Peripheral artery disease of the legs - self-care
Peripheral vascular disease - self-care; Intermittent claudication - self-care
Exercise, including walking at least 30 minutes a day, decreases the risk of heart attacks, stroke, hypertension, some cancers, osteoporosis, depression and obesity.
Peripheral vascular disease (PVD), also known as peripheral artery disease, is a chronic peripheral manifestation of atherosclerosis, which may affect the lower limbs and cerebral or renal vessels, causing a reduction of blood flow in the arteries of the trunk, arms, and legs. People with PVD are at increased risk of stroke, myocardial infarctions, renal failure, intestinal angina, and lower leg ulcers or limb loss. The risk of peripheral vascular disease increases with age, and by age 70, as many as 20 percent of the population may be affected by this condition. In peripheral vascular disease, fatty deposits build up in the inner linings of artery walls. These deposits cause blockages and restrict blood flow, mainly in arteries leading to the kidneys, stomach, arms, legs, and feet. In its early stages, symptoms include cramping or fatigue in the legs and buttocks during activity. Such cramping subsides by standing still. This is called intermittent claudication.
Arteriosclerosis of the extremities is a disease of the peripheral blood vessels that is characterized by narrowing and hardening of the arteries that supply the legs and feet. The narrowing of the arteries causes a decrease in blood flow. Symptoms include leg pain, numbness, cold legs or feet and muscle pain in the thighs, calves or feet.
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. Contact your provider right away if you have any of these symptoms during or after exercise:
- Chest pain
- Breathing problems
- Dizziness
- An uneven heart rate
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 or more stops before your normal stop and walk the rest of the way.
- Aim for a total of 30 minutes of walking, 5 times per week.
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
Contact your provider right away 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 high cholesterol, ask your provider about it as it 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, clopidogrel (Plavix), or other medicines which keep your blood from forming clots
- Cilostazol, a medicine that widens (dilates) the blood vessels and also thins the blood
Do not stop taking these medicines without first talking with your provider.
When to Call the Doctor
Contact 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: Libby P, Bonow RO, Mann DL, Tomaselli GF, Bhatt DL, Solomon SD, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Philadelphia, PA: Elsevier; 2022:chap 43.
Michael W. Peripheral artery disease. In: Kellerman RD, Rakel DP, Heidelbaugh JJ, Lee EM, eds. Conn's Current Therapy 2024. Philadelphia, PA: Elsevier 2024:152-155.
Henkin S, Creager MA. Peripheral artery disease. In: Hoffman R, Benz EJ, Silberstein LE, et al, eds. Hematology: Basic Principles and Practice. 8th ed. Philadelphia, PA: Elsevier; 2023:chap 146.
Simons JP, Schanzer A. Lower extremity arterial disease: decision making and medical management. In: Sidawy AN, Perler BA, eds. Rutherford's Vascular Surgery and Endovascular Therapy. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 108.
Version Info
Last reviewed on: 10/11/2024
Reviewed by: Frank D. Brodkey, MD, FCCM, Associate Professor, Section of Pulmonary and Critical Care Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
