The Ultimate Guide to Peripheral Artery Disease (PAD): Symptoms, Risk Factors & Early Detection
More than 18 million people in the United States have symptoms of peripheral artery disease, yet many have no idea they are living with it. PAD often develops quietly. Leg pain gets brushed off as “just getting older,” or the aching stops once you sit down, so it doesn’t feel urgent. The reality is that this common circulatory condition can put your heart, brain, and limbs at serious risk if it goes unrecognized.
September is Peripheral Artery Disease Awareness Month, making this an ideal time to understand what PAD is, how to spot the warning signs, who is most at risk, and why early detection can change the course of the disease. At Maryland Vascular Specialists, our board-certified vascular physicians see patients every day who wish they had come in sooner. This guide is designed to give you clear, practical information so you can decide whether it’s time to get checked.
What Is Peripheral Artery Disease?
Peripheral artery disease (also called peripheral arterial disease or PAD) occurs when arteries that carry blood to your limbs—most often the legs—become narrowed or blocked. The usual culprit is atherosclerosis, the buildup of fatty deposits (plaque) inside the artery walls. As the arteries narrow, muscles and tissues downstream don’t get the oxygen-rich blood they need.
PAD is more than a leg problem. Because atherosclerosis often affects multiple areas of the body, people with PAD face higher risks of heart attack, stroke, and, in advanced cases, non-healing wounds or limb loss. The good news is that when PAD is found early, many of these complications can be slowed or prevented.
Symptoms of PAD: What to Watch For
In the earliest stages, PAD may cause no noticeable symptoms at all. When symptoms do appear, they can vary widely from person to person. The classic sign is intermittent claudication—pain, cramping, aching, or fatigue in the legs, thighs, or hips that starts during walking or exercise and eases with rest.
Other common symptoms include:
- Pain or aching in the legs even at rest (especially at night)
- Difficulty walking or reduced ability to cover distances you once managed easily
- A sensation of coldness in one or both legs or feet
- Numbness or weakness in the legs
- Non-healing sores or wounds on the feet, toes, or legs
- Hair loss or shiny, discolored skin on the legs or feet
- Slow-growing toenails
- Erectile dysfunction in men
Some people describe a general throbbing or body-wide aching that improves when they sit or lie down. Because the pain often disappears with rest, many delay seeking care. If you have persistent leg symptoms that interfere with daily activities—or if wounds on your feet are slow to heal—it’s worth having a vascular specialist take a closer look.
Who Is at Risk for PAD?
PAD becomes more common with age, particularly after 50, and risk rises further after 65. Men are affected somewhat more often than women, but the condition is far from rare in either group. Several other factors significantly increase the likelihood of developing PAD:
- Smoking or a history of smoking (one of the strongest risk factors)
- Diabetes
- High blood pressure
- High cholesterol
- Obesity
- A sedentary lifestyle with little regular exercise
- Family history of vascular disease, heart disease, or stroke
- Existing heart disease or previous stroke
If several of these apply to you, regular screening makes sense even if you feel fine. Many people with PAD never experience classic claudication, yet they still carry elevated cardiovascular risk.
Why Early Detection Matters
Left untreated, PAD can progress. Reduced blood flow may lead to chronic limb-threatening ischemia—severe pain at rest, non-healing ulcers, or tissue loss that can result in amputation. At the same time, the same atherosclerotic process that narrows leg arteries often affects the coronary and carotid arteries, raising the chance of heart attack or stroke.
Early detection allows for simpler interventions: lifestyle changes, medication, and, when needed, minimally invasive procedures that restore blood flow before irreversible damage occurs. Finding PAD early is one of the most effective ways to protect both your limbs and your overall cardiovascular health.
How PAD Is Diagnosed
Diagnosis usually begins with a conversation about your symptoms and medical history, followed by a physical exam that includes checking pulses in the legs and feet. Several straightforward, non-invasive tests help confirm the presence and severity of PAD:
- Ankle-Brachial Index (ABI) – A simple comparison of blood pressure in the ankle versus the arm. It is quick, painless, and highly useful for screening.
- Doppler and duplex ultrasound – These imaging tests show how blood is flowing through the arteries and can pinpoint the location and degree of blockages.
- Toe pressure measurements – Especially helpful in people with diabetes or calcified vessels where standard ABI may be less accurate.
In some cases, additional imaging such as CT or MR angiography may be used to plan treatment. At Maryland Vascular Specialists, our accredited vascular labs use state-of-the-art ultrasound technology so that diagnosis and treatment planning can often happen in the same convenient outpatient setting.
Taking the Next Step
PAD is common, under-recognized, and highly manageable when caught early. If you have risk factors, experience leg pain with walking, notice cold feet, or have wounds that won’t heal, a vascular evaluation can provide clarity and peace of mind.
Our fellowship-trained, board-certified vascular physicians at Maryland Vascular Specialists specialize in both the diagnosis and treatment of PAD. We emphasize conservative approaches first—lifestyle guidance and medical therapy—and offer advanced minimally invasive outpatient procedures when intervention is needed. With 16 locations across the Greater Baltimore-Washington region and into Pennsylvania, comprehensive care is close to home.
Don’t wait for symptoms to become severe. Early detection can protect your mobility, your limbs, and your long-term health. Contact Maryland Vascular Specialists today to schedule a consultation and take the first step toward clearer answers and better vascular health.
Medical Disclaimer
This content is for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Speak with a qualified healthcare professional about personal symptoms and screening needs. If you have sudden, severe abdominal or back pain, fainting, or other possible signs of a ruptured AAA, call 911 immediately.