Peripheral arterial disease (PAD)

Peripheral arterial disease (PAD) is a common condition. It happens when a build-up of fatty deposits in the arteries restricts blood supply to leg muscles. It's also known as peripheral vascular disease (PVD). See your GP if you experience recurring leg pain when exercising, (see symptoms of PAD below).

Symptoms of peripheral arterial disease

Many people with PAD have no symptoms. Some develop a painful ache in their legs when they walk, which usually disappears after a few minutes' rest.

The pain can range from mild to severe. It usually goes away after a few minutes when you rest your legs.

Both legs are often affected at the same time, although the pain may be worse in one leg.

Other symptoms of PAD can include:

  • hair loss on your legs and feet
  • numbness or weakness in the legs
  • brittle, slow-growing toenails 
  • ulcers (open sores) on your feet and legs, which don't heal
  • changing skin colour on your legs, such as turning pale or blue
  • shiny skin 
  • in men, erectile dysfunction
  • the muscles in your legs shrinking (wasting)

The symptoms of PAD often develop slowly, over time.

If your symptoms develop quickly, or get suddenly worse, it could be a sign of a serious problem requiring immediate treatment.

When to see your GP

You should see your GP if you experience recurring leg pain when exercising.

Many people mistakenly think this is just part of growing older. But there's no reason why an otherwise healthy person should experience leg pain.

PAD is usually diagnosed by assessing your symptoms and through a physical examination by your GP. They will compare the strength of the pulses, or may measure blood pressure in your limbs.

Causes of peripheral arterial disease

PAD is a form of cardiovascular disease (CVD), meaning it affects the blood vessels.

It's usually caused by a build-up of fatty deposits in the walls of the leg arteries. The fatty deposits are made up of cholesterol and other waste substances.

The build-up of fatty deposits on the walls of the arteries makes the arteries narrower. This restricts blood flow to the legs. This process is called atherosclerosis (arteriosclerosis).

There are certain things that can increase your chances of developing PAD and other forms of CVD, including:

Your risk of developing PAD also increases as you get older. Men tend to develop the condition more often than women.

Treating peripheral arterial disease

PAD is largely treated through lifestyle changes and medication.

Exercising regularly and stopping smoking, if you smoke, are the main lifestyle changes that can ease the symptoms of PAD and reduce the chances of the condition getting worse. It's also important to:

The underlying causes should also be treated, including high blood pressurehigh cholesterol, and diabetes. Medication, and in some cases surgery, can be used to improve the blood flow in your legs.

With treatment, most people's symptoms stay relatively stable. Some people may experience an improvement in their pain.

If treatment is unsuccessful or you can't make appropriate lifestyle changes, there's a risk of potentially serious complications.

Complications of peripheral arterial disease

PAD isn't immediately life-threatening. But the process of atherosclerosis that causes it can lead to serious and potentially fatal problems.

Coronary heart disease (CHD)

The blockages in the arteries in the legs can also affect other areas of your body, such as the arteries supplying the heart and brain. 

This means that having PAD makes you more likely to develop another form of cardiovascular disease (CVD), such as:

Critical limb ischaemia (CLI)

If the blood flow to the legs becomes severely restricted, critical limb ischaemia (CLI) can develop. CLI is an extremely serious complication that can be challenging to treat.

Symptoms of CLI include:

  • a severe burning pain in your legs and feet that continues even when you're resting
  • your skin turning pale, shiny, smooth and dry
  • wounds and ulcers (open sores) on your feet and legs that don't heal
  • loss of muscle mass in your legs
  • the skin on your toes or lower limbs becoming cold and numb, turning red and then black, and/or beginning to swell and produce foul-smelling pus, causing severe pain (gangrene).

If you think you're developing symptoms of CLI, contact your GP immediately. If this isn't possible contact GP out of hours service.

An angioplasty or bypass graft is usually recommended if you have CLI, although these may not always be successful or possible. In a few cases, an amputation below the knee may be required.

