Peripheral Vascular Disease
Learning About Peripheral Arterial Disease of the Legs
What is peripheral arterial disease?
Peripheral arterial disease (PAD) is narrowing or blockage of arteries in your arms and legs.
The most common cause of PAD is the buildup of plaque on the inside of arteries. Plaque is made of extra cholesterol, calcium, and other material in your blood. Over time, plaque builds up along the inner walls of the arteries, including those that supply blood to your legs. This buildup leads to poor blood flow.
This information focuses on peripheral arterial disease of the legs, the area where it is most common.
When you have PAD of the legs and you walk or exercise, your leg muscles do not get enough blood, and you can get painful cramps. The cramps are called intermittent claudication.
Peripheral arterial disease is also called peripheral vascular disease.
What are the symptoms?
Many people who have PAD do not have any symptoms. But if you have symptoms, you may have a tight, aching, or squeezing pain in the calf, thigh, or buttock. This pain usually happens after you have walked a certain distance. The pain goes away if you stop walking.
As PAD gets worse, you may have pain in your foot or toe when you are not walking. You also may have symptoms that you can see, such as:
- Feet and toes that become pale from exercise or when elevated.
- Loss of hair on the feet and toes.
- Feet that turn red when dangled.
- Blue or purple marks on the legs, feet, or toes.
- Sores on the feet or toes.
- Discolored or black skin on the legs or feet. This is a sign of gangrene (death of tissue).
How can you prevent PAD?
- Quit smoking. Quitting smoking is one of the best things you can do to help prevent PAD. If you need help quitting, talk to your doctor about stop-smoking programs and medicines. These can increase your chances of quitting for good.
- Stay at a healthy weight.
- If you have diabetes, control your blood sugar levels.
- Keep your cholesterol and high blood pressure at healthy levels. Eating a heart-healthy diet and being active can help you do this. If you have high cholesterol or blood pressure, you also may need to take medicines.
- Be physically active. Get at least 30 minutes of exercise on most days of the week. Walking is a good choice. You also may want to do other activities, such as running, swimming, cycling, or playing tennis or team sports.
- Eat a variety of heart-healthy foods.
- Eat fruits, vegetables, whole grains (like oatmeal), dried beans and peas, nuts and seeds, soy products (like tofu), and fat-free or low-fat dairy products.
- Replace butter, margarine, and hydrogenated or partially hydrogenated oils with olive and canola oils. (Canola oil margarine without trans fat is fine.)
- Replace red meat with fish, poultry, and soy protein (like tofu).
- Limit processed and packaged foods like chips, crackers, and cookies.
How is PAD treated?
Your doctor may suggest:
- Quitting smoking. It's one of the most important things you can do. If you need help quitting, talk to your doctor about stop-smoking programs and medicines. These can increase your chances of quitting for good.
- Lifestyle changes, such as eating heart-healthy foods.
- Regular exercise. Your doctor may suggest a program that includes walking and weight training exercises. You might try a supervised program or try it at home. Your goal is to be able to walk farther without pain.
- Medicine. This may help blood flow, which helps your leg pain. You may also need to take medicine to help manage other problems, such as high cholesterol and diabetes.
- Procedures, such as opening blocked arteries (angioplasty) or using healthy blood vessels to create detours around narrowed or blocked arteries (bypass surgery).
Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.
Peripheral Arterial Disease of the Leg: After Your Visit
Your Care Instructions
Peripheral arterial disease (PAD) occurs when the blood vessels (arteries) that supply blood to the legs, belly, pelvis, arms, or neck get too narrow. This reduces blood flow to that area. The legs are affected most often. Fatty buildup (plaque) in the arteries usually is the cause of PAD. This buildup is also called "hardening" of the arteries. Your risk of PAD increases if you smoke or have high cholesterol, high blood pressure, diabetes, or a family history of PAD.
One of the main symptoms of PAD is intermittent claudication. This is a tight, aching, or squeezing pain in the calf, foot, thigh, or buttock that occurs during exercise. The pain usually gets worse during exercise and goes away when you rest. But as PAD gets worse, you may feel pain even at rest.
Medicines and lifestyle changes may help your symptoms. But in some cases, surgery or other treatment is needed. It is important that you follow up with your doctor.
Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It’s also a good idea to know your test results and keep a list of the medicines you take.
How can you care for yourself at home?
- Do not smoke. Smoking can make PAD worse. If you need help quitting, talk to your doctor about stop-smoking programs and medicines. These can increase your chances of quitting for good.
- Take your medicines exactly as prescribed. Call your doctor if you think you are having a problem with your medicine.
- Talk to your doctor about how a heart-healthy diet and exercise can help you.
- Take good care of your feet.
- Treat cuts and scrapes on your legs right away. Poor blood flow prevents (or slows) quick healing of even small cuts or scrapes. This is even more important if you have diabetes.
- Avoid shoes that are too tight or that rub your feet. Shoes should be comfortable and fit well.
- Avoid socks or stockings that are tight enough to leave elastic-band marks on your legs. Tight socks can make circulation problems worse.
- Keep your feet clean and moisturized to prevent drying and cracking. Place cotton or lamb's wool between your toes to prevent rubbing and to absorb moisture.
- If you have a sore on your leg or foot, keep it dry and cover it with a nonstick bandage until you see your doctor.
When should you call for help?
Call 911 anytime you think you may need emergency care. For example, call if:
- You have symptoms of a heart attack. These may include:
- Chest pain or pressure, or a strange feeling in the chest.
- Shortness of breath.
- Nausea or vomiting.
- Pain, pressure, or a strange feeling in the back, neck, jaw, or upper belly or in one or both shoulders or arms.
- Lightheadedness or sudden weakness.
- A fast or irregular heartbeat.
After you call 911, the operator may tell you to chew 1 adult-strength or 2 to 4 low-dose aspirin. Wait for an ambulance. Do not try to drive yourself.
- You have sudden, severe leg pain, and your leg is cool and pale.
- You have signs of a stroke. These may include:
- Sudden numbness, paralysis, or weakness in your face, arm, or leg, especially on only one side of your body.
- New problems with walking or balance.
- Sudden vision changes.
- Drooling or slurred speech.
- New problems speaking or understanding simple statements, or feeling confused.
- A sudden, severe headache that is different from past headaches.
Call your doctor now or seek immediate medical care if:
- You have leg pain that does not go away even if you rest.
- Your leg pain changes or gets worse. For example, if you have more pain with normal activity or the same pain with decreased activity, you should call.
- You have an open sore on your leg or foot that is infected. Signs of infection include:
- Increased pain, swelling, warmth, or redness.
- Red streaks leading from the sore.
- Pus draining from the sore.
- A fever.
Watch closely for changes in your health, and be sure to contact your doctor if you have any problems.