Symptoms of peripheral vascular disease (PVD) in the foot include pain, cramping, and tingling. Treatment can slow progression and includes lifestyle changes, medication, and surgery.

PVD, also known as peripheral artery disease (PAD), occurs when the blood vessels thicken or harden, leading to limited or blocked circulation.

PVD affects an estimated 8.5 million people in the United States and usually occurs in people older than 50 years.

This article discusses PVD symptoms, causes, treatment, and possible complications.

PVD causes symptoms in the legs and feet. Symptoms include:

  • tingling
  • cramping
  • weakness
  • pain
  • foot wounds that heal slowly or not at all
  • diminished or absent pulse in the foot or ankle
  • numbness
  • shiny skin
  • leg muscle shrinkage
  • a foot or lower leg that is noticeably cooler, bluer, or paler than the rest of the body
  • slow toenail or leg hair growth

Symptoms typically worsen during exercise because the body’s tissues need increased blood flow. Some of these symptoms may be less noticeable when a person is at rest.

The most common cause of PVD is atherosclerosis, which is the accumulation of fatty plaque in a person’s blood vessels.

Risk factors that increase a person’s likelihood of developing atherosclerosis include:

PVD treatment can depend on the severity of a person’s condition, the symptoms they have, and whether they are experiencing complications.

Lifestyle changes

The following lifestyle changes can ease PVD symptoms and reduce the risk of complications:


Doctors can prescribe medications to help treat PVD.

Drugs such as angiotensin ll receptor blockers and angiotensin-converting enzyme inhibitors lower blood pressure and relax blood vessels to keep them from narrowing.

Statin medication lowers blood fat and cholesterol, which can slow the accumulation of vascular plaque.

Antiplatelet and anticoagulant medication reduces the risk of heart attack and stroke by preventing blood clots from forming.

Doctors commonly prescribe cilostazol, a vasodilator medication, when PVD causes pain with walking. This medication helps dilate the vessels and allows more blood flow to the extremities.


The following surgical treatments are available for PVD.

  • Angioplasty: This surgery widens blood vessels using a catheter with an inflatable balloon to flatten plaque. Doctors can also insert stents to reduce the risk of blood vessels becoming narrow again.
  • Bypass: This type of surgery removes the blocked portion of the blood vessel and replaces it with a healthy section of blood vessel from another part of the body.
  • Atherectomy: This surgery allows doctors to remove blood vessel plaque using a catheter with a rotating shaver tip.

PVD complications may arise from inadequate blood supply to vital organs or limbs. They include:

  • reduced mobility
  • stroke
  • heart attack
  • erectile dysfunction in males

Critical limb ischemia (CLI) is a serious complication that is difficult to treat. It happens when there is severely reduced blood flow to the legs. CLI can cause the following symptoms:

  • persistent and severe burning pain in the legs and feet
  • pale, shiny, smooth, and dry skin
  • wounds or sores on the legs that do not heal
  • loss of muscle in the legs
  • skin on the legs and feet becoming cold and numb, turning red then black — which may be difficult to see on dark skin — and producing smelly pus, which indicates gangrene

CLI can lead to leg or foot amputation or even death.

Treatment can reduce the risk of experiencing PVD complications.

Below are answers to some common questions about PVD in the feet.

Should you walk with peripheral artery disease?

Although people with PAD should check with their doctors before starting a new exercise program, walking is generally safe.

In a 2022 study, one group of participants with PAD walked for exercise at a comfortable pace without inducing ischemic leg symptoms, such as pain. Another group walked for exercise at a faster pace, which induced these symptoms.

At 4-month and 6-month follow-ups, the people in the faster-pace group had increased their walking speed. The participants in the slower group had decreased their walking speed during daily life and worsened their physical performance score.

Should you wear compression socks if you have peripheral artery disease?

People with severe PAD may not be able to wear compression socks as the socks can reduce blood flow to the leg. A vascular specialist can evaluate a person’s PAD to determine whether they can safely wear compression socks.

How quickly does peripheral artery disease progress?

The rate at which PAD progresses can vary between individuals. Overall health, PAD severity, and treatment adherence are some of the factors that influence the disease’s progression.

What is the best sleeping position for peripheral artery disease?

A person can ask a doctor to recommend a sleep position based on their condition.

Options to try include:

  • back sleeping
  • back sleeping with leg elevation
  • side sleeping with a pillow between the knees

When side sleeping, a person should avoid the fetal position since it may reduce circulation.

A person should contact a doctor right away if they experience:

  • a worsening coldness, numbness, blueness, or paleness of a limb or foot
  • chest pain and shortness of breath
  • persistent leg pain that does not go away with rest
  • leg swelling, heat, or redness, which may be difficult to see on dark skin
  • new sores
  • signs of infection, such as fever or a feeling of illness

Factors such as treatment status, disease severity, and a person’s cardiovascular health can influence the outlook for PVD.

In people who have had PVD for 5 years, around 80% will have stable symptoms, and only 1–2% will experience CLI.

Around 20–30% of people with PVD will die within 5 years of developing the condition. Around 75% of these deaths are from cardiovascular disease.

PVD occurs mainly in people over 50 years. Other risk factors include tobacco use, diabetes, and high blood pressure.

Symptoms of PVD include pain, numbness, tingling, and paleness of the affected foot or limb.

Lifestyle changes are critical to preventing PVD from worsening. Medication and surgical intervention can reduce a person’s risk of complications.