Peripheral arterial disease - Symptoms of peripheral arterial disease

Many people with peripheral arterial disease (PAD) don't have any symptoms. However, you may feel painful aching in your leg muscles that is triggered by physical activity, such as walking or climbing stairs.

The pain, known as intermittent claudication, usually develops in your calves, but your hip, buttock or thigh muscles can be affected.

The pain can range from mild to severe, and will usually go 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 (see below).

When to seek medical advice

See your GP if you experience recurring episodes of leg pain after physical activity, especially if you smoke, or have a confirmed diagnosis of diabetes, high blood pressure and/or high cholesterol.

Many people mistakenly think recurring episodes of leg pain are part of growing older. This is not the case – there is no reason why an otherwise healthy person should experience leg pain.

Read more about diagnosing PAD.

When to seek urgent medical advice

Some symptoms may suggest that the supply of blood to your legs has become severely restricted, and you may need to see a doctor urgently. These include:

• your symptoms getting suddenly worse
• constant leg pain, even when resting
• being unable to move the affected leg
• a sudden loss of normal sensation in the affected leg, or a burning or prickling sensation
• a difference in the colour and temperature of your legs
• persistent ulcers on one or both legs
• the muscles in your legs beginning to waste away
• the skin on your toes or lower limbs turning red and then black and/or beginning to swell and produce foul-smelling pus, causing severe pain (gangrene)

If you experience any of the problems listed above, contact your GP as soon as possible. If this is not possible, phone NHS 111 or your local out-of-hours service. 

These symptoms could be a sign of a complication of PAD called critical limb ischemia (CLI), which requires urgent treatment. 

Read more about the complications of PAD.