By Dr. V.S.N. Anil
Many people experience calf or thigh pain while walking and assume it is due to ageing, arthritis or lack of exercise. However, pain that starts after walking a certain distance and improves after a few minutes of rest may be a warning sign of Peripheral Artery Disease (PAD).
PAD occurs when arteries carrying blood to the legs become narrowed or blocked, most commonly because of atherosclerosis—the gradual buildup of fatty deposits or plaque inside the arterial walls. As arteries narrow, leg muscles may not receive enough blood and oxygen during activity, causing pain and discomfort.
A Warning Sign That Is Often Ignored
One typical symptom of PAD is intermittent claudication. A person may walk normally for a certain distance before developing calf pain or cramping, heaviness or tiredness. The discomfort improves with rest but returns when walking.
Because the pain disappears with rest, many people ignore it and gradually reduce their walking. PAD should not be dismissed as a normal part of ageing.
Who Is at Risk?
PAD becomes more common with increasing age, but several factors increase the risk. These include:
- Diabetes
- Cigarette or tobacco use
- High blood pressure
- High cholesterol
- Kidney disease
- Obesity
- History of heart disease or stroke
Diabetes and tobacco use are particularly important risk factors. Long-standing diabetes may also reduce sensation in the feet, allowing wounds or injuries to go unnoticed.
PAD is not only a disease of the legs. Since atherosclerosis can affect arteries throughout the body, PAD can also indicate an increased risk of heart attack and stroke.
Symptoms You Should Not Ignore
Reduced circulation to the legs can cause:
- A foot that feels unusually cold
- Changes in skin colour
- Reduced hair growth over the legs
- Wounds or ulcers on the toes or feet that heal slowly
- Pain in the foot even while resting
A non-healing wound or blackening of a toe should never be ignored, particularly in a person with diabetes.
In severe cases, blood supply can become so poor that foot tissues are threatened. This condition, known as Chronic Limb-Threatening Ischemia (CLTI), requires prompt specialist assessment to help prevent tissue loss and reduce the risk of amputation.
Sudden severe leg pain associated with a cold, pale or numb foot, weakness, or loss of movement requires immediate medical attention.
How Is PAD Diagnosed?
The Ankle-Brachial Index (ABI) compares blood pressure at the ankle with blood pressure in the arm and can help identify reduced arterial circulation.
A Doppler ultrasound provides information about blood flow and the location of arterial narrowing or blockage. When an intervention is being considered, CT angiography or other vascular imaging may be required for detailed arterial mapping.
Does Every Blockage Need an Operation?
No.
Treatment depends on disease severity, symptoms and the condition of the limb.
For many patients with mild or moderate PAD, treatment focuses on controlling the factors responsible for atherosclerosis. Stopping tobacco use is one of the most important steps. Good control of diabetes, blood pressure and cholesterol is equally important.
Appropriate medications and a structured walking programme can improve symptoms and reduce cardiovascular risk.
Modern Treatment Can Restore Blood Flow
Patients with severe lifestyle-limiting symptoms, persistent rest pain, non-healing wounds or threatened limbs may require restoration of blood flow.
During angioplasty, a thin catheter is passed through the blood vessels to the narrowed or blocked artery. A balloon is used to open the artery, and in selected situations, a stent or another device may be required to maintain blood flow.
For longer or more complex arterial blockages, bypass surgery may provide a new route for blood to reach the leg and foot.
Treatment is individualized. The goal is to improve walking and quality of life, heal wounds, protect the limb and reduce future cardiovascular complications.
Preventing Amputation Starts Early
Many amputations do not begin with a dramatic event. They may start with a small blister, minor injury or ulcer in a person with diabetes or poor circulation.
Regular inspection of the feet is particularly important for people with diabetes and PAD. Cuts, blisters, colour changes and wounds should be noticed early.
Walking barefoot should be avoided, and footwear should fit properly. Most importantly, a wound that is not healing should prompt an assessment of the blood supply to the foot rather than repeated dressing alone.
Modern vascular care combines restoration of circulation with wound care, infection control, diabetes management and appropriate foot care. Early recognition offers the best opportunity for limb preservation.
Listen to What Your Legs Are Telling You
Pain while walking is not always due to blocked arteries. Conditions involving the joints, muscles, nerves or spine can produce similar symptoms.
However, recurring walking-induced leg pain deserves proper evaluation—especially in people with diabetes, tobacco exposure or other cardiovascular risk factors.
Do not assume that leg pain, a non-healing foot wound or changes in the toes are merely consequences of ageing or diabetes.
Peripheral Artery Disease can often be identified with simple tests. When detected early, lifestyle changes, medicines and modern vascular treatments can improve symptoms, protect the limb and reduce the risk of serious cardiovascular complications.
Early recognition can make the difference between living with progressive disease and preserving mobility, independence and quality of life.
For More Details
Dr. V.S.N. Anil
M.B.B.S., DNB (General Surgery), DrNB (Vascular Surgery)
Consultant Vascular & Endovascular Surgeon
Sri Sri Holistic Hospitals, Hyderabad
