As a foot doctor, one of the diseases that I see the effects of in the legs and feet is Peripheral Arterial Disease or PAD. Peripheral Arterial Disease, if not managed, improved, or reversed can lead to catastrophic consequences like chronic wounds, gangrene, and amputation. Peripheral Arterial Disease is a disease in your blood vessels, specifically the arteries outside of your heart. PAD causes thickening of the walls of your arteries, and plaque buildup which all cause poor blood flow to your legs and feet. Peripheral Arterial Disease is seen alongside many other diseases like diabetes, chronic kidney disease, high cholesterol, or with unhealthy lifestyle factors like smoking. These are the most common signs of Peripheral Arterial Disease.
9 Signs of Peripheral Arterial Disease Are:
1. Weak pulses to your legs and or feet
When you see your foot doctor or podiatrist, one of the first things we should do before starting treatment is do an exam. This exam does include a general checkup of the circulation to your feet by feeling for two pulses in your feet. If these pulses are weaker than normal, or faint, this is a sign of Peripheral Vascular Disease. As foot doctors, another way we check the circulation in your feet is through how quickly your capillaries (the tiniest of blood vessels that connect your arteries and veins) can refill with blood. If this takes longer than several seconds, this is also a sign of Peripheral Vascular Disease or PAD.
2. Hair growth on legs or toes slows down or stops
Another sign of poor blood flow is a lack of hair growth or no hair growth at all, when there was previously hair on an area. This is definitely true for your feet and legs. If you notice that over time, you are noticing less hair growing on your legs, you have to shave less than you once did, this can be a sign of Peripheral Vascular Disease
3. Skin on legs and feet looks tight or shiny
Another sign of Peripheral Vascular Disease is shiny, almost tight-looking skin on your legs and feet. The skin looks shiny because of the lack of hair growth, and the skin also becomes thinner over time due to decreased blood flow. The skin also usually looks tight as well, almost like glass.
4. Toenail growth slows down
Due to the poor blood flow that comes with Peripheral Arterial Disease, the roots of your toenails aren't getting the oxygen and nutrients they need to be healthy and grow, so their growth slows down dramatically. If you notice that over time, you don't need to trim your toenails as often as you once did, or they just don't look like they are growing at all, this can be a sign of Peripheral Vascular Disease.
5. Cuts, wounds to feet or legs take much longer to heal
If you're noticing that any break in the skin takes much longer to heal than these injuries once did, this can be a sign of Peripheral Arterial Disease. If you're feet and legs aren't getting enough oxygen and nutrients to be healthy, it becomes a lot harder to heal from skin injuries, even the simplest ones like scrapes, blisters, or small cuts.
6. Skin on legs and feet is easier to get injured
If you notice that over time, the tiniest bump, or friction will cause a wound on your legs and feet, this can also be a sign of Peripheral Vascular Disease. Due to the lack of blood flow, the skin on your legs and feet becomes thinner and is more prone to injury.
7. Pain in legs, feet, or butt after walking a specific distance
Pain in the legs feet, or even the buttocks after walking or doing an activity after a specific amount of time is called intermittent claudication, and seen in those with Peripheral Vascular Disease. Intermittent claudication happens with PAD because more oxygen and blood flow is required to your legs when you are active. Because of the PAD, your legs and feet are unable to get the nutrients they need, and they then become starved of oxygen, which results in pain.
Intermittent claudication doesn't have to be seen in high-energy activities, it can be seen in small activities like walking outside to your mailbox and walking to the kitchen, or bedroom. Intermittent claudication is a sign that Peripheral Vascular Disease is advancing,
8. Pain in legs, feet, or butt, without any activity
Rest pain is the next stage of the progression of Peripheral Vascular Disease. As discussed above, the pain from intermittent claudication happens because certain activities require more blood flow and oxygen to the legs and feet than they can get due to the PAD, the result of this being low oxygen levels, known as hypoxia, and pain. In rest pain, even when you are in a recliner, lying down on a couch, or sleeping in bed, the leg pain and cramps are there. A telltale sign of rest pain is that it improves once the leg is danging down, forcing more blood into the leg and foot, than what it was getting being more elevated. This is a sign of advanced Peripheral Arterial Disease known as CLI or Critical Limb Ischemia and is not to be ignored.
End stage Peripheral Arterial Disease is unfortunately gangrene. Sometimes gangrene can begin through a wound or ulcer on the skin, but for many people with PAD, this is not required. The circulation to the toes and feet is so pad at this point, that these parts will just start to die off by turning black. Management and treatment for gangrene include hospitalization, IV antibiotics, and amputation. Gangrene is not reversible. At this stage of PAD, the end goal is to save as much of the patient's foot or leg as possible and to save their life as well. Unfortunately, the person's Peripheral Arterial Disease is so severe, that an entire foot or leg has to be amputated.
These are the most common signs of Peripheral Vascular Disease or PAD. If you notice any of the signs, especially several of them, please make an appointment with your local foot doctor or podiatrist. We can examine you, send you out for more testing to confirm the diagnosis of Peripheral Arterial Disease, and get you in front of other specialists all to prevent chronic ulcers, and eventually gangrene.
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Are you in the Phoenix area and in need of a podiatrist? My name is Dr. Tarr, I am a board-certified foot doctor, and also the owner of Direct Podiatry Arizona in Tempe, AZ. To view my available appointment times, click here.