Lower body pain (legs, hips, lower back), characteristic of peripheral arterial disease, can be mistaken for diseases like arthritis. Watch out for weakness in legs, intermittent claudication (cramps after walking or climbing stairs), slow-healing sores on your toes or feet, nocturnal leg pain, temperature differences in feet, poor growth of nails and leg hair, and weak pulse in legs.
A nagging pain in the leg, lower backaches, pins and needles sensations in the lower body ‒ symptoms such as these and we usually blame it on the back, that hearty walk around the block, or even aging. But, sometimes, these are warning signs of a dangerous condition waiting to rear its head. Often silent and potentially deadly, peripheral arterial disease (PAD) is a condition in which arteries carrying blood to your legs, stomach, arms, and head (peripheries) are narrowed or blocked by a buildup of fatty deposits (atherosclerosis). As a result, blood flow to these regions, especially your leg, is reduced. PAD, also known as peripheral vascular disease, can affect men and women equally. But men are more likely than women to get severe or symptomatic PAD.1
The prevalence and incidence of PAD are age-related, rising over 10% among patients in their 60s and 70s. Almost 20% of adults older than 70 years may have PAD.2
Symptoms Of Peripheral Artery Disease
Although often preventable, PAD is called a silent and deadly disease because many people have no symptoms at all. To boot, symptoms of PAD mimic those of other diseases, leading to misinterpretations. According to research studies, PAD is commonly underdiagnosed, undertreated, and even poorly understood. Doctors often do not recognize the symptoms or connect the dots. Study results indicate that underdiagnosis of PAD in primary care practice may be a reason for ineffective secondary prevention of cardiovascular risk associated with PAD.3
The symptoms of PAD can be mistaken for symptoms of other medical conditions ‒ for instance, hip pain, a symptom of PAD, is commonly mistaken as being indicative of arthritis. Many people also assume that recurring episodes of leg pain are a sign of aging. Such episodes should actually be given immediate attention.
Here are some symptoms of PAD that should set off your alarm bells.4
- Fatigue, heaviness, tiredness, or painful cramping in your hip, thigh, or calf muscles that occurs after certain activities, such as walking or climbing stairs. This symptom is called intermittent claudication. This pain or discomfort goes away once the activity is stopped and during rest.
- Numbness or weakness of the legs.
- Coldness in your lower leg or foot, especially when compared with the other side.
- Sores or wounds on toes, feet, or legs that are just not healing.
- No pulse or a weak pulse in your legs or feet.
- Color changes in the skin of the feet, such as pale or bluish skin tone of the feet
- A lower temperature in one leg compared to the other leg.
- Poor nail growth and decreased hair growth on toes and legs.
- Pain in the legs or feet that wakes you up at night. Sometimes, as the disease progresses, the blood flow to the legs is not sufficient enough to supply nutrients and oxygen. In such cases, you’ll feel pain in the feet even when you are not moving.
What Are The Implications Of Undetected PAD?
PAD is a significant public health problem and affects millions of people ‒ in the United States alone, 8‒12 million people, especially over the age of 50, have PAD [Facts About Peripheral Arterial Disease (P.A.D.), US Department of Health and Human Services].
As the majority of cases of PAD go undetected in routine clinical practice, it may lead to impaired quality of life. Intermittent claudication significantly reduces the mobility of the patient. Recurrent episodes of nonhealing ulcers and ischemic rest pain, which is a continuous burning pain of the lower leg or feet, can be troublesome and restrictive.
PAD is associated with life-threatening vascular diseases. Clogged or narrowed arteries in the leg is a red flag that other arteries, including those in the heart and brain, may also be blocked. Having PAD greatly increases your risk of heart attack, stroke, amputation, and death. Early detection of PAD is crucial for timely treatment and prevention of these.5
Additional research is needed to gain a better understanding of the atypical symptoms of PAD. Also, the role of age, gender, race, and co-morbid conditions (medical conditions that occur simultaneously) on the symptom experience of patients with PAD need to be further evaluated.
The United States Preventive Services Task Force does not recommend PAD screening in apparently healthy people. But if you are experiencing nagging leg pain or have heart disease, carotid artery disease, or kidney disease, or if a sibling or parent has PAD, get evaluated.6
Various other factors increase the risk of developing PAD. Knowing these risk factors7 may enable you to recognize PAD and consult with an interventional radiologist to be assessed for vascular disease. You should get tested for PAD if you
- are over age 50
- have high cholesterol
- have an inactive lifestyle
- have diabetes, especially for more than ten years
- have ever smoked or smoke now
- have high blood pressure or a personal history of heart disease or other vascular diseases
- feel cramping or tiredness in the muscle while walking or exercising, but which is relieved by resting
- have leg pain that tends to wake you up at night.
References [ + ]
|1.||↑||Criqui, Michael H., and Victor Aboyans. “Epidemiology of peripheral artery disease.” Circulation research 116, no. 9 (2015): 1509-1526.|
|2, 3.||↑||Olin, Jeffrey W., and Brett A. Sealove. “Peripheral artery disease: current insight into the disease and its diagnosis and management.” In Mayo Clinic Proceedings, vol. 85, no. 7, pp. 678-692. Elsevier, 2010.|
|4.||↑||Peripheral artery disease (PAD), Mayo Clinic|
|5.||↑||Caro, Jaime, Kristen Migliaccio-Walle, Khajak J. Ishak, and Irina Proskorovsky. “The morbidity and mortality following a diagnosis of peripheral arterial disease: long-term follow-up of a large database.” BMC Cardiovascular Disorders 5, no. 1 (2005): 14.|
|6.||↑||Peripheral artery disease: often silent, sometimes deadly, potentially preventable, Harvard Health Publications- Harvard Medical School|
|7.||↑||What Most Women Don’t Know About P.A.D., NIH Mediline Plus|