Peripheral artery disease (PAD) - Symptoms and causes (2024)

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Peripheral artery disease (PAD) - Symptoms and causes (1)


Claudication is pain in the legs or arms that occurs while walking or using the arms. The pain is caused by too little blood flow to the legs or arms. Claudication is usually a symptom of peripheral artery disease, in which the arteries that supply blood to the arms or legs, usually the legs, are narrowed. The narrowing is usually due to a buildup of fatty deposits (plaques) on the artery walls.

Peripheral artery disease (also called peripheral arterial disease) is a common condition in which narrowed arteries reduce blood flow to the arms or legs.

In peripheral artery disease (PAD), the legs or arms — usually the legs — don't receive enough blood flow to keep up with demand. This may cause leg pain when walking (claudication) and other symptoms.

Peripheral artery disease is usually a sign of a buildup of fatty deposits in the arteries (atherosclerosis). Atherosclerosis causes narrowing of the arteries that can reduce blood flow in the legs and, sometimes, the arms.

Peripheral artery disease treatment includes exercising, eating a healthy diet and not smoking or using tobacco.


Many people with peripheral artery disease have mild or no symptoms. Some people have leg pain when walking (claudication).

Claudication symptoms include muscle pain or cramping in the legs or arms that begins during exercise and ends with rest. The pain is most commonly felt in the calf. The pain ranges from mild to severe. Severe leg pain may make it hard to walk or do other types of physical activity.

Other peripheral artery disease symptoms may include:

  • Coldness in the lower leg or foot, especially when compared with the other side
  • Leg numbness or weakness
  • No pulse or a weak pulse in the legs or feet
  • Painful cramping in one or both of the hips, thighs or calf muscles after certain activities, such as walking or climbing stairs
  • Shiny skin on the legs
  • Skin color changes on the legs
  • Slower growth of the toenails
  • Sores on the toes, feet or legs that won't heal
  • Pain when using the arms, such as aching and cramping when knitting, writing or doing other manual tasks
  • Erectile dysfunction
  • Hair loss or slower hair growth on the legs

If peripheral artery disease gets worse, pain may occur during rest or when lying down. The pain may interrupt sleep. Hanging the legs over the edge of the bed or walking may temporarily relieve the pain.

When to see a doctor

Call your health care provider if you have leg pain, numbness or other symptoms of peripheral artery disease.

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Development of atherosclerosis

Peripheral artery disease (PAD) - Symptoms and causes (2)

Development of atherosclerosis

If there's too much cholesterol in the blood, the cholesterol and other substances may form deposits called plaque. Plaque can cause an artery to become narrowed or blocked. If a plaque ruptures, a blood clot can form. Plaque and blood clots can reduce blood flow through an artery.

Peripheral artery disease is often caused by a buildup of fatty, cholesterol-containing deposits (plaques) on artery walls. This process is called atherosclerosis. It reduces blood flow through the arteries.

Atherosclerosis affects arteries throughout the body. When it occurs in the arteries supplying blood to the limbs, it causes peripheral artery disease.

Less common causes of peripheral artery disease include:

  • Blood vessel inflammation
  • Injury to the arms or legs
  • Changes in the muscles or ligaments
  • Radiation exposure

Risk factors

Smoking or having diabetes greatly increases the risk of developing peripheral artery disease.Other things that increase the risk of peripheral artery disease include:

  • A family history of peripheral artery disease, heart disease or stroke
  • High blood pressure
  • High cholesterol
  • High levels of an amino acid called hom*ocysteine, which increase the risk for coronary artery disease
  • Increasing age, especially after 65 (or after 50 if you have risk factors for atherosclerosis)
  • Obesity (a body mass index over 30)


Complications of peripheral artery disease caused by atherosclerosis include:

  • Critical limb ischemia. In this condition, an injury or infection causes tissue to die. Symptoms include open sores on the limbs that don't heal. Treatment may include amputation of the affected limb.
  • Stroke and heart attack. Plaque buildup in the arteries can also affect the blood vessels in the heart and brain.


