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Aching legs could be more than sore muscles

If walking makes your legs ache or you've been told you have poor circulation, it could be a symptom of peripheral artery disease, or PAD.

The peripheral arteries are outside the chest and abdomen and supply blood to the arms and legs. PAD develops when these arteries harden or become clogged with plaque, leaving the arms or legs without adequate blood flow and oxygen. This obstructed blood flow puts a strain on the entire cardiovascular system — including the heart itself — but the problem often goes undiagnosed until there's major damage.

"Peripheral artery disease is a common problem, but many people don't realize they have it," said Laurie Lowther, Lake Regional's Wound Healing Center director. "The symptoms can be subtle, especially in the early stages. But left untreated, PAD can increase the risk for heart attack or stroke. In some extreme cases, it leads to lower limb amputation."


Although PAD can affect the arms, it's more likely to affect the legs and feet. Symptoms include cramping, fatigue, heaviness, and pain or discomfort in the legs and buttocks, especially during activity. Other symptoms include chronic toe or foot sores; numbness in the extremities; weakness in the calf muscle; cold legs and feet; or feet that turn pale when elevated.

"If you have these signs, talk with your doctor," Lowther said.

Risk Factors

A major risk factor for PAD is diabetes. In fact, the American Diabetes Association reports an estimated one out of three people older than 50 who have diabetes also have PAD.

Other factors besides diabetes and age that increase an individual’s risk for PAD include smoking, high blood pressure, abnormal cholesterol, being overweight, being physically inactive, and having a personal or family history of heart disease, heart attack or stroke.

"The risk factors for PAD are the same as those for heart attack and stroke," Lowther said. "The good news is the same actions will improve all of these forms of cardiovascular disease."


Treatment options for PAD include lifestyle changes, such as regular exercise and quitting smoking. In addition, a doctor may prescribe medication to reduce blood pressure or to control cholesterol or diabetes.

Improved foot care to reduce the risk of non-healing injuries or advanced therapies may be necessary.

"It's important to take care of your feet and legs," Lowther said. "When you have reduced blood flow to your feet and legs, even scrapes and injuries can more easily lead to serious infection."


Before treatment can begin, PAD must be diagnosed. Testing for PAD often includes an ankle-brachial index, or ABI.

"The ABI test compares the blood pressure in the legs to the blood pressure in the arms," Lowther said. "This can reveal problems with circulation."

The American Diabetes Association recommends that people with diabetes who are older than 50 have an ABI to test for PAD.

"Finding PAD early and treating it can save a limb or even your life," Lowther said. "If you have concerns, talk with your doctor."

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