What to Know About Foot Problems with PAD

Medically Reviewed by James Beckerman, MD, FACC on February 13, 2024
3 min read

Peripheral artery disease (PAD) is a circulatory condition where the arteries narrow and reduce blood flow to the limbs. It’s usually caused by atherosclerosis, a buildup of fatty deposits in the arteries that blocks your circulation. PAD symptoms include leg pain, which can limit your ability to walk and impact your quality of life. 

If you have PAD that’s caused by atherosclerosis, you have an increased risk of having a heart attack or stroke. If left untreated, severe PAD can lead to the loss of a limb. A doctor can look for signs of foot problems with PAD during a standard physical exam. 

While some people with PAD have mild symptoms, others have foot pain or trouble walking. Some common peripheral artery disease symptoms in the feet include: 

  • Cramping in hip, thigh, or calf muscle while climbing stairs or walking
  • Leg weakness or numbness
  • Coldness in extremities such as the lower leg or foot
  • Sores that won’t heal
  • A change in color of legs
  • No pulse or weak pulse in the feet or legs

‌If you’re experiencing any of these symptoms, see your doctor.

The easiest way for your doctor to diagnose PAD in your feet -- or vascular problems that could lead to peripheral artery disease -- is with a pulse check during a physical exam. During this exam, your doctor looks at your skin and for any foot deformities such as hammertoes or bunions. People with diabetes have a higher risk of developing foot complications because of neuropathy, which causes numbness in the feet. This means that you won’t feel pain when a foot problem such as peripheral artery disease happens.

Some diagnostic tools that doctors can use to find foot problems with PAD include: ‌

  • Ankle brachial index (ABI). A doctor uses a blood pressure cuff on your arm and leg with a Doppler and ultrasound machine to hear a pulse in the foot. It’s helpful in assessing blood flow. An abnormal ABI means you may need additional testing and treatment. 
  • Pulse volume recording (PVR). This test measures blood volume changes in the legs, both before and after exercise on a treadmill. Blood pressure cuffs on arms and legs record blood pressure changes during inflation. PVR is most helpful in detecting blockages in the legs. 
  • Vascular ultrasound. A vascular ultrasound evaluates blood circulation. A handheld device is placed on the skin over an artery. Soundwaves create an image of the blood vessel, which helps detect an arterial blockage.

When you’re looking for PAD pain relief, certain lifestyle changes can help reduce PAD symptoms, including: ‌

  • Stopping smoking. Quitting smoking helps slow the development of peripheral artery disease and helps to lower blood pressure. 
  • Eating a balanced diet. A diet high in fiber and low in cholesterol, sodium, and unhealthy fats is best. Losing weight can help raise your HDL (good) cholesterol and lower your total cholesterol. 
  • Getting active. Exercise, especially walking, is great for patients who have foot problems with PAD. Those who walk regularly experience improvement in leg pain. Take intermittent breaks when you’re experiencing PAD foot pain during your workout. PAD develops over a long time period, and improvement will take some time, too.‌
  • Taking care of your health. It’s important to manage any health conditions you have, whether high blood pressure, high cholesterol, or diabetes, to feel your best. ‌

PAD may require treatment with medications such as antihypertensives, statins, and antiplatelet drugs. One antihypertensive medication prescribed to help improve walking distance, cilostazol, has been proven to help those with PAD-caused pain in the legs to exercise longer.