The best way to prevent leg pain due to peripheral artery disease is to maintain a healthy lifestyle. That means:

  • Don't smoke.
  • Control blood sugar.
  • Eat foods that are low in saturated fat.
  • Get regular exercise — but check with your care provider about what type and how much is best for you.
  • Maintain a healthy weight.
  • Manage blood pressure and cholesterol.

By Mayo Clinic Staff

Peripheral artery disease (PAD) care at Mayo Clinic

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June 21, 2022


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  1. Peripheral arterial disease. Merck Manual Professional Version. Accessed April 11, 2022.
  2. Hayward RA, et al. Screening for lower extremity peripheral artery disease. Accessed May 24, 2022.
  3. Neschis DG, et al. Clinical features and diagnosis of lower extremity peripheral artery disease. Accessed April 11, 2022.
  4. Prevention and treatment of PAD. American Heart Association. Accessed April 11, 2022.
  5. Gerhard-Herman MD, et al. 2016 AHA/ACC guideline on the management of patients with lower extremity peripheral artery disease: A report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2016; doi:10.1161/CIR.0000000000000471.
  6. Ferri FF. Peripheral artery disease. In: Ferri's Clinical Advisor 2022. Elsevier; 2022. Accessed April 11, 2022.
  7. Mankad R (expert opinion). Mayo Clinic, Rochester, Minn. May 4, 2018.
  8. Ami TR. Allscripts EPSi. Mayo Clinic. April 13, 2022.
  9. Davies MG. Management of claudication due to peripheral artery disease. Accessed April 11, 2022.
  10. Harris L, et al. Epidemiology, risk factors, and natural history of peripheral artery disease. Accessed April 11, 2022.
  11. Bjarnason H (expert opinion). Mayo Clinic. Oct. 15, 2020.
  12. Whelton PK, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: A report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertension. 2018; doi:10.1161/HYP.0000000000000065.
  13. Hoffman R, et al. Peripheral artery disease. In: Hematology: Basic Principles and Practice. 7th ed. Elsevier; 2018. Accessed April 11, 2022.
  14. Grundy SM, et al. 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA guideline on the management of blood cholesterol: Executive summary: A report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2019; doi:10.1161/CIR.0000000000000624.
  15. Wan D, et al. Diet and nutrition in peripheral artery disease. The Canadian Journal of Cardiology. 2022; doi:10.1016/j.cjca.2022.01.021.


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Peripheral artery disease (PAD) - Symptoms and causes (2024)


Peripheral artery disease (PAD) - Symptoms and causes? ›

When you develop PAD, your extremities — usually your legs — don't receive enough blood flow to keep up with demand. This causes symptoms, most notably leg pain when walking. Peripheral artery disease is also likely to be a sign of a more widespread accumulation of fatty deposits in your arteries (atherosclerosis).

How do I stop my PAD from progressing? ›

Lifestyle changes
  1. Quit using tobacco products. ...
  2. Eat a balanced diet that's high in fiber and low in cholesterol, fat and sodium. ...
  3. Exercise. ...
  4. Manage other health conditions, such as high blood pressure, diabetes or high cholesterol.
  5. Keep your stress level low.

What is the classic symptom of PAD? ›

The most common symptom of lower-extremity peripheral artery disease, or PAD, is painful muscle cramping in the hips, thighs or calves when walking, climbing stairs or exercising. The pain of PAD often goes away when you stop exercising, although this may take a few minutes.

What are the red flags of peripheral artery disease? ›

Persistent or intermittent leg pain (claudication) or cramping when walking. Numbness or loss of sensation in the affected limb. Sores that heal slowly or fail to heal. Differences between limbs in relation to color and/or warmth.

What symptom is most common in patients with PAD? ›

Symptoms of PAD can vary, but there are a few common ones. Pain, aching, heaviness, or cramping in your legs that comes when walking or climbing stairs and goes away after rest is called intermittent claudication. It is the most common PAD symptom.

