What Is Peripheral Arterial Disease and its impact on foot health

At FootHouse Podiatry Clinic in Southeast Kent we see many patients with Peripheral arterial disease. Peripheral arterial disease is a term used to describe a narrowing or occlusion of the peripheral arteries affecting the blood supply to the lower limb. The FootHouse Podiatry team, believe understanding peripheral arterial disease is crucial to provide critical and effective care while also raising awareness about the condition to our patients.

Symptoms of Peripheral Arterial Disease

• Diminished circulation leads to pain in the lower limb on walking or exercise, which is relieved by rest. This is called Intermittent claudication and is the most common symptom of peripheral arterial disease.

• Painful cramping in the calf or thigh during activity

• Cramps in bed at night

• Coldness in the lower leg or foot.

• Changes in skin colour or texture including; blue, black purple, red, white

• Sores or cuts on the skin which are taking a long time to heal

  
  

Features of acute limb ischemia

• Pain - often described as cramping or burning to severe muscle pain

• Pallor - Pale skin

• Pulseless

• Perishingly cold

• Paraesthesia

• Loss of Power

  
  

Strong Risk Factors for peripheral arterial disease include

1.       Smoking

2.       Diabetes mellitus

3.       Hypertension

4.       Hypercholesterolaemia (High Cholesterol)

Diagnosis Early Diagnosis of peripheral arterial disease is the key to managing this condition. At every appointment we take the following steps if PAD is suspected:

Take a detailed medial history

Your podiatrist will ask about:

• Leg pain when walking (claudication) or at rest

• Cold feet, numbness, or tingling

• History of diabetes, smoking, high blood pressure, or cholesterol

• Medication

• Non-healing wounds on toes or legs

• Family history of circulation issues or stroke.

Carry out a complete physical examination of the lower limb

Your podiatrist will check for visual signs of PAD:

• Pale or bluish skin

• Shiny, thin skin with hair loss on legs or feet

• Thickened toenails

• Delayed wound healing or ulcers

• Cold temperature in one or both feet

• Weak or absent pulses in the feet and ankles

• Palpate pulses: - Dorsalis pedis (top of foot) -Posterior tibial (inside ankle)

  
  

  Complete a doppler assessment

• A lower limb Doppler test is a non-invasive ultrasound test used to assess blood flow in the arteries and veins of your legs and feet.

  Complete an Ankle -Brachial pressure index

• Compares the blood pressure in your ankle to the pressure in your arm

• An ABPI below 0.9 usually suggests PAD

• Above 1.3 may indicate hardened (calcified) arteries — common in diabetics

This helps quantify how much arterial narrowing may be present.

Complete urgent referrals to the vascular teams when required.

If PAD is suspected:

• Your podiatrist may refer you to a vascular specialist or your GP

• Further imaging like a duplex ultrasound or angiogram may be advised

  
  

For those diagnosed with peripheral arterial disease managing the condition and monitoring foot health is essential to avoid complications.  If left untreated Peripheral Arterial Disease can lead to serious complications including infections, gangrene, necrosis or amputation. If you or someone you know is experiencing symptoms, don't hesitate to reach out to the FootHouse team for professional assessment, advice and care.

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