Leg Pain and Peripheral Artery Disease

Peripheral arterial disease (PAD) is a common circulatory problem in which fatty deposits build up on the inner linings of artery walls. The buildup reduces blood flow to the limbs.

PAD often causes leg pain when walking or exercising. However, many patients do not experience symptoms. People with PAD also may have fatty buildup in the arteries of the heart and brain. Therefore, they are at greater risk for suffering a heart attack or stroke.

Did you know?

  • PAD affects about 12-20 percent of Americans 60 years and older.
  • People with PAD are more likely to die of a heart attack or stroke than those without PAD.
  • PAD is more common in men than in women.
  • Treatment significantly improves circulation in the large majority of patients.


PAD is the partial or complete blockage of blood flow through the arteries in your limbs, usually your legs. It occurs when plaque (a substance made of cholesterol, calcium and fibrous tissue) builds up in your body's blood vessels. This buildup is called atherosclerosis, or "hardening of the arteries." When arteries become blocked or narrowed, blood can't flow properly. As a result, the muscles of your legs don't receive enough oxygen. This can cause discomfort or pain in your legs while walking, called claudication.

PAD can also be a sign that you have blocked blood vessels in other parts of your body. If you have PAD, you have a higher risk of having a heart attack or stroke. Left untreated, PAD can lead to serious issues, including amputation and disability.

Warning signs of PAD

  • Leg pain or cramping (claudication) with walking or exercise that stops with rest and returns with activity.
  • Pain in the ball of the foot or toes.
  • Nighttime foot pain that improves when hanging your foot over the side of the bed.
  • Ulcers or sores on the foot, ankle or toes that will not heal.
  • Blue or black discoloration of the toes.

Risk factors for PAD

  • Smoking
  • Diabetes
  • High blood pressure
  • High cholesterol
  • Coronary artery disease
  • Family history of serious vascular problems
  • Limb ischemia

A more serious type of PAD is called critical limb ischemia (CLI). CLI is an even more severe blockage in the arteries in your legs. CLI can cause severe pain in legs, feet or toes even when you're at rest and may result in developing sores or wounds that do not heal.

Diagnostic testing

  • Blood pressure measurements in the arm and leg (ABI).
  • Doppler exams (sound wave test).
  • Arteriogram (injection of dye in blood vessels in the legs).
  • Other imaging tests (CT or MR scan).


Revascularization, or reopening the blocked vein or artery, is the primary goal of treating PAD and limb ischemia. Because the majority of cases are in the lower legs, our physicians specialize in a variety of techniques for lower extremity revascularization to restore blood flow to the legs and feet.