How can I fix my PAD naturally? ›

Exercise is the best way to reduce PAD symptoms naturally; exercise can also reduce the risk of developing another cardiovascular disease like heart disease, stroke, or heart attack.

Can drinking water help peripheral artery disease? ›

But drinking water--at least 8 glasses per day--can further reduce your risk. How? Staying well hydrated is a great way to lower your blood pressure. And lowering blood pressure to a healthy range reduces your risk for all forms of CVD, including PAD.

What can be mistaken for PAD disease? ›

Connective tissue disorders: The most well-recognized connective tissue disorders associated with lower extremity vascular complications that may mimic peripheral arterial disease are Ehlers-Danlos syndrome type IV (EDS IV), Marfan syndrome, and Loeys-Dietz syndrome (LDS).

What not to eat if you have peripheral artery disease? ›

Foods to avoid with PAD
  • saturated fats, found in butter, palm and coconut oils, cheese, and red meat.
  • trans fats, which are sometimes found in processed foods (they were recently banned in the United States)
  • sodium, which is typically found in convenience foods, salty snacks, and processed meats.
Feb 6, 2024

What is the best position to sleep in with peripheral artery disease? ›

However, reports suggest that sleeping on your back does assist those who suffer from PAD. So why is this? Essentially, sleeping on your back helps distribute any weight evenly, and this, in turn, reduces pressure on any affected blood vessels.

What do legs look like with peripheral artery disease? ›

Discoloration: People with PAD may notice that the skin on their legs or feet is blue or purple in color. This occurs when the skin doesn't receive enough oxygen-rich blood. Dry, itchy, or scaly skin: Without enough blood, skin cells can't renew as quickly. This can lead to skin-related symptoms.

What does the skin look like with peripheral artery disease? ›

Other symptoms of peripheral arterial disease may include: changes in the skin, including decreased skin temperature, or thin, brittle shiny skin on the legs and feet. diminished pulses in the legs and the feet. gangrene (dead tissue due to lack of blood flow)

How can I test for peripheral artery disease at home? ›

Leg-elevation test

Lie on your back on a bed and raise your legs 60 degrees, bend and extend your knees for about 30 seconds to 1 minute. The foot with poor blood flow may become pale or feel painful.

What is considered the first symptom of peripheral arterial disease? ›

Many people with peripheral artery disease have mild or no symptoms. Some people have leg pain when walking (claudication). Claudication symptoms include muscle pain or cramping in the legs or arms that begins during exercise and ends with rest. The pain is most commonly felt in the calf.

What are the symptoms of PAD at night? ›

When PAD becomes severe, you may have:
  • Impotence.
  • Pain and cramps at night.
  • Pain or tingling in the feet or toes, which can be so severe that even the weight of clothes or bed sheets is painful.
  • Pain that is worse when you elevate your legs, and improves when you dangle your legs over the side of the bed.

What is stage 1 of peripheral artery disease? ›

Stage 1: Asymptomatic PAD

This first stage would be considered catching PAD early and gives us the greatest opportunity to slow or stop the condition's progression through risk reduction factors such as improved diet and exercise, quitting smoking, and other lifestyle improvements.

Can you stop PAD getting worse? ›

There's no cure for peripheral arterial disease (PAD), but lifestyle changes and medicine can help reduce the symptoms. These treatments can also help reduce your risk of developing other types of cardiovascular disease (CVD), such as: coronary heart disease. stroke.

Can you reverse mild PAD? ›

In most cases, lifestyle changes, exercise and claudication medications are enough to slow the progression or even reverse the symptoms of PAD.

What is the best exercise for peripheral arterial disease? ›

One of the best exercises for PAD is walking. This low-impact activity elevates your heart rate and — once you get through the initial challenges — can help improve mobility over time. You'll likely have some discomfort when you start, but it will go away as you continue walking.

Do compression socks help with peripheral artery disease? ›

It's best to skip compression socks. They don't help with PAD and can actually cause more harm. If you wear them to prevent swelling or blood clots, check with your doctor to see whether they're still a good idea.


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