Leg pain that comes on when you walk and goes away when you stop is easy to dismiss as getting older or being out of shape. But that pattern, called claudication, is the hallmark symptom of peripheral artery disease (PAD). And PAD is more common and more serious than most people realize.
What Is PAD?
Peripheral artery disease is a narrowing of the arteries that carry blood to your legs. Plaque (fatty deposits) builds up inside the artery walls over years, gradually reducing blood flow. When your leg muscles need more oxygen during walking, the narrowed arteries cannot deliver enough, causing cramping, aching, or fatigue.
PAD affects roughly 8 to 12 million Americans. It is most common in adults over 50, smokers, diabetics, and people with high blood pressure or high cholesterol. On Long Island, where many residents are in these risk categories and walk regularly for commuting or exercise, PAD symptoms often surface during routine activity.
Warning Signs You Should Not Ignore
The classic symptom is leg cramping or aching during walking that relieves with rest. But PAD can also present as a tired or heavy feeling in the legs during activity, cold feet or toes (especially compared to the other foot), slow-healing cuts or sores on the feet or toes, shiny or discolored skin on the legs, weak or absent pulses in the feet, and numbness or tingling in the feet.
In advanced cases, pain may occur even at rest, particularly when lying down. Some patients notice they hang their feet off the bed at night to relieve discomfort, because gravity helps blood reach the feet.
Why PAD Matters Beyond Leg Pain
PAD is not just a leg problem. The same plaque buildup affecting your leg arteries is likely present in other arteries too. Patients with PAD have a significantly higher risk of heart attack and stroke. Early detection and management of PAD is also cardiovascular prevention.
Additionally, untreated PAD can progress to critical limb ischemia, where blood flow is so reduced that tissue damage, wounds, and in severe cases, amputation become risks. Early evaluation and treatment dramatically reduce these outcomes.
How PAD Is Diagnosed
At M&S Vascular in Great Neck, Dr. Amir Salem evaluates PAD using several approaches. An ankle-brachial index (ABI) test compares blood pressure in your ankles to your arms. A lower reading in the ankles suggests arterial narrowing. The test is painless and takes about 15 minutes.
Duplex ultrasound can visualize blood flow in the leg arteries and identify blockage locations. In some cases, CT angiography or other advanced imaging helps plan treatment.
Treatment Options
PAD treatment starts with risk factor management. Smoking cessation is the single most important step. Blood pressure control, cholesterol management with statins, diabetes control, and supervised walking exercise all improve outcomes.
Medications such as antiplatelet drugs (aspirin or clopidogrel) reduce cardiovascular risk. Cilostazol may improve walking distance for some patients.
When lifestyle changes and medications are not enough, minimally invasive vascular procedures can open blocked arteries. Angioplasty, stenting, and atherectomy are performed through a catheter without major surgery. Dr. Salem discusses these options when the clinical picture supports intervention.
Getting Tested on Long Island
If you have leg pain with walking, cold feet, diabetes with circulation concerns, or risk factors for vascular disease, a PAD evaluation at M&S Great Neck is a straightforward next step. The office at 935 Northern Boulevard serves patients from across Nassau and Suffolk counties. Call (516) 960-1954.