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General Medical Questions
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Question : My lower leg hurts when I walk. Could it be peripheral artery disease?
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The Trusted Source
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Howard LeWine, M.D.

Howard LeWine, M.D., is chief editor of Internet Publishing, Harvard Health Publications. He is a clinical instructor of medicine at Harvard Medical School and Brigham and Women's Hospital. Dr. LeWine has been a primary care internist and teacher of internal medicine since 1978.

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February 11, 2014
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Peripheral artery disease (PAD) surely is one cause of leg pain. Fatty plaques can build up and harden in leg arteries. The area inside the artery can narrow and slow don't blood flow.

When PAD is the cause of your leg pain, you usually won’t feel any symptoms at rest. Your muscles don’t need much oxygen. So, even slow blood flow is adequate.

That changes when you start walking. Your leg muscles work harder and need more oxygen. But blood flow can’t increase to deliver more oxygen. So, they scream in pain. If you stop walking, and the leg muscles stop working as hard, the pain gradually goes away.

Leg pain from PAD is most often in the calf. But it can be in the upper leg or even in the buttock.

If you do have PAD and you develop leg pain at rest, you must seek medical attention immediately. It could mean that blood supply is completely blocked.

Sometimes people have symptoms similar to PAD caused by nerves that get pinched as they exit the spine. This can happen from a “slipped disc” or arthritis in the spine (called spinal stenosis).

Another cause of leg pain is injury to the leg bones or muscles. The pain can happen at rest. More often, it happens when you first begin to use the leg muscles. Not several minutes after you start using the leg muscles, as is usually true with PAD.

If your symptoms persist, make an appointment with your doctor. He or she will feel the pulses in your feet and legs. Weak pulses can mean PAD.

An even better test for PAD is called an ankle-brachial index (ABI). Pressure measurements are taken in your arms at the elbows and your legs at the ankle. Normally, your leg pressures should be at least as high as your arm pressures. If your pressure in one or both legs is lower than your arm, you likely have PAD.

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