When people experience leg pain or cramping while walking that improves with rest, it’s often overlooked as a side effect of aging. But it could be a sign of Peripheral Arterial Disease (PAD): the most common form of vascular disease (a condition of the blood vessels) affecting more than 200 million people in the world.
PAD is the narrowing of blood vessels in the legs. It’s caused by atherosclerosis, or the hardening of arteries, that reduces blood flow to the legs. In the most severe cases, people can feel constant foot pain and develop gangrene—open sores that don’t heal—which may lead to limb loss. People with PAD are at a higher risk for heart disease, heart attack and stroke.
The good news? Lives can be saved when PAD is recognized and treated effectively.
Who’s at risk?
PAD mostly affects people in their 60s and older. In the United States, 20% of people over age 80 have PAD. While nothing can stop the aging process, there are other risk factors for PAD that can be controlled. These include:
- Quitting smoking.
- Controlling diabetes.
- Managing high blood pressure and high cholesterol.
PAD was originally thought to be more common in men, but that’s not the case. Women often experience symptoms that aren’t typical for PAD. They’re also less likely to be screened and treated for it.
While leg cramping when walking is the most recognized sign of PAD, more than half of people with PAD have no symptoms. Identifying PAD begins with a patient history to review risk factors and symptoms and a physical exam looking for pulses in the feet. The diagnosis can be confirmed with a non-invasive (no entry into the body) test called ABI (ankle-brachial index), which measures blood pressure in the ankles.
Treatment and management
Once diagnosed, most people with PAD are treated with medication—usually baby aspirin and statins (medicine that lowers cholesterol). This also helps lower the risk of heart attack and stroke. Providers also work with patients to manage other risk factors, including diabetes.
Some patients require an angiogram, which is a minor endovascular procedure where stents are delivered through a small puncture, or hole, in the artery. Bypass surgery of the artery is saved for the most serious cases—those patients whose lifestyles are severely limited because of PAD, and those with gangrene. These patients have often lost mobility, and independence, and their limbs may be threatened.
Let your doctor know if you are having leg pain, especially while walking. Your provider can check the pulses in your feet and request other PAD screenings, if needed.
Find more information about PAD on the Society for Vascular Surgery website.