Peripheral Arterial Disease (PAD)
Peripheral arterial disease is a result of diminished blood flow in the arteries to the legs and feet due to some type of disease process. Blood flow is important for proper function, and diminished blood flow can cause a variety of issues. The presence of peripheral arterial disease may indicate other widespread arterial disease in the body that can affect the brain, and heart.
Symptoms:
Most people do not complain of symptoms of peripheral arterial disease during the early stages of the disease. However, as the disease worsens, symptoms such loss of hair on the feet and legs, change in toenail color, cold legs or feet might appear. The most obvious symptom is muscle pain and cramping during walking; or at late stages of peripheral arterial disease, leg pain even at rest. Some patients might develop non healing ulcerations in the lower extremities.
Risk Factors:
Risk factors for peripheral arterial disease includes;
Diagnosis:
Obtaining a comprehensive medical history and careful physical examination is vital. Evaluation of the pulses in the feet, and assessment of the skin can assist with diagnosis of peripheral arterial disease. Non invasive tests are available that can more accurately determine the diminished blood flow to the lower extremity. Ankle Brachial Index (ABI) is one such test. Other more advanced and comprehensive tests are available if required.
Treatment:
In early stages of peripheral arterial disease, lifestyle changes including smoking cessation, regular exercise, and heart healthy diet are recommended. As the disease progresses, medication might be required to improve the blood flow to the extremities, and decrease symptoms. In severe cases, surgeries might be required.
Associated Issues:
Peripheral arterial disease can cause further complications associated with existing foot deformities such as hammertoes, and bunions. These deformities can cause ulcers to form at sites of high pressure, resulting in ulceration that does not heal from lack of blood flow. There are many other associated issues due to peripheral arterial disease.
To avoid these complications, patient’s should:
Peripheral arterial disease is a result of diminished blood flow in the arteries to the legs and feet due to some type of disease process. Blood flow is important for proper function, and diminished blood flow can cause a variety of issues. The presence of peripheral arterial disease may indicate other widespread arterial disease in the body that can affect the brain, and heart.
Symptoms:
Most people do not complain of symptoms of peripheral arterial disease during the early stages of the disease. However, as the disease worsens, symptoms such loss of hair on the feet and legs, change in toenail color, cold legs or feet might appear. The most obvious symptom is muscle pain and cramping during walking; or at late stages of peripheral arterial disease, leg pain even at rest. Some patients might develop non healing ulcerations in the lower extremities.
Risk Factors:
Risk factors for peripheral arterial disease includes;
- Being over age 50
- Smoking (currently or previously)
- Diabetes
- High blood pressure
- High cholesterol
- Personal or family history of PAD, heart disease, heart attack or stroke
- Sedentary lifestyle (infrequent or no exercise)
Diagnosis:
Obtaining a comprehensive medical history and careful physical examination is vital. Evaluation of the pulses in the feet, and assessment of the skin can assist with diagnosis of peripheral arterial disease. Non invasive tests are available that can more accurately determine the diminished blood flow to the lower extremity. Ankle Brachial Index (ABI) is one such test. Other more advanced and comprehensive tests are available if required.
Treatment:
In early stages of peripheral arterial disease, lifestyle changes including smoking cessation, regular exercise, and heart healthy diet are recommended. As the disease progresses, medication might be required to improve the blood flow to the extremities, and decrease symptoms. In severe cases, surgeries might be required.
Associated Issues:
Peripheral arterial disease can cause further complications associated with existing foot deformities such as hammertoes, and bunions. These deformities can cause ulcers to form at sites of high pressure, resulting in ulceration that does not heal from lack of blood flow. There are many other associated issues due to peripheral arterial disease.
To avoid these complications, patient’s should:
- Wash your feet daily. Use warm (not hot) water and a mild soap. Dry your feet—including between the toes—gently and well.
- Keep the skin soft. For dry skin, apply a thin coat of lotion that does not contain alcohol. Apply over the top and bottom of your feet but not between the toes.
- Trim toenails straight across and file the edges. Keep edges rounded to avoid ingrown toenails, which can cause infections.
- Always wear shoes and socks. To avoid cuts and abrasions, never go barefoot—even indoors.
- Choose the right shoes and socks. When buying new shoes, have an expert make sure they fit well. At first, wear them for just a few hours daily to help prevent blisters and examine the feet afterward to check for areas of irritation. Wear seamless socks to avoid getting sores.
- Check your feet every day. Check all over for sores, cuts, bruises, breaks in the skin, rashes, corns, calluses, blisters, red spots, swelling, ingrown toenails, toenail infections or pain.
- Call your foot and ankle surgeon. If you develop any of the above problems, seek professional help immediately. Do not try to take care of cuts, sores or infections yourself.