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Peripheral artery disease of the legs - self-care

Peripheral vascular disease - self-care; Intermittent claudication - self-care

Peripheral artery disease (PAD) is a narrowing of the blood vessels that bring blood to the legs and feet. It can occur when cholesterol and other fatty material (atherosclerotic plaque) build-up on the walls of your arteries.

PAD is mostly seen in people above 65 years of age. Diabetes, smoking, and high blood pressure increase the risk for PAD.

The symptoms of PAD include cramps in the legs mostly during physical activities (intermittent claudication). In severe cases, there may also be pain when the leg is at rest.

Managing the risk factors can reduce the risk of further cardiovascular damage. Treatment mainly includes medicines and rehabilitation. In severe case, surgery may also be done.

Walking Improves Blood Flow

A regular walking program will improve blood flow as new, small blood vessels form. The walking program is mainly as follows:

  • Warm up by walking at a pace that does not cause your normal leg symptoms.
  • Then walk to the point of mild-to-moderate pain or discomfort.
  • Rest until the pain goes away, then try walking again.

Your goal over time is to be able to walk 30 to 60 minutes. Always talk with your health care provider before you start an exercise program. Call your provider right away if you have any of these symptoms during or after exercise:

Make simple changes to add walking to your day.

  • At work, try taking the stairs instead of the elevator, take a 5-minute walk break every hour, or add a 10- to 20-minute walk during lunch.
  • Try parking at the far end of the parking lot, or even down the street. Even better, try walking to the store.
  • If you ride the bus, get off the bus 1 stop before your normal stop and walk the rest of the way.

Lifestyle Changes

Stop smoking. Smoking narrows your arteries and increases the risk for atherosclerotic plaque or blood clots forming. Other things you can do to stay as healthy as possible are to:

  • Make sure your blood pressure is well-controlled.
  • Reduce your weight, if you are overweight.
  • Eat a low-cholesterol and low-fat diet.
  • Test your blood sugar if you have diabetes, and keep it under control.

Take Care of Your Feet

Check your feet every day. Inspect the tops, sides, soles, heels, and between your toes. If you have vision problems, ask someone to check your feet for you. Use a moisturizer to keep your skin healthier. Look for:

  • Dry or cracked skin
  • Blisters or sores
  • Bruises or cuts
  • Redness, warmth, or tenderness
  • Firm or hard spots

Call your provider right way about any foot problems. DO NOT try to treat them yourself first.

What Else?

If you are taking medicines for high blood pressure, high cholesterol, or diabetes, take them as prescribed. If you are not taking medicine for a high cholesterol, ask your provider about them as they may still help you even if your cholesterol is not high.

Your provider may prescribe the following medicines to control your peripheral artery disease:

  • Aspirin or a medicine called clopidogrel (Plavix), which keeps your blood from forming clots
  • Cilostazol, a medicine that widens (dilates) the blood vessels

DO NOT stop taking these medicines without first talking with your provider.

When to Call the Doctor

Call your provider if you have:

  • A leg or foot that is cool to the touch, pale, blue, or numb
  • Chest pain or shortness of breath when you have leg pain
  • Leg pain that does not go away, even when you are not walking or moving (called rest pain)
  • Legs that are red, hot, or swollen
  • New sores on your legs or feet
  • Signs of infection (fever, sweats, red and painful skin, general ill feeling)
  • Sores that do not heal

References

Bonaca MP, Creager MA. Peripheral artery diseases. In: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 11th ed. Philadelphia, PA: Elsevier; 2019:chap 64.

Kullo IJ. Peripheral artery disease. In: Kellerman RD, Rakel DP, eds. Conn's Current Therapy 2019. Philadelphia, PA: Elsevier; 2019:141-145.

Simons JP, Robinson WP, Schanzer A. Lower extremity arterial disease: medical management and decision making. In: Sidawy AN, Perler BA, eds. Rutherford's Vascular Surgery and Endovascular Therapy. 9th ed. Philadelphia, PA: Elsevier; 2019:chap 105.

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Review Date: 10/13/2018

Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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