PAD: The Hidden Cause of Leg Pain When Walking

If your legs start aching or cramping after you’ve been walking for a while, you might just chalk it up to getting older. Maybe you think it’s arthritis, a muscle strain, or simply the result of being a little less active than you used to be.

Any of those could very well be the case. But recurring leg pain during physical activity can also be a sign of something more: peripheral artery disease, or PAD.

PAD occurs when narrowed arteries reduce blood flow to the legs and feet. It’s a common vascular condition, but it’s often undiagnosed because people assume their symptoms are simply a normal part of aging. Recognizing the warning signs and talking with your healthcare provider can help you get the right diagnosis and, when necessary, the treatment you need to keep you moving.

Concerned about leg pain when walking? Talk with a vascular specialist at (614) 627-2000.

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What Is Peripheral Artery Disease (PAD)? 

According to the American Heart Association, peripheral artery disease is a condition in which plaque builds up inside the arteries that carry blood to areas such as the legs and feet. This buildup, known as atherosclerosis, can narrow the arteries and limit the amount of oxygen-rich blood reaching the muscles.

As a result, your legs may not get enough blood when they need it most – like when you're walking or exercising.

“PAD is essentially a circulation problem,” says Mount Carmel Vascular Surgeon Dr. Kapil Gopal. “When the arteries supplying the legs become narrowed, the muscles may not receive enough blood and oxygen during activity. That can cause pain or fatigue, but it’s important to recognize that PAD can also be a sign of plaque buildup elsewhere in the body.”

PAD is more than a condition that affects how far you can walk. Because it’s associated with atherosclerosis throughout the body, it can also increase the risk of cardiovascular problems, including heart attack and stroke.

Common PAD Symptoms 

One of the most recognizable symptoms of PAD is called intermittent claudication.

It typically causes pain, cramping, aching, heaviness, or fatigue in the calf, thigh, hip, buttocks, foot, or ankle during walking or other physical activity. The discomfort often improves after you stop and rest, only to return when you start walking again.

That’s a pattern worth paying attention to. If you consistently notice that your legs begin to hurt after walking a certain distance – and the discomfort improves when you stop – it’s a good idea to mention it to your healthcare provider.

It can be easy to assume the problem is arthritis, aging, or simply being out of shape. But PAD-related pain occurs in the muscles rather than the joints, and recognizing that distinction can help lead to the right diagnosis.

Other PAD Warning Signs  

Not everyone with PAD experiences the classic pattern of pain while walking. Other symptoms can include:

• Numbness or weakness in the legs
• Feet or lower legs that feel unusually cold
• Wounds or sores on the feet or toes that heal slowly
• Changes in skin color
• Shiny skin or reduced hair growth on the legs
• Weaker pulses in the feet
• Leg or foot pain that occurs even while resting 

These symptoms shouldn't be ignored. As blood flow becomes more restricted, PAD can affect wound healing and, in severe cases, even threaten the health of the affected limb.

Who’s Most at Risk 

Certain factors increase your risk of developing PAD, including:

• Smoking
• Diabetes
• High blood pressure
• High cholesterol
• Obesity
• A personal or family history of vascular disease
• Being 65 or older

Smoking and diabetes are particularly key risk factors. As is age, which is a big reason why it’s important for older adults to know more about PAD.
If you have one or more risk factors – even if you don't have obvious symptoms – it’s important to talk with your provider about whether screening for PAD is a good idea for you.

How PAD Is Diagnosed and Treated 

Diagnosing PAD starts with a conversation about your symptoms and medical history, followed by a physical examination. Your provider will likely check the pulses and circulation in your legs and feet, too.

One of the most common tests in a PAD examination is what’s called an ankle-brachial index (ABI). It’s a simple, noninvasive test that compares the blood pressure in your ankle with the blood pressure in your arm to help determine whether blood flow to your legs is reduced. Depending on the results, your provider may recommend additional testing, like an ultrasound or other imaging.

Treatment options depend on the severity of the disease and your overall health. They may include lifestyle changes, quitting smoking, managing blood pressure and cholesterol, medications, and an appropriate exercise program. In some cases, minimally invasive procedures such as angioplasty or stent placement may be recommended to improve blood flow.

The goal isn't simply to make walking more comfortable; it’s to help reduce the risk of complications and protect your cardiovascular health.

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Don't Assume Leg Pain Is Just Part of Aging 

Leg pain, cramping, or fatigue when you're walking isn't something you should automatically dismiss as a normal part of getting older.

PAD is common, and recognizing the symptoms can lead to earlier evaluation and treatment. And that can be critically important. Because PAD can be a sign of a broader problem with your arteries, addressing it may help reduce your risk of more serious cardiovascular complications.

If you're experiencing recurring leg pain, cramping, or fatigue when walking, talk with your healthcare provider. A simple evaluation can help determine what's causing your symptoms. And if PAD is the culprit, our expert specialists can help identify treatment options that can help keep you moving and support your long-term health.