Diabetics know to have their feet checked every time they see their doctor, but everyone else should do that, as well. Feet should be checked for any discoloration or unusual nail growth, and the doctor should also take a pulse — yes, a pulse! — in the foot.
Taking a pulse in the foot uncovers signs of peripheral artery disease (PAD), a narrowing of the arteries to the limbs. While most people have heard of coronary artery disease (CAD), which is caused by a narrowing of the major blood vessels to the heart, they may not have heard of PAD. But, the two go hand-in-hand. If someone has CAD, they probably have PAD, and vice versa. If your blood vessels are narrowed in one part of the body, they’re probably narrowed in other parts as well.
Approximately half of people with PAD have no symptoms, especially at the early stages. Or, to be more precise, they are unaware that they have symptoms. They may have leg pain while walking, but write it off as a normal feature of aging. However, if it is not normal aging, but undetected PAD, it puts the person at greater risk of cardiac events like a heart attack or a stroke.
Symptoms
Not everyone with PAD has symptoms, but, if they do, the following symptoms are the most common:
- Cramping, fatigue, or sense of heaviness in the lower body during exertion. This usually occurs in the calves, but may also be felt in one or both hips or thighs. The feeling may or may not go away after a few minutes of rest. This is called claudication, and is the most common symptom of PAD.
- A sensation of numbness or weakness in one or both legs
- Decreased temperature of one lower leg or foot, as compared to the other leg or foot or the rest of the body
- Any change in the color of the legs, feet, or toes
- Shiny leg skin
- Unusually slow toenail growth
- Decreased hair growth on legs, feet, or toes
- Dead tissue (gangrene)
- Non-healing or slow-healing sores or wounds on the leg, foot, or toe
Risk Factors
If the symptoms listed above make you think of diabetes, you’re onto something. One of the greatest risk factors for PAD is diabetes, and more than 25% of diabetics have PAD. The other major risk factor for PAD is smoking.
Other risk factors for PAD include:
- Being over 65 years old
- Being over 50 years old, with:
a family history of PAD,
a history of diabetes or smoking,
high cholesterol,
high blood pressure, or
obesity - Being under 50 years old, with diabetes and any of the risk factors listed above
- A diagnosis of atherosclerosis, at any age
Complications
Complications from PAD put a person at risk of
- Critical limb ischemia, in which decreased blood flow to the legs causes chronic sores or infections. Left untreated, these can lead to gangrene, and may require amputation of the affected part of the leg
- Heart attack or If the blood vessels in your legs are narrowed, the blood vessels to your heart and brain are probably narrowed as well.
Treatment
- Most people with PAD can be treated with therapeutic life changes (TLC), such as a structured exercise program. They may also be put on a statin and aspirin.
- If someone is diabetic, it is imperative that they keep their blood sugar under control in order to prevent PAD from progressing.
- Patients with advanced PAD may require a stent. Even if they undergo this procedure, they will need to institute TLC in order to prevent further progression of the disease.
PAD is a serious condition, but with appropriate lifestyle changes, it can be stopped in its tracks.
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