Peripheral Arterial Disease (PAD): 10 Common Signs and When to See a Doctor

Peripheral Arterial Disease (PAD): 10 Common Signs and When to See a Doctor

Peripheral Arterial Disease (PAD) is a frequent yet widely underdiagnosed circulatory condition. It occurs when the arteries supplying blood to your limbs—most commonly the legs—become narrowed or blocked due to a buildup of fatty deposits (atherosclerosis).

Because PAD restricts oxygen-rich blood from reaching your muscles, it can lead to mobility issues and, if left untreated, serious cardiovascular events. Below, we outline the key warning signs and what you need to know about diagnosis and treatment.

What is Peripheral Arterial Disease?

PAD is a manifestation of atherosclerosis outside of the heart and brain. When plaque builds up in the leg arteries, the muscles cannot get the oxygen they need, especially during physical activity.

While anyone can develop PAD, it is most common in individuals over 60, smokers, and those living with diabetes or high blood pressure.

10 Common Signs of Peripheral Arterial Disease

Many people mistake the early signs of PAD for “just getting older” or arthritis. Recognizing these 10 symptoms can be life-saving:

1. Intermittent Claudication: This is the hallmark sign—cramping, aching, or fatigue in the calf, thigh, or buttock that starts during exercise and stops within minutes of rest.

2. Leg Numbness or Weakness: A feeling that your legs “give out” or feel heavy during activity.

3. Coldness in the Lower Leg or Foot: One foot may feel significantly colder than the other.

4. Sores That Won’t Heal: Ulcers or wounds on the toes, feet, or legs that heal very slowly or not at all.

5. Change in Leg Color: The skin may look pale, bluish, or reddish when hanging down.

6. Hair Loss: Noticing a “smooth” look on the legs or shins where hair has stopped growing.

7. Slower Toenail Growth: Thickened or brittle nails that grow noticeably slower than usual.

8. Shiny Skin: The skin on your legs or feet may appear tight and shiny.

9. Weak Pulse: A doctor may find a very faint or absent pulse in your feet or behind the knee.

10. Erectile Dysfunction: In men, reduced blood flow in the pelvic arteries can lead to difficulty achieving or maintaining an erection.

When to See a Doctor

You should consult a vascular specialist or your GP if you experience any persistent leg pain. Early intervention is the best way to prevent Chronic Limb-Threatening Ischaemia (CLTI).

Seek Medical Attention If:

• You have pain in your feet or toes even while resting (especially at night).

• You notice black skin or “gangrene” on your toes.

• You are a smoker or have diabetes and notice any of the “10 signs” above.

Note: PAD is a “marker” for widespread vascular disease. If you have PAD, you are at a significantly higher risk for heart attack and stroke.

How is PAD Diagnosed?

Diagnosis is usually straightforward and non-invasive:

• Ankle-Brachial Index (ABI): A quick test comparing the blood pressure in your ankle to the pressure in your arm.

• Duplex Ultrasound: Uses sound waves to visualize blood flow through the vessels.

• CT or MR Angiography: Advanced imaging to map the exact location of blockages.

Modern Treatment Options

Treatment aims to manage pain and reduce the risk of limb loss or heart complications.