Symptoms of Peripheral Arterial Disease

Introduction

Peripheral Arterial Disease (PAD) is a common yet often overlooked circulatory condition that occurs when arteries supplying blood to the legs and feet become narrowed due to plaque buildup. As the arteries harden and blood flow decreases, the body begins to show warning signs some subtle, some severe. Many people dismiss these symptoms as aging or fatigue, which delays diagnosis and allows the condition to worsen over time. Recognizing the early symptoms of PAD can help you seek timely treatment, prevent complications, and maintain mobility and quality of life. 

Understanding Peripheral Arterial Disease (PAD)

PAD is primarily caused by atherosclerosis, a buildup of fatty deposits inside the artery walls. As arteries supplying blood to the lower limbs narrow, the muscles and tissues don’t get enough oxygen-rich blood. This results in pain, weakness, and discomfort that worsen with movement. Without treatment, PAD can increase the risk of infections, ulcers, heart attack, stroke, and in severe cases, amputation. More than a disease of the legs, PAD is a red flag for cardiovascular health. It indicates that your arteries everywhere may be narrowing, making early diagnosis essential.

Major Symptoms of Peripheral Arterial Disease

1. Leg Pain While Walking (Claudication) :- One of the most common and noticeable symptoms of PAD is claudication, a cramp-like pain in the legs that appears when walking or climbing stairs. This pain occurs because the leg muscles need more oxygen during movement, but narrowed arteries can’t supply enough blood.

Claudication may feel like

• Tightness in the calf
• Sharp pain in the thigh or hips
• Cramping that improves with rest
• A burning sensation

Most people ignore this discomfort thinking it’s due to aging or weakness, but when the pain consistently appears after walking a certain distance, it’s a strong indicator of PAD.

2. Numbness or Weakness in Legs :- Reduced blood flow affects nerve and muscle function. People with PAD often experience

• Persistent numbness in the feet or toes
• Weakness in the legs
• A feeling of heaviness after slight activity

This symptom may also lead to difficulty standing for long periods or climbing steps. Over time, the numbness may worsen if blood supply continues to decline.

3. Coldness in Feet or Lower Leg :- If one foot feels significantly colder than the other, it may be due to blocked arteries. This happens because the blood is not reaching the extremities efficiently, causing the temperature to drop. Cold sensations may also make it difficult to sleep or cause discomfort in colder weather. This is particularly concerning when paired with pain or color changes in the feet.

4. Weak or Absent Pulse in the Feet :- Doctors often check the pulse in the feet to assess blood flow. A weak or non-detectable pulse is a physical sign that the arteries are not supplying enough blood. Although this symptom is not always felt by the patient, it is crucial during medical examination. Low pulse strength is an alarming indicator that the narrowing of arteries may be advanced.

5. Changes in Skin Color :- Poor circulation affects the appearance of the legs and feet. PAD may cause

• Pale skin when legs are elevated
• Reddish or bluish color when legs are lowered
• Thin, shiny skin due to lack of nutrients

These changes signal that the tissue is not receiving enough oxygen, making it vulnerable to injury or infection.

6. Slow-Healing Wounds or Sores :- One of the most serious symptoms of PAD is the presence of wounds, cuts, or ulcers on the feet that heal very slowly or not at all. Without proper blood flow, the body cannot repair tissues effectively. These wounds can become infected and lead to serious complications, including gangrene. If you see a non-healing sore on your foot or leg, immediate medical attention is critical.

7. Hair Loss on Legs and Feet :- Blood carries essential nutrients needed for hair growth. When arteries are blocked, hair follicles weaken, leading to

• Hair thinning on calves
• Complete hair loss in patches
• Reduced nail growth

This is often one of the early warning signs before more painful symptoms appear and may be noticed by doctors during physical examination.

8. Shiny Skin and Brittle Toenails :- PAD restricts nutrient supply to the skin, making it thinner and shinier than usual. Toenails may also become

• Brittle
• Thickened
• Slow-growing

These subtle changes show the impact of poor circulation on the skin and nails.

9. Erectile Dysfunction (Especially in Men) :- In men, PAD can restrict blood flow to the pelvic region, leading to erectile dysfunction (ED). Although Pain at Rest (Critical Limb Ischemia) As PAD progresses, pain may begin even when the person is resting. This is a sign of critical limb ischemia, a severe stage of PAD.

Rest pain often

• Occurs at night
• Improves when legs are dangled off the bed
• Feels like burning or throbbing in the toes

This stage requires urgent medical treatment to prevent limb loss.

11. Muscle Atrophy :- Long-term lack of blood flow leads to muscle shrinkage. The legs may look thinner, weaker, or less toned than normal. This occurs because the tissues are not getting adequate oxygen and nutrients. Muscle atrophy is usually a sign of advanced PAD and reduced activity levels.

Why PAD Symptoms Must Not Be Ignored

Ignoring PAD symptoms allows the arteries to become progressively narrower, increasing the risk of life-threatening complications such as

1. Heart attack
2. Stroke
3. Severe infections
4. Tissue death (gangrene)
5. Amputation in extreme cases

Early diagnosis and lifestyle changes combined with medical treatment can prevent these complications and restore mobility.

When to See a Doctor

Seek medical help if you notice

1. Persistent leg pain or cramping
2. Non-healing foot wounds
3. Significant color or temperature changes in your legs
4. Numbness or weakness that affects daily activities

Doctors may perform tests such as Ankle-Brachial Index (ABI), ultrasound, or angiography to examine blood flow.

Conclusion

Peripheral Arterial Disease often begins silently, but the body gives several clear signals when blood flow is reduced. By understanding and recognizing these symptoms early, you can protect your heart health, prevent complications, and maintain a healthy, active life.