Dr. Stuart A. McIntosh, podiatrist, of The Foot and Ankle Clinic tends the feet of Clarence D. Burgess. *Photo by B. Candace Ray
Dr. Stuart A. McIntosh, podiatrist, of The Foot and Ankle Clinic tends the feet of Clarence D. Burgess. *Photo by B. Candace Ray
Peripheral arterial disease (PAD) happens when there is a narrowing of the blood vessels outside of your heart. The cause of PAD is atherosclerosis, which happens when plaque, a substance made up of fat and cholesterol, builds up on the walls of the arteries. The most commonly affected arteries are those that supply blood to the legs. The plaque causes the arteries to narrow or become blocked and can reduce or stop blood flow.

The main symptom is pain in one or both legs when you walk or exercise and is relieved when you rest for a few minutes. This pain varies between cases and you may feel aching, cramping or tiredness in your legs.

This is called intermittent claudication. When you walk, your calf muscles need an extra blood and oxygen supply.

The narrowed artery cannot deliver the extra blood and so pain occurs from the oxygen-starved muscles. The pain comes on more rapidly when you walk up a hill or stairs than when on the flat.

A person with PAD also has an increased risk of heart attack and stroke. You can often stop or reverse the build-up of plaque in the arteries with dietary changes, exercise, and efforts to lower high cholesterol levels and high blood pressure.

How is peripheral arterial disease diagnosed?

The diagnosis is usually made through a series of tests, including the ankle brachial pressure index (ABPI), the toe brachial pressure index (TBPI) and ultrasound assessments of arteries and veins.

One of these tests alone cannot determine if PAD is present therefore a comprehensive lower limb vascular assessment is required to determine the presence and extent of PAD.

The podiatrists at The Foot and Ankle Clinic recommend that comprehensive lower limb vascular assessments be carried out for any individual who experiences pain, cramping or tiredness in the legs when walking.

Vascular assessments are also recommended for anyone with diabetes, high blood pressure, high cholesterol, varicose veins, swelling in the lower leg or ankle or a history of smoking as these can all contribute to or increase your chances of PAD.

Exercise regularly

Regular exercise encourages other smaller arteries in the legs to enlarge and improve the blood supply. If you exercise regularly, there is a good chance that symptoms will improve, and the distance that you can walk before pain develops will increase.

Walking is the best exercise if you have PAD, and regular exercise means a walk every day, or on most days.

  • Walk until the pain develops, then rest for a few minutes.
  • Carry on walking when the pain has eased.
  • Keep this up for at least 30 minutes each day and preferably for an hour a day. The pain is not damaging to the muscles.

Other exercises such as cycling and swimming will also help you to become fit and are good for the heart, however, these should be done in addition to walking, as walking has been shown to be the best exercise to improve symptoms of PAD.

Take care of your feet

Good foot hygiene is important and should include drying your feet thoroughly after bathing, especially between the toes. Check for any colour change or irritation on the skin of the soles and sides of the feet as well as between the toes. Also check for any difference in temperature from one foot to the other.

The Foot & Ankle Clinic has a team of podiatrists available six days a week to provide podiatry consultation and comprehensive lower limb vascular assessments. GP referrals are not essential.

For more information, call 296-1288.