Why Do My Legs Hurt When I Walk? Understanding Peripheral Arterial Disease

If you’re over 60 and experiencing cramping pain in your calf muscles while walking — pain that eases when you rest — you might have a condition called peripheral arterial disease (PAD).

What Is Intermittent Claudication?

This cramping pain brought on by walking, and relieved by resting, is known as intermittent claudication. It is one of the hallmark symptoms of PAD.

What Causes Peripheral Arterial Disease?

PAD happens when the arteries carrying blood to your legs become narrowed or blocked. This is most often due to atherosclerosis, a buildup of fatty deposits and inflammation in the arteries, similar to what causes heart disease or strokes.Over time, the damaged artery lining (intima) collects fatty cells and platelets, leading to restricted blood flow to the legs.

Risk Factors for Peripheral Arterial Disease

Some risk factors are beyond your control (non-modifiable), while others can be changed (modifiable).

Non-modifiable risk factors:- Being male- Age over 50

Modifiable risk factors:- High blood pressure- Diabetes- Smoking- High cholesterol

Why Do My Legs Hurt When I Walk?

When you walk, your muscles need more oxygen. But if narrowed or blocked arteries reduce blood flow, your legs cannot get enough oxygen to meet this demand. This results in cramping or pain with exercise.

What Are the Risks of PAD?

There are two main complications of peripheral arterial disease:

1. Major adverse limb events — involving the risk of losing toes or even part of the leg. Fortunately, this is rare (about 1 in 100 non-diabetic patients and 1 in 50 diabetic patients over five years).

2. Major adverse cardiovascular events — such as heart attacks or strokes, which are far more common and life-threatening in PAD patients than limb loss.

Peripheral Arterial Disease, Understanding your condition- Managing symptoms effectively- Reducing your risk of heart attack, stroke, or major limb loss

How Can I Reduce My Risks?

Improving walking distance and reducing serious complications are both possible through a combination of lifestyle changes and medical treatment.

- Regular walking and exercise- Healthy diet- Complete smoking cessation- Good blood pressure control- Blood sugar control- Cholesterol control (target total cholesterol < 4.5)

Two medications are recommended for all PAD patients:- Clopidogrel 75 mg once daily (lifelong, as a blood thinner)- High-dose statin (Atorvastatin 80 mg) to reduce stroke or heart attack risk

Is There a Treatment to Improve Walking?

Yes — the National Institute for Clinical Excellence (NICE) recommends a supervised exercise program as the best treatment.Additionally, a medication called Naftidrofuryl Oxalate (200 mg two to three times daily for 3–6 months) may help, but its effectiveness is about 50%.

Getting a Timely Diagnosis

Early diagnosis of PAD is key to protecting your health. A vascular surgeon can diagnose PAD through a clinical examination, pulse checks, and a Doppler test to measure blood flow in your legs.The benefits of early diagnosis include:- Understanding your condition- Managing symptoms effectively- Reducing your risk of heart attack, stroke, or major limb loss

If you would like professional advice or treatment, contact Mr. Devaraj Srinivasamurthy, Consultant Vascular Surgeon, for a specialist consultation.