Peripheral Arterial Disease and Your Toes

PAD affects 8 million Americans—those with diabetes are at greatest risk
leg discomfort from PAD

It’s common knowledge that vascular disease (disease of the blood vessels) can lead to heart attack and stroke, but did you know it could also lead to loss of limbs? One serious condition that can lead to loss of limbs is peripheral arterial disease (PAD), which refers to blockages in the arteries outside the heart.

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PAD is caused by arteriosclerosis or “hardening of the arteries,” which happens when fatty material builds up on the artery walls. This causes them to become stiff and narrow and decreases blood flow in the legs and feet. As a result, when the muscles of your legs are active, they cannot get enough blood and oxygen.

Opened Artery

Today, PAD affects about 8 million Americans and it is estimated that one in three diabetics over the age of 50 is suffering from this condition. Over time and in severe cases, removal of part or all of the foot or leg (rarely the arm), is necessary — especially for people who also have diabetes. In fact, 15 percent of people with diabetes will develop a foot ulcer in their lifetime,  and of those up to one in four will require amputation of a toe – or worse yet, their leg.

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Once PAD is diagnosed, it allows physicians to identify where the arterial blockages are and to aggressively treat them with medications or interventions, which prevent the complications of the disease. People with coronary artery disease (CAD) should also pay attention to signs of PAD.

“Over the last decade, we have seen a significant improvement in our ability to treat vascular disease both with medications and procedural interventions,” says vascular surgeon Levester Kirksey, MD. “We now have very good minimally invasive procedures to open blockages and provide immediate relief to patients.”

These, he said provide durable results and allow patients to resume their normal activities. But, he notes, vessel blockages can build up over a lifetime, and the symptoms may not become obvious until later in life. PAD leg pain may also be missed because it is attributed to other disorders. For many people, the outward symptoms will not appear until the artery has narrowed by 60 percent or more.

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Dr. Kirksey says it is important for patients to take action to minimize the  complications of vascular disease. They can do this by educating themselves on PAD, examining their legs and feet for sores or changes in skin color or temperature, practicing good foot care including podiatry visits, seeing their doctors and having diagnostic tests done when necessary. Those with diabetes should be especially vigilant.

And of course, eating healthy, maintaining a healthy weight, being active and not smoking are all ways to reduce your chances of having PAD and/or developing severe complications – such as the loss of a limb. 

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