What are the symptoms of peripheral artery disease (PAD)?

For many people, the first sign of peripheral artery disease, or PAD, is tightness, heaviness, cramping, pain or weakness in their legs while they are walking or being active. Other people describe an aching, burning sensation in their muscles, but not in their joints. In both cases, the discomfort or pain usually disappears once they stop moving and sit down. Other symptoms are tiredness, discoloration (often bluish) of the toes or feet, numbness in the legs or feet, sores on the toes, feet or legs that will not heal, and buttock discomfort with exercise.

 

If you have these symptoms, your doctor may suspect that the blood vessels that supply blood to your legs have narrowed, possibly starving your feet and lower legs of the oxygen they need to be healthy. Your doctor will examine you, possibly run some tests and recommend a treatment plan for you.

 

In its early stages, common symptoms of poor leg circulation are cramping, fatigue, heaviness, pain, or discomfort in the legs and buttocks during activity. This usually subsides when the activity stops. It’s called “intermittent claudication.” Symptoms of poor kidney circulation include sudden high blood pressure, or blood pressure that is hard or impossible to control with medications. Severe blockage of the kidney arteries may result in loss of kidney function or failure.

Peripheral arterial disease (PAD) may cause intermittent claudication of the legs, which is associated with the following symptoms when walking or climbing stairs:

 

- Pain

- Numbness

- Achiness

- A feeling of heaviness in the legs

- Cramping

 

These symptoms often ease when resting, because the muscles of the legs do not require as much oxygenated blood as they do during movement. Other signs and symptoms of PAD include:

 

- Weak pulses in the legs or feet

- Sores or wounds on the toes, feet, or legs that don't heal well

- A pale or bluish skin color

- One leg feeling cooler than the other leg

- Poor nail growth on the toes

- Less hair growth on the affected leg(s)

- Erectile dysfunction, particularly in men who also have diabetes

Many people with diabetes and peripheral artery disease do not have any symptoms. Some people may experience mild leg pain or trouble walking and believe that it's just a sign of getting older. Others may have the following symptoms:

• Leg pain, particularly when walking or exercising, which disappears after a few minutes of rest
• Numbness, tingling, or coldness in the lower legs or feet
• Sores or infections on your feet or legs that heal slowly

Peripheral arterial disease is plaque blocking the arteries supplying blood to other areas of the body, often the legs, arms, or kidneys. If a leg artery is narrowed, it may be unable to increase blood flow to meet the requirements of the leg for oxygen and nutrients during exercise, causing leg cramping, which is relieved by rest. The narrowing of arteries supplying the kidneys can aggravate high blood pressure or impair kidney function.

The most common symptom of peripheral arterial disease (PAD) -- generally associated with blocked arteries of the leg -- is called intermittent claudication. Claudication refers to limping because of pain in the thigh, calf, and/or buttocks that occurs when walking. Just as chest pain or angina of the heart can signal a heart attack, intermittent claudication may be considered as "angina of the legs" and may indicate lack of blood flow to the legs.

Other symptoms of PAD may include, but are not limited to, the following:

• cool/cold feet to touch
• pain in the legs while lying flat and relieved by a sitting position
• loss of pulses in legs or feet
• pale color when legs are raised up
• dependent rubor (redness when legs are in a dependent [hanging down] position)
• shiny skin
• loss of hair on feet
• thickened toenail (may have fungal infections)
• nonhealing wound or ulcer
• gangrene
• loss of muscle or fatty tissue

The most severe symptom of peripheral arterial disease caused by atherosclerosis is called critical limb ischemia (lack of oxygen to the limb/leg at rest). Critical limb ischemia (CLI) is defined as pain in the leg(s) while at rest, or "rest pain." CLI is also associated with the breakdown of tissues (muscle/skin) in the form of ulcers or gangrene in the limb, which may occur because blood flow to the limb is so decreased that the basic needs of the limb for oxygen and nutrients are not being met.