Peripheral arterial disease (PAD) is a narrowing or blockage of arteries that causes poor blood flow to your arms and legs. If you have PAD, when you walk or exercise your leg muscles don't get enough blood, and you can get painful cramps. 

Peripheral arterial disease is also called peripheral vascular disease. It most often occurs in your legs. 

The most common cause is the buildup of plaque on the inside of your arteries. Plaque is made of extra cholesterol, calcium and other material in your blood. Over time, it builds up along the inner walls of your arteries, including those that supply blood to your legs. High cholesterol, high blood pressure and smoking all contribute to plaque buildup. 

Every part of your body needs blood that’s rich in oxygen. But plaque buildup prevents your blood from flowing freely and starves your muscles and other tissues in your lower body. 

Symptoms and Treatment

Many people who have peripheral arterial disease don't have any symptoms. If you do have symptoms, you may have a tight, aching or squeezing pain in your calf, thigh or buttock. This pain, called intermittent claudication, usually happens after you have walked a certain distance. For example, your pain may always start after you’ve walked a block or two, or after a few minutes and then go away if you stop walking. As your condition gets worse, you may have pain in your foot or toe when you aren't walking. 

Your doctor will talk with you about your symptoms and past health and will do a physical exam. During the exam, your doctor will check your pulse at your groin, behind your knee, on the inner ankle and on the top of your foot. Your pulse shows the strength of blood flow. An absent or weak pulse in these spots is a sign of peripheral arterial disease. Your doctor may also look at the color of your foot when it’s higher than the level of your heart and after exercise. The color of your foot can be a clue to whether enough blood is getting through your arteries. 

You’ll likely have a test that compares the blood pressure in your legs with the blood pressure in your arms. This is called an ankle-brachial index. A test called an arterial Doppler ultrasound may also be done to check the blood flow in your arteries. Blood tests to check your cholesterol and blood sugar can tell whether you may have other problems related to PAD, such as high cholesterol and diabetes. 

Treatment for peripheral arterial disease relies mainly on healthy lifestyle changes and taking care to manage high blood pressure and cholesterol. You may need medicines to ease symptoms or to manage other health problems. In some cases, you may need surgery or a procedure called angioplasty. 

When you have PAD, you have a high risk of having a heart attack or stroke. Making healthy changes can help reduce this risk: 

  • If you smoke, quit. It's one of the most important things you can do. 
  • If you need help, talk to your doctor about programs and medicines that can help you stop. 
  • Eat healthy foods. 
  • Follow an exercise program. 
  • Manage your cholesterol and blood pressure if they’re high. 
  • You may need medicines to help you do this. 
  • If you have diabetes, keep your blood sugar in a target range. 
  • Lose weight if you need to, and maintain a healthy weight. 

Your doctor may suggest that you attend a cardiac rehabilitation program. In cardiac rehab, you’ll get education and support to help you develop new, healthy habits. 

If lifestyle changes don't help, your doctor may prescribe medicine that can help relieve the pain when you walk. 

In rare cases, advanced peripheral arterial disease can cause tissues in your leg or foot to die because they don't get enough oxygen as a result of poor blood flow. If this happens, part of your leg or foot must be removed (amputated). This is more common in people who also have diabetes.