up on Peripheral Artery Disease

By Adam Levine, DO, FACC, FSCAI
Medical Director Cardiac Cath Lab and Medical Director Progressive Care Unit, 
Virtua Our Lady of Lourdes Hospital

If you suffer from leg pain while walking, climbing stairs, or exercising, you may blame arthritis or old age. But the problem could be much more serious—peripheral artery disease (PAD).

PAD occurs when plaque builds up inside the arteries in the legs. The vessels harden and narrow, restricting the flow of oxygen-rich blood to the legs. This causes muscle pain and cramping when walking, a condition called claudication. PAD is also a pretty good indication that you likely have plaque buildup in other arteries, possibly those leading to your heart and brain. This may increase your risk for a heart attack and stroke.

Symptoms Progress Slowly
An estimated 10 million Americans have PAD. It usually strikes after age 50. High blood pressure, high cholesterol, smoking, diabetes, obesity, and a previous heart attack or stroke are all risk factors for developing PAD.

PAD develops slowly and can go unnoticed because there may be mild or no symptoms. As the disease progresses, activity can trigger discomfort in the lower legs, thighs, and hips.

The pain from claudication often disappears after a few minutes of rest. As the disease progresses, the pain may occur while at rest or lying down. Other symptoms include:

  • Leg numbness or weakness
  • Pale or bluish skin
  • Lack of hair or nail growth
  • Coldness in the lower leg or foot
  • Sores on toes, feet, or legs that heal slowly or not at all

Don’t Confuse PAD with Arthritis
It’s important to know the difference between pain caused by arthritis and symptoms that indicate blocked blood flow.

Arthritis generally is associated with specific joints—the hands, wrists, feet, knees, hips, ankles, shoulders, and elbows. When cartilage around the joint breaks down, pain, stiffness, and swelling can result. Arthritic joints may also be warm and have limited movement.

PAD is diagnosed with a simple test called an ankle-brachial index. It measures blood flow by comparing blood pressure in your arms with blood pressure in your legs. A much lower leg pressure may mean PAD.

Lifestyle changes, like healthy eating, exercise, and not smoking, are often the first line of treatment. Your doctor may also prescribe medications to improve blood flow and lower blood pressure, cholesterol and blood sugar.

Minimally invasive treatment options use catheters to open a blocked artery and remove plaque. These include an angioplasty and a stent to keep the vessel open.

If you have leg pain, don’t dismiss it as a normal part of aging or arthritis. Talk to your doctor.

Virtua’s vein and vascular specialists treat the full range of venous and vascular disorders, from varicose and spider veins to arterial disorders to serious blood clots. To learn more, click here.

Updated September 8, 2020

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