Karen Hearle, BSc Podiatry, MCPod, PhD
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Atherosclerosis (Peripheral Arterial Disease)

Abbey Podiatry • July 8, 2020
What is Atherosclerosis or Peripheral Arterial Disease (PAD)?
Arthrosclerosis is the furring-up and stiffening of the arteries. When this furring-up happens in the arteries of the legs your podiatrist or doctor may call it Peripheral Arterial Disease or PAD for short. Arteries carry the blood containing oxygen and other nutrients needed by your body. The furring-up caused by PAD reduces the flow of blood which reduces the amount of oxygen reaching your feet. As a result, your feet are more likely to need attention to keep them healthy.

Who can get Peripheral Arterial Disease? 
Peripheral Arterial Disease (PAD) is common and your chances of having the disease to some degree increase with age. Up to one in three people over the age of 65 may have some PAD.

What are my chances of getting PAD?
As with all medical conditions the chances of getting the disease depends upon lots of factors, both lifestyle and inherited. As you get older your chances of developing the disease increase, although it is clear that exercise helps to reduce the chances of developing PAD. You are more at risk of developing PAD if you are overweight, smoke or drink alcohol. People with high blood pressure or high levels of cholesterol in their blood have a higher risk of developing the disease. Other medical conditions, for example, diabetes, may also increase your chances of developing PAD.

How can Abbey Podiatry Help?
The good news is that at Abbey Podiatry we screen all new patients for atherosclerosis and check for the first signs of the disease at each appointment. Every time we see you, we check all the major arteries in your foot for a pulse so that we can be sure there is a good blood supply to your feet and that there are no developing issues. Annually we use a Doppler probe to check the blood flow to your feet. The Doppler probe is a non-invasive and painless test which will allow your podiatrist to determine the quality of the blood supply to the whole of your feet and give an early warning of any problems to you and your GP.

How can I tell if I have Atherosclerosis or Peripheral Arterial Disease PAD?
Atherosclerosis or PAD is a progressive disease that needs to be managed through monitoring and appropriate intervention. Your podiatrist keeps records that will alert her to any changes in your foot health.
Your podiatrist will look for the signs of the early stages of PAD such as thickened nails, dry skin or a lack of hair on the foot. She will check to see if you have, a sensation of “pins and needles” or perhaps a degree of numbness or coldness in one or both of your feet. She may ask you if you experience calf-cramping which is relieved by resting, but returns when walking the same distance, a symptom known as “intermittent claudication”.
Since the disease is progressive, at later stages the furring up of the arteries becomes more severe and further symptoms may occur. Your podiatrist will look for temperature differences between your feet, especially if one foot is colder than the other. She will compare the skin colour of the feet to see if one foot appears whiter or redder than the other. She will ask you if you are experiencing “night cramps”, which are relieved by hanging the affected foot down. She will want to know if you have cramping pain when sitting, a symptom known as “rest pain”. 
If you have late stage PAD you may be at risk of the tissue in your feet starting to breakdown forming ulcers. Your podiatrist will check your feet for any signs of ulcers. If you already have ulcers, your podiatrist will dress and help you to manage the healing.
In severe PAD a clot can form in a furred-up artery completely blocking the artery. This is felt as a sudden and extremely painful foot and needs emergency medical treatment to remove the blockage. 

Can Atherosclerosis or PAD be treated?
Prevention of disease is always better than cure. Atherosclerosis is a progressive disease which needs to be managed by a variety of healthcare professionals. Your podiatrist is experienced in monitoring your feet for any changes that could indicate the early stages of atherosclerosis or PAD. She will discuss with you the next steps to take.  
If you have the early signs of arthrosclerosis or PAD, your podiatrist will assess your current physical condition and suggest practical changes you can make to improve the condition and reduce the chances of it worsening.
If you have symptoms of more severe PAD, your podiatrist will advise you to see your GP. Your GP can prescribe statins to lower your cholesterol, or medication to prevent clots; the GP may also consider referring you to a vascular consultant. The vascular consultant may carry out further testing which enables them to see the condition of your arteries. If he finds blockages in some arteries these can be treated by a procedure called angioplasty. The surgeon may carry out bypass surgery as an alternative, a more major surgical procedure than angioplasty.


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