Recognizing the Signs of Peripheral Artery Disease (PAD) in Your Legs

Leg pain is often dismissed as a normal part of aging or increased activity, but in some cases, it may indicate a more serious condition known as peripheral artery disease (PAD). PAD occurs when narrowed arteries reduce blood flow to the limbs, primarily the legs, and can lead to severe complications if left untreated.

According to Dr. Aaron Aday, a vascular medicine specialist, PAD is significantly underdiagnosed, despite affecting an estimated 7 to 12 million people in the U.S., with many cases going unrecognized because symptoms are subtle or masked. The disease's severity ranges from mild discomfort to critical limb ischemia, which can cause ulcers, gangrene, and even necessitate amputation.

What is PAD?
PAD results from atherosclerosis, where plaques build up inside the arteries, impeding blood flow. While major risks like high blood pressure are shared with other cardiovascular diseases, smoking and diabetes stand out as the most influential risk factors specifically linked to PAD. Notably, smoking appears to have a stronger association with PAD than other forms of atherosclerosis.

Symptoms of PAD
Many individuals with PAD are asymptomatic, but classic signs include leg pain during walking or exercise that subsides with rest. This pain often presents as cramping, aching, burning, or a feeling of heaviness, typically in the thigh, calf, or buttocks, depending on where blood flow is obstructed. Progression of the disease can also cause slow-healing leg or foot wounds, skin discoloration, or slow-growing nails. In severe cases, poor blood circulation may cause ulcers, gangrene, and tissue death.

Who is at risk?
Age is a key factor, with risk increasing as one gets older. Men are also generally at higher risk than women. Studies suggest that approximately 30% of Black adults and 20% of non-Hispanic whites may develop PAD over their lifetime. Disparities in limb amputation rates exist across regions, but biological reasons for these differences are not yet fully understood.

Detection and Diagnosis
If PAD symptoms are suspected, consulting a healthcare provider is essential. The initial test is often the ankle-brachial index, comparing blood pressure in the arms and legs, which helps identify blood flow discrepancies. Further diagnostics, such as ultrasound, CT angiography, or MRI, may be necessary to locate blockages. Treatments include procedures like angioplasty, stent placement, or bypass surgery to restore blood flow. Without treatment, PAD can worsen, leading to increased pain, sedentary habits, and higher risk of heart attack or stroke.

Prevention and Lifestyle Changes
Preventive measures involve lifestyle modifications like adopting a heart-healthy diet, engaging in supervised exercise programs aimed at improving walking endurance, and managing underlying conditions like high blood pressure, diabetes, and high cholesterol through medications.

Why Awareness Matters
One significant challenge in combating PAD is a lack of awareness among both healthcare providers and patients. Many people underestimate leg pain or changes as a part of aging, delaying diagnosis and treatment. Patients should feel empowered to advocate for their health and seek thorough evaluations for unusual leg symptoms.

For more information and support on peripheral artery disease, visit the American Heart Association’s dedicated PAD resource page.

Source: medicalxpress.com/news/2025-10-leg-pain-pad.html