Peripheral Artery Disease Treatments That Ease Leg Pain and Protect Your Heart
Plus find out why PAD is harder to diagnose in women
Key Takeaways
- Peripheral artery disease restricts blood flow and causes leg pain when walking.
- Simple PAD treatments like walking and diet changes can improve symptoms fast.
- Treating PAD early helps reduce risk of heart attack, stroke and serious health complications.
It’s no secret that as we get older, our bodies start to react differently to the same activities. Clutching the pages of a paperback can cause cramping in the hands. Retrieving groceries from shopping bags can trigger back pain. But if your legs ache every time you walk, it could be peripheral artery disease (PAD). Here we break down what the condition is and who’s most at risk, plus share the best peripheral artery disease treatment options to ease the ache and help ward off serious complications.
What is peripheral artery disease?
PAD occurs due to plaque buildup in the artery walls of the legs and starts to restrict blood flow. “Over time, fatty deposits occur in the blood vessels and can progress to more complex areas of stenosis, or blockages,” adds vascular surgeon and PAD expert Britt Tonnessen, MD, an associate professor of surgery (vascular) at the Yale School of Medicine.
“In peripheral artery disease, the legs or arms—usually the legs—don’t receive enough blood flow to keep up with demand,” adds cardiologist Evelina Grayver, MD, director of the Women’s Heart Program at the Katz Institute for Women’s Health in Queens, NY, and assistant professor in the Department of Cardiology at the Donald and Barbara Zucker School of Medicine at Hofstra University/Northwell. “This may cause leg pain when walking [claudication] and other symptoms.” (Learn more about the symptoms of PAD.)
Woman's World Answers
Peripheral artery disease risk factors
“The incidence of PAD increases with age, especially over 65,” says Dr. Tonnessen. “It afflicts 12 percent of the U.S. population over the age of 40,” and jumps up to 25 percent of women over 80. Other risk factors for peripheral artery disease include:
- Diabetes
- Obesity
- Smoking
- High cholesterol
- High blood pressure
- A family history of PAD, heart disease or stroke
- High levels of the amino acid homocysteine, which can increase the risk for coronary artery disease
Why PAD is harder to diagnose in women
“Women are more likely to have asymptomatic (silent) peripheral artery disease or to present with atypical symptoms, which can lead to underdiagnosis,” Dr. Tonnessen says. “Only about 50 percent of those with PAD have pain in their legs.”
There are also some conditions, according to the National Heart, Lung, and Blood Institute, that can be mistaken for or confused with PAD. This includes arthritis, vein problems, or nerve issues like sciatica. “Symptoms of pain, aches or cramps with walking claudication can happen in the buttock, hip, thigh or calf,” adds Dr. Grayver. “So PAD often goes undiagnosed by healthcare professionals.”
If the disease is suspected, a doctor will use your health and family history, as well as any symptoms, to decide whether or not to test for peripheral artery disease. Once your doctor determines that a test is necessary, it is relatively simple to diagnose PAD.
“An examination of the legs and feet will check for pulses,” Dr. Tonnessen says. “Then the best screening test for PAD is an ankle-brachial index study. This is a test which uses blood pressure cuffs to compare pressure in the legs to the arms. Normal readings are >0.9 (essentially, 90 percent circulation in the lower legs). The lower the reading, the more serious the PAD.”
Lower readings may warrant additional tests. “Your doctor may also do imaging tests such as ultrasound, magnetic resonance angiography (MRA), and computed tomographic (CT) angiography,” says Dr. Grayver.
Peripheral artery disease treatment options
Sounds obvious, but a healthy lifestyle is the most effective strategy for managing PAD and its symptoms, says Dr. Grayver. The good news: It doesn’t have to be a chore! These smart peripheral artery disease treatment tips ease pain and keep symptoms in check.