Driving and peripheral arterial disease

If you hold a bus, coach, or lorry licence, or drive a taxi, you should tell the Driver &Vehicle Agency (DVA) about peripheral arterial disease.

You may be able to drive following assessment.

Drivers with a car or motorcycle licence do not need to tell the DVA, unless your condition affects your driving.

The information on this page has been adapted from original content from the NHS website.

For further information see terms and conditions.

This page was published July 2018

This page is due for review February 2020

Health conditions A to Z

Search by health condition or symptoms

Or find conditions beginning with …

Share this page

What do you want to do?
What is your question about?
Do you want a reply?
Your email address
To reply to you, we need your email address
Your feedback

We will not reply to your feedback.  Don't include any personal or financial information, for example National Insurance, credit card numbers, or phone numbers.

This feedback form is for issues with the nidirect website only.

You can use it to report a problem or suggest an improvement to a webpage.

If you have a question about a government service or policy, you should contact the relevant government organisation directly as we don’t have access to information about you held by government departments.

You must be aged 13 years or older - if you’re younger, ask someone with parental responsibility to send the feedback for you.

The nidirect privacy notice applies to any information you send on this feedback form.

Don't include any personal or financial information, for example National Insurance, credit card numbers, or phone numbers.

Plain text only, 750 characters maximum.
Plain text only, 750 characters maximum.

What to do next

Comments or queries about angling can be emailed to anglingcorrespondence@daera-ni.gov.uk 

What to do next

If you have a comment or query about benefits, you will need to contact the government department or agency which handles that benefit.  Contacts for common benefits are listed below.

Carer's Allowance

Call 0800 587 0912
Email 
dcs.incomingpostteamdhc2@nissa.gsi.gov.uk

Discretionary support / Short-term benefit advance

Call 0800 587 2750 
Email 
customerservice.unit@communities-ni.gov.uk

Disability Living Allowance

Call 0800 587 0912 
Email dcs.incomingpostteamdhc2@nissa.gsi.gov.uk

Employment and Support Allowance

Call 0800 587 1377

Jobseeker’s Allowance

Contact your local Jobs & Benefits office

Personal Independence Payment

Call 0800 587 0932

If your query is about another benefit, select ‘Other’ from the drop-down menu above.

What to do next

Comments or queries about the Blue Badge scheme can be emailed to bluebadges@infrastructure-ni.gov.uk or you can also call 0300 200 7818.

What to do next

For queries or advice about careers, contact the Careers Service.

What to do next

For queries or advice about Child Maintenance, contact the Child Maintenance Service.

What to do next

For queries or advice about claiming compensation due to a road problem, contact DFI Roads claim unit.

What to do next

For queries or advice about criminal record checks, email ani@accessni.gov.uk

What to do next

Application and payment queries can be emailed to ema_ni@slc.co.uk

What to do next

For queries or advice about employment rights, contact the Labour Relations Agency.

What to do next

For queries or advice about birth, death, marriage and civil partnership certificates and research, contact the General Register Office Northern Ireland (GRONI) by email gro_nisra@finance-ni.gov.uk

What to do next

For queries about:

If your query is about another topic, select ‘Other’ from the drop-down menu above.

What to do next

For queries or advice about passports, contact HM Passport Office.

What to do next

For queries or advice about Penalty Charge Notices (PCNs), including parking tickets and bus lane PCNs, email dcu@infrastructure-ni.gov.uk

What to do next

For queries or advice about pensions, contact the Northern Ireland Pension Centre.

What to do next

If you wish to report a problem with a road or street you can do so online in this section.

If you wish to check on a problem or fault you have already reported, contact DfI Roads.

What to do next

For queries or advice about historical, social or cultural records relating to Northern Ireland, use the Public Record Office of Northern Ireland (PRONI) enquiry service.

What to do next

For queries or advice about rates, email LPSCustomerTeam@lpsni.gov.uk

What to do next

For queries or advice about  60+ and Senior Citizen SmartPasses (which can be used to get concessionary travel on public transport), contact Smartpass - Translink.