You probably check your face in the mirror every morning, but rarely look twice at your feet. Most of us only notice them when something hurts. Yet the feet can be one of the earliest places to spot a quiet problem.
Peripheral artery disease, often shortened to PAD, is a narrowing of the arteries that carry blood to the legs and feet.
According to the Centers for Disease Control and Prevention, about 6.5 million Americans aged 40 and older live with it. Many have no idea. Up to 40 percent feel no leg pain at all.
The same narrowing that limits blood flow to the feet is usually happening in other arteries too. The CDC notes that people with PAD are also at risk of coronary artery disease and cerebrovascular disease, which can lead to a heart attack or stroke.
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The five foot signs doctors look for
The first clue is often temperature. The National Heart, Lung, and Blood Institute notes that one foot may feel colder than the other.
If a single foot stays cool while the other feels normal, that difference is worth noticing.
Skin color is the second sign. The NHLBI describes the foot or leg becoming pale, discolored, or blue. A healthy foot has a warm, pinkish tone.
A foot that looks washed out when lying flat, or dusky when hanging down, suggests the small vessels are not getting enough blood.
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The third clue is a sore that will not close. Cuts, blisters and small wounds on the toes or feet may heal slowly or not at all when circulation is poor.
Blood carries the oxygen and immune cells that healing needs. When the supply is cut back, even minor skin injuries can linger for weeks.
The fourth sign is cramping or aching in the calves, thighs or feet that comes on when you walk and eases after a few minutes of rest.
Doctors call this intermittent claudication, which simply means pain that comes and goes with activity. The NHLBI points out that only about one in four people with PAD get it.
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The fifth clue is subtler. According to MedlinePlus, the medical library run by the National Institutes of Health, legs and feet may feel numb at rest and the skin may look pale.
Sores on the toes may be slow to heal and even turn black. Any darkening of the skin on a toe or heel is a reason to see a doctor without waiting.
Why your feet feel it first
The feet sit at the end of the longest blood supply route in the body. When plaque, the waxy buildup inside artery walls, narrows the pipes, the feet feel the shortage before organs higher up.
That is why foot changes can be an early tell for arteries elsewhere.
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The pattern matters because the arteries do not get narrow in just one place. The same process that starves the feet of blood tends to be happening in the heart and the vessels feeding the brain.
The American College of Foot and Ankle Surgeons' Foot Health Facts notes that PAD may indicate more widespread arterial disease. That can affect the brain, causing stroke, or the heart, causing a heart attack.
When to see a doctor
Call your doctor if one foot is cold and the other is normal. See a doctor if the skin on a foot looks pale or bluish, or if a cut or sore has not healed within a couple of weeks.
Calves that cramp when you walk a short distance and settle when you rest are another reason to go in. Numbness or a dark patch on a toe should not wait.
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A simple office test called the ankle-brachial index compares the blood pressure in the ankle with the blood pressure in the arm. It takes a few minutes and can confirm whether the arteries in the legs are narrowed.
This article is made and published by Mie Hermansen, who may have used AI in the preparation.