Take a daily aspirin
“I recommend my patients to take aspirin or other similar antiplatelet medicines to prevent serious complications from PAD and associated atherosclerosis,” says Dr. Grayver. According to the American College of Cardiology (ACC), both aspirin and clopidogrel (another antiplatelet medication) are recommended to reduce the risk of cardiovascular events or stroke in patients with PAD. Your doctor can determine the best daily dosage for you, but the ACC reports taking 75 mg to 325 mg of aspirin is generally a safe and effective treatment dose for peripheral artery disease.
Walk this way
“The Society for Vascular Surgery and many other medical societies endorse walking as a way to improve vascular health,” says Dr. Tonnessen. “There is good evidence that walking can train the leg muscles in patients with PAD.” Engaging in a walking program can help folks build up to walking farther and longer without pain. The trick: Turn it into a game of red light, green light. Walk until you feel pain, then stop for a break. When the ache subsides, resume your stroll.
“Walking regularly 20 to 30 minutes a day at least five days a week is what I advise,” Dr. Tonnessen adds. “For those who can only walk short distances due to the claudication, include the rest times in the total walk times. Stop, stand and then go again when the pain improves. Over a period of six to eight weeks, a person with PAD may be about to double her walking distance.”
The proof: A review in the Journal of Cardiopulmonary Rehabilitation and Prevention found that regular walking helped PAD patients walk up to 420 ft. farther pain-free within 12 weeks. And a separate study in the Journal of Vascular Surgery found that when people with claudication walked as little as two to three times per week until they felt pain (then stopped before resuming), they were able to walk more than twice as far. What’s more, their blood vessels were up to 82 percent more dilated within 12 weeks, a sign of improved blood flow.
Try the Mediterranean diet
Enjoying more low-fat (or healthy fat) foods is a smart strategy for improving your cardiovascular health, says Dr. Grayver. Whenever possible, replace foods like butter, fatty cuts of meat and high-fat cheeses with healthier fare such as olive oil, fish and grains and beans. Better yet, consider adopting a Mediterranean diet to help treat peripheral artery disease.
A review in Circulation Research that looked at 45 studies confirmed that the evidence in favor of a Mediterranean diet is “large, strong and consistent” and is associated with better cardiovascular health outcomes. That translates to a reduced risk of coronary heart disease, ischemic stroke and total cardiovascular disease, all of which can worsen peripheral artery disease symptoms.
Savor chocolate
A study in Circulation Research found that people with peripheral artery disease who drank a cocoa beverage daily for six months could walk farther than those who didn’t. Researchers credited this benefit to cocoa’s antioxidants, which improve blood flow to the legs to ease pain. To make getting the benefits easy, try adding a protein powder made with cacao to your morning smoothie. One to try: Just Ingredients Chocolate Protein Powder, which also contains 100 percent grass-fed whey protein from New Zealand.
Opt for ‘hot-cold’ therapy
A spa-inspired treatment that boosts blood flow and eases peripheral artery disease symptoms: heat and cold therapy. “A more ‘out of the box’ treatment may include sauna treatments followed by cold plunges, allowing for more blood flow to develop,” says Dr. Grayver. A study in Physical Therapy confirms that the combination of hot and cold treatment improves the speed at which blood is able to travel through the arteries.
No access to a sauna? No problem! You can achieve the same benefits in the shower using hot and cold water. The researchers found that the optimal ratio is three minutes of heat followed by one minute of cold.
Supplement with gingko bliloba
A review of studies in the The American Journal of Medicine suggests that ginkgo biloba extract may help reduce intermittent claudication, a type of leg pain caused by poor blood flow that affects about one in three people with PAD. While researchers acknowledge that more research is still needed, it’s worth asking your doctor if this may be right for you.
The importance of peripheral artery disease treatment
PAD treatments can do more than just improve your symptoms—they can also boost blood flow throughout your body, which may help reduce your risk of heart attacks and prevent blood clots. If the above lifestyle remedies don’t provide as much relief as you’d hoped, your doctor may prescribe medication such as statins or drugs to prevent blood clots. In severe cases, your doctor may recommend a stent or bypass surgery to improve blood flow.
The bottom line: Talk to your doctor about what’s right for you. Treating peripheral artery disease can make a big difference in your overall health.
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