Peripheral Arterial Disease
Peripheral artery disease, or peripheral arterial disease is a circulatory problem that is a cause of leg pain due to narrowed arteries that reduce the blood flow to your limbs. If you develop peripheral artery disease, your extremities are not able to receive enough blood flow, which then causes leg pain when walking, otherwise known as intermittent claudication. The condition of peripheral artery disease also is likely to be a sign of fatty deposits in your arteries. This condition can reduce blood flow not only to your legs, but also to your heart and brain. In many cases, peripheral artery disease can be treated successfully through quitting smoking, exercising regularly, and eating healthy foods. Additionally, early diagnosis and early treatment can help keep peripheral artery disease from getting worse, and it can assist you in reducing your chance of having heart disease or suffering from a stroke.
Many people who have peripheral artery disease have very mild or no symptoms at all, but about 10% of people with the condition experience leg pain when walking. This muscle pain or cramping in your legs or arms is often triggered by activity, such as walking. It usually disappears once you have had a few minutes of rest. Pain in the calf is the most common location, but the location is determined by the location of the clogged or narrowed artery. The severity of this condition is also varied, from very mild discomfort to severe pain that makes it difficult for you to walk or participate in other types of physical activity.
Symptoms of Peripheral Arterial Disease
- Numbness or weakness in the legs
- Painful cramping felt in your hip, thigh, or calf muscles when climbing stairs or walking
- Sores present on your toes, feet, or legs that will not heal
- Coldness in your lower leg or foot, which may not be present in the opposite foot or leg
- Hair loss on your feet and legs
- The color of your legs has changed
- Toenails appear different
As this condition progresses, the pain you feel may not only occur during exercise or walking, but also when you are resting or lying down. This pain may be strong enough that it disrupts your sleep. You may find that walking around your room or hanging your legs over the edge of your bed may relieve the pain temporarily.
Causes of Peripheral Arterial Disease
Typically the cause of peripheral artery disease is atherosclerosis, in which fatty deposits or plaques build up in your artery walls, resulting in a reduced blood flow. This disease affects arteries throughout your body. When it occurs in the arteries that supply the blood to your limbs, the result is peripheral artery disease. Another less common cause of Peripheral Arterial Disease may be blood clots in your arteries, injury to your limbs, atypical anatomy of your muscles or ligaments, or even infection. All in all, the most common cause of peripheral arterial disease is atherosclerosis.
There are certain factors that put you at an increased risk of developing peripheral arterial disease. Smoking and obesity are two factors that are under your control and that negatively impact your chances of developing peripheral arterial disease. Other factors include diabetes, high blood pressure, high cholesterol, increasing age (particularly after age 50), a family history of peripheral artery disease, heart disease, or stroke, excessive levels of homocysteine (a protein component that builds and maintains tissue), and excessive levels of C-reactive protein. Additionally it is important to note that people who smoke or have diabetes have the greatest risk of developing complications from peripheral artery disease. Those complications may include tissue death in a leg as a result of decreased blood flow, also known as gangrene.
If you are experiencing leg pain, numbness, or other symptoms that are parallel to the symptoms of peripheral artery disease, you should call your doctor. It is important that you receive early diagnosis and treatment of this condition in order to keep your arms and legs healthy, but also to decrease your personal risk of developing heart disease, stroke, and other health problems. When you do see your doctor, there are several tests that your doctor may perform. First, your doctor will likely perform a physical exam. Your doctor will be looking for a weak or absent pulse below a narrowed area of your artery, whooshing sounds over your arteries, a poor wound healing in an area with restricted blood flow, and decreased blood pressure in an affected limb. An ankle-brachial index is a common test that is used by doctors to diagnose PAD. This test compares the blood pressure from your ankle with the blood pressure in your arm. The doctor will use a regular blood pressure cuff and a special ultrasound device in order to evaluate your blood pressure and flow. A third test may involve ultrasound. Using ultrasound imaging techniques, your doctor will be able to evaluate your blood flow through your blood vessels and identify if you have any blocked or narrowed arteries. A fourth test is an angiography. With this test, your doctor can inject a dye which is a contrast material into your blood vessels. This test will allow your doctor to view your blood flow through your arteries. Then your doctor will be able to trace the flow of the contrast material using imaging techniques that may include X-ray imaging or magnetic resonance angiography or computerized tomography angiography. Another type is catheter angiography, and while this type is more invasive, it will allow for diagnosis and treatment at the same time. Finally, your doctor may perform a blood test that will measure your cholesterol as well as check your levels of C-reactive protein and homocysteine.
If undiagnosed and untreated, peripheral artery disease can lead to complications. Open sores that do not heal can lead to infectio
n of your feet and legs. Tissue death, or gangrene can result in amputation of the affected limb in serious cases. Some of the most serious complications of peripheral arterial disease are stroke and heart attack. Atherosclerosis, though most commonly found in your legs, can also cause fat deposits to build up in your arteries that supply your heart and brain. The end result is that you have a greater risk of coronary artery disease and stroke. As you can see, it is important that you see your doctor if you suspect that you may have this condition so that you can receive treatment before the condition worsens.
Once you have been diagnose with peripheral arterial disease, there are two treatment goals. First, you want to manage your pain symptoms so that you can be pain free when participating in physical activities or even just walking. 
Secondly, you want to stop the progression of atherosclerosis in your body in order to reduce your risk of having a heart attack or a stroke. Often these goals can be accomplished through lifestyle changes. If you smoke, quitting can benefit your health tremendously. Smoking contributes to constriction and can damage your arteries. It is a serious risk factor for developing peripheral artery disease and also contributes to making the disease worse if you already have it. Taking proper care of your feet is also important. You should wash your feet every day and moisturize them well to prevent cracks from forming, which may lead to infection. You should also wear dry socks and well-fitting shoes. Be careful when trimming your nails and always avoid walking barefoot. If you have peripheral artery disease, you are at risk of poor healing of sores on your feet and lower legs. Additionally, poor circulation of blood can lead to postponed or improper healing of a sore and a risk of infection.
Sometimes, however, lifestyle changes are not enough to treat peripheral artery disease, and as a result, you will need medical treatment. Your doctor may need to prescribe blood pressure medicine, medicine to reduce cholesterol, medicine to prevent blood clots, or even medicine to control your pain.
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