Medical expert of the article
New publications
Peripheral vascular disease of the legs
Last reviewed: 05.07.2025
All iLive content is medically reviewed or fact checked to ensure as much factual accuracy as possible.
We have strict sourcing guidelines and only link to reputable media sites, academic research institutions and, whenever possible, medically peer reviewed studies. Note that the numbers in parentheses ([1], [2], etc.) are clickable links to these studies.
If you feel that any of our content is inaccurate, out-of-date, or otherwise questionable, please select it and press Ctrl + Enter.
Peripheral vascular disease is usually classified by doctors as a sign of atherosclerosis (the development of fatty deposits that narrow the peripheral arteries of the leg). How to recognize this disease and what to do if it has already been diagnosed?
Description of peripheral vascular disease
When people hear the term peripheral vasculature, most people think of the heart. But narrowing of the peripheral vasculature can affect other areas of the body, including some types of leg pain. It can be an important warning sign of potentially serious circulatory problems.
When leg pain occurs during physical activity and the legs stop hurting immediately after resting, there is a chance that the vessels in the legs are blocked. Doctors call this condition of the lower extremities peripheral vascular disease.
The leg pain associated with this condition is severe enough to prevent a person from working, walking on the tennis court, or even crossing the street. Symptoms of peripheral vascular disease are also known as atherosclerosis of the extremities. In this condition, fibrous plaques in the vessels can narrow the large and medium-sized arteries of the body, impeding blood flow.
As these plaques grow, the arteries become less elastic, cracking and roughening their smooth inner surfaces, making it more likely for blood clots to become lodged in the arterial walls. This happens differently in each person’s arterial system: in some, atherosclerosis clogs the channels that supply blood to the heart muscle and brain, while in others, plaques accumulate mainly in the vessels that lead to the extremities – most often the legs.
Causes and risk factors of peripheral vascular disease
Some degree of narrowing due to peripheral atherosclerosis occurs in 12 percent of people aged 65 to 70 and up to 20 percent of those over 75, and only a fraction of these people experience any symptoms of atherosclerosis at the onset of the disease. The rest are asymptomatic at first.
When there is a stenosis, or narrowing, of the artery that normally supplies blood to the legs, smaller vessels attempt to compensate for the blood flow around the clot in the artery. This strategy eventually fails because these secondary blood channels simply do not have the capacity of the larger artery.
The lack of blood flow may go unnoticed when the disease is in its early stages and you don't need to move much. But when you need to move faster and harder, the circulatory system can no longer supply enough oxygen, and it becomes all too obvious.
The arteries are catastrophically short of oxygen, which is their fuel, and the muscles are literally screaming in pain. Such discomfort can be perceived by a person as numbness or fatigue. On the external level, this is called intermittent claudication (the term comes from claudicare, the Latin verb "to limp"). Smoking is an increased risk factor.
[ 6 ]
Symptoms of Peripheral Vascular Disease
A classic symptom of peripheral arterial disease is cramping pain in the legs when walking - intermittent claudication. The pain may increase when a person walks faster or uphill. The pain usually subsides when a man or woman rests. The cause is ischemia in the working muscles, a kind of "leg angina." Angina, or chest pain, is usually caused by insufficient blood supply to the heart muscle, and leg angina is similar.
Leg pain and claudication are most often caused by overuse during athletic exercise, but can be caused by other factors, including exposure to cold or certain medications, such as some beta blockers, which constrict blood vessels and reduce peripheral blood flow.
The location of the blockage in the arteries determines the symptoms of poor blood flow in the legs. If the blockage is relatively small in the arterial branches of the leg, shin pain may result. A more severe blockage of blood flow may result in thigh pain, and a blockage of blood flow above the groin area (in the blood vessels of the abdomen) may cause buttock pain and impotence.
Severe narrowing of the arteries
When the arteries are severely narrowed or blocked, pain in the legs may be felt even when resting. Or the legs may look normal, but the toes may be pale, discolored, or bluish (especially when the legs are in the air). They will be cold to the touch. The pulses in the legs may be weak or absent.
In the most severe cases of oxygen starvation, tissue may die. The lower part of the leg, ankles may become covered with trophic ulcers, and in the most advanced cases gangrene may lead to the need for amputation of fingers or toes. However, such serious complications of peripheral arterial disease are rare.
Treatment of peripheral vascular disease
Depending on the general health of the patient and the extent of peripheral atherosclerosis, treatment of peripheral vascular disease includes good foot care with a daily walking program. Existing blockages in blood flow should be removed or reduced conservatively, or bypass surgery should be performed around the blocked area of the arteries. Smoking should be stopped immediately. It aggravates blood flow problems.
Pentoxifylline (Trental) can be used as a treatment, this drug makes the blood less viscous, it flows more easily with the help of smaller blood vessels. This treatment helps many patients.
Experts disagree about the benefits of low-dose aspirin. Proponents say it can slow the progression of arterial narrowing and possibly reduce the need for surgery, even if it doesn't relieve pain.
Other doctors say that if you have peripheral vascular disease, a person who regularly takes aspirin may have problems with blood clotting.
Depending on the location and extent of peripheral vascular disease, surgery may include arterial bypass grafting, endovascular repair (penetrating the blood vessel), or surgical procedures (angioplasty or atherectomy).
What Questions to Ask Your Doctor About Peripheral Vascular Disease
What to do if you have a leg cramp or a sprain? What type of treatment do you recommend?
If treatment involves painkillers, what are the side effects of the drugs?
If you take medications with aspirin, will you combine taking aspirin with other treatments?
Besides walking, are there any special exercises for the legs?
Do you recommend surgeries? What are the side effects, risks, and is there another treatment option?
How to help your legs?
Without enough blood reaching the feet, they become susceptible to injury or infection, which can persist and develop into ulcers. Therefore, people with peripheral atherosclerosis should wash their feet every day, and immediately apply a moisturizing lotion or baby oil.
A very good method of prevention is to place cotton or sheep wool pads between your toes if your toes are stiff. And put on the shoes you will be walking in. You should also wear comfortable, breathable boots or shoes that will protect your feet, and avoid shoes made of leatherette or other synthetic materials.
Keeping your feet warm during the cold season is also important. Wool socks, as well as wool and cotton combinations, are also good for keeping your feet healthy.
Patients with peripheral vascular disease should not wear garters, stockings, or socks made of elastic materials because they may interfere with blood flow.