PAD Symptoms and Risks

Peripheral artery disease (PAD) happens when narrowed or blocked arteries reduce blood flow, most often to the legs and feet. Some people with PAD have no symptoms, especially at first. Others may notice leg pain, cramping, weakness or changes in their skin, feet or toes. 

Knowing the symptoms and risk factors for PAD can help you get care earlier. Early diagnosis and treatment can help improve blood flow, protect your mobility and lower your risk of serious complications. 

What are the symptoms of PAD? 

PAD symptoms can be easy to miss. Some people think leg pain, tiredness or slower walking is just part of aging. But leg symptoms that happen with activity and improve with rest may be a sign of reduced blood flow. 

Common PAD symptoms include: 

• Leg pain, cramping, aching, heaviness or fatigue during activity: This is called claudication. It often happens while walking, climbing stairs or exercising and usually improves after a few minutes of rest. 
• Pain in the calf, thigh, hip or buttock: PAD pain often affects the calf but can happen in other parts of the leg. 
• Numbness or weakness in the legs or feet 
• One foot or leg that feels colder than the other 
• Cold, numb or tingling toes 
• Wounds or sores on the feet, toes or legs that heal slowly or do not heal 
• Shiny skin or hair loss on the legs or feet 
• Slow-growing toenails 
• Skin color changes in the legs or feet 
• Erectile dysfunction in men 

Your health care provider may also notice a weak pulse in your legs or feet during an exam. 

Can you have PAD without symptoms? 

Yes. Many people with PAD do not have clear symptoms. Some people may also change how they walk or limit activity without realizing it, which can hide symptoms. 

This is why it is important to talk to your provider if you have risk factors for PAD, even if you do not have leg pain. People who smoke or have diabetes are at especially high risk.  

When should you seek care for PAD symptoms? 

Make an appointment with a health care provider if you have: 

• Leg pain, cramping or weakness when walking 
• Foot or toe wounds that are slow to heal 
• Numbness, coldness or color changes in one leg or foot 
• Leg symptoms that keep you from normal activities 
• PAD risk factors, such as smoking, diabetes, high blood pressure or high cholesterol 

Seek emergency care right away if you have sudden severe leg pain, a cold or pale foot, sudden numbness or weakness, loss of movement in the leg or signs of a serious infection in a wound. 

What are the risk factors for PAD? 

Certain things can raise your risk for PAD. Some risk factors can be managed with lifestyle changes and medical care. Others, such as age and family history, cannot be changed. 

Smoking or tobacco use 

Smoking is one of the strongest risk factors for PAD. Chemicals in tobacco can damage blood vessels, speed up plaque buildup and make it harder for blood to flow through the arteries. 

Diabetes 

High blood sugar can damage blood vessels over time. People with diabetes are at higher risk for PAD and may also have a higher risk of foot wounds and infections. 

High blood pressure 

High blood pressure puts extra force on artery walls. Over time, this can damage the arteries and increase the chance of plaque buildup. 

High cholesterol 

High cholesterol can lead to fatty plaque inside the arteries. This plaque can narrow the arteries and reduce blood flow to the legs and feet. 

Older age 

PAD becomes more common with age. Risk increases as people get older, especially when other risk factors such as smoking, diabetes, high blood pressure or high cholesterol are present. 

Family history of vascular disease 

You may be more likely to develop PAD if a close family member has PAD, coronary artery disease, carotid artery disease or another vascular condition. 

Excess weight or obesity 

Excess weight can raise the risk of diabetes, high blood pressure and high cholesterol, which are all linked to PAD. 

Lack of regular physical activity 

Not getting enough physical activity can increase the risk of PAD and other heart and vascular conditions. It can also make walking symptoms worse over time. 

Unhealthy diet 

A diet high in saturated fat, trans fat, sodium and added sugar may increase the risk of high cholesterol, high blood pressure, diabetes and plaque buildup in the arteries. 

Other heart or vascular diseases 

People with coronary artery disease, carotid artery disease or a history of stroke or heart attack have a higher risk of PAD. PAD is often a sign that atherosclerosis may be affecting more than one area of the body. 

Chronic kidney disease 

Chronic kidney disease is linked with a higher risk of PAD and other vascular problems.  

Race, ethnicity and health disparities 

PAD is more common in some groups, including Black adults and some Hispanic, Native American, South Asian and Southeast Asian populations. Differences in PAD risk can be affected by many factors, including rates of diabetes and high blood pressure, access to care and social drivers of health. 

Lower your risk of PAD 

You may not be able to control every PAD risk factor, but healthy changes can help protect your blood vessels. Quitting smoking, managing diabetes, controlling blood pressure and cholesterol, staying active and working with your health care provider can all help lower your risk. 

Get answers about PAD 

If you have symptoms of PAD or risk factors for poor circulation, Banner Health can help. Our vascular specialists diagnose PAD and create treatment plans to improve blood flow, manage symptoms and help prevent complications. 

Learn more about PAD diagnosis.