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Published on: 2/6/2026

Peripheral Artery Disease: Why Leg Pain in Seniors Is a Sign of Atherosclerosis

Leg pain in older adults that starts with walking and improves with rest is often a sign of Peripheral Artery Disease caused by atherosclerosis narrowing the leg arteries and limiting oxygen to the muscles. This matters because PAD signals plaque elsewhere and raises heart attack and stroke risk, yet it is treatable with lifestyle changes, medications, and sometimes procedures when caught early. There are several factors to consider, including specific symptoms, tests, and warning signs that can change your next steps; see below for the complete details.

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Explanation

Peripheral Artery Disease: Why Leg Pain in Seniors Is a Sign of Atherosclerosis

Leg pain is often brushed off as “just getting older.” Sore calves, aching thighs, or tired legs can seem like a normal part of aging. But in many seniors, leg pain—especially pain that comes on with walking and improves with rest—can be a warning sign of Peripheral Artery Disease (PAD). PAD is most often caused by atherosclerosis, a condition that affects blood vessels throughout the body.

Understanding this connection can help people recognize symptoms early, reduce risks, and take practical steps to protect their health.


What Is Peripheral Artery Disease?

Peripheral Artery Disease is a condition where the arteries that supply blood to the legs and feet become narrowed or blocked. This reduced blood flow means leg muscles may not get enough oxygen, especially during activity.

PAD is common in older adults and is often underdiagnosed because symptoms may be mild at first or mistaken for arthritis, muscle strain, or “poor circulation.”

At the heart of PAD is atherosclerosis.


Understanding Atherosclerosis in Simple Terms

Atherosclerosis is a process where fatty deposits (called plaque) build up inside the arteries. Over time, these deposits:

  • Narrow the artery
  • Make the artery stiff and less flexible
  • Reduce blood flow to organs and tissues

Atherosclerosis does not happen overnight. It develops slowly over many years and can affect arteries in different parts of the body, including:

  • The heart (leading to heart attacks)
  • The brain (leading to strokes)
  • The legs and feet (leading to Peripheral Artery Disease)

When atherosclerosis affects the leg arteries, PAD develops.


Why Atherosclerosis Causes Leg Pain

Leg muscles need more oxygen-rich blood when you walk, climb stairs, or exercise. If arteries are narrowed by atherosclerosis, they cannot deliver enough blood during activity.

This leads to a classic symptom called claudication, which means muscle pain due to poor blood flow.

Typical features of PAD-related leg pain include:

  • Pain, cramping, or tightness in the calf, thigh, or buttock
  • Pain that starts with walking or exercise
  • Pain that improves after resting for a few minutes
  • Pain that returns when walking again

This pattern is a strong clue that atherosclerosis is limiting blood flow.


Why Seniors Are at Higher Risk

Atherosclerosis is more common with age. Years of wear and tear on blood vessels increase the chance of plaque buildup.

Risk factors that are especially common in seniors include:

  • High blood pressure
  • High cholesterol
  • Diabetes
  • Smoking (current or past)
  • Lack of regular physical activity
  • Family history of heart or vascular disease

Even people who feel otherwise healthy can develop atherosclerosis silently. PAD may be the first noticeable sign.


Other Symptoms of PAD Linked to Atherosclerosis

Not everyone with PAD feels classic leg pain. Some people have subtle or unusual symptoms, such as:

  • Leg fatigue or heaviness
  • Slower walking speed
  • Cold feet or toes
  • Numbness or tingling in the legs
  • Poor wound healing on the feet or legs
  • Shiny skin or hair loss on the lower legs

In more advanced cases, pain may occur even at rest, especially at night. This is a more serious sign and needs medical attention.


Why PAD Is More Than a Leg Problem

One important reason doctors take PAD seriously is that it signals widespread atherosclerosis.

If plaque is building up in the leg arteries, it is often also present in the arteries of the heart and brain. This means PAD is linked to a higher risk of:

  • Heart attack
  • Stroke
  • Reduced mobility and independence

PAD itself is not something to panic about, but it is a clear signal that the cardiovascular system needs attention.


How PAD and Atherosclerosis Are Diagnosed

Doctors use a combination of history, physical exams, and simple tests to evaluate PAD.

Common diagnostic steps include:

  • Asking about walking-related leg pain
  • Checking pulses in the feet and legs
  • Measuring blood pressure in the arms and ankles (ankle-brachial index)
  • Ultrasound or imaging studies when needed

If you are unsure whether your symptoms are concerning, you might consider doing a free, online symptom check for Medically approved LLM Symptom Checker Chat Bot to help organize your symptoms before speaking with a healthcare professional.


Managing PAD and Atherosclerosis

While atherosclerosis cannot be completely reversed, it can often be slowed or stabilized. Many people with PAD live active, fulfilling lives with proper care.

Treatment plans may include:

Lifestyle Changes

  • Regular walking programs to improve circulation
  • Quitting smoking, if applicable
  • Eating a heart-healthy diet
  • Maintaining a healthy weight

Medical Management

  • Medications to lower cholesterol
  • Blood pressure control
  • Blood sugar management for diabetes
  • Medications to reduce clot risk

Procedures (When Needed)

  • Minimally invasive treatments to open narrowed arteries
  • Surgery in more advanced cases

Early diagnosis makes treatment more effective and often less invasive.


Why Ignoring Leg Pain Can Be Risky

It is understandable to ignore leg pain, especially if it comes and goes. However, untreated PAD caused by atherosclerosis can lead to:

  • Worsening pain and reduced mobility
  • Chronic wounds or infections
  • Increased risk of heart attack or stroke

Paying attention to leg symptoms is not about being alarmist—it is about being proactive.


When to Speak to a Doctor

You should speak to a doctor if you experience:

  • Leg pain or cramping when walking
  • Pain that improves with rest
  • Cold, numb, or weak legs
  • Non-healing sores on the feet or legs
  • Any sudden or severe leg pain

If symptoms are severe, sudden, or associated with chest pain, shortness of breath, or weakness on one side of the body, seek urgent medical care.


A Balanced Perspective for Seniors

Peripheral Artery Disease and atherosclerosis are common, especially as people age. Having PAD does not mean disaster is inevitable. Many people manage the condition successfully for years.

The key points to remember are:

  • Leg pain can be an early sign of atherosclerosis
  • PAD is often treatable, especially when caught early
  • Addressing risk factors protects not just your legs, but your heart and brain

Listening to your body, getting checked when something feels off, and working with a healthcare professional can make a real difference.


Final Thought

If you or a loved one notice leg pain that seems out of proportion to normal aging, do not ignore it. Consider starting with a free, online symptom check for Medically approved LLM Symptom Checker Chat Bot and then speak to a doctor about anything that could be serious or life-threatening. Early action is one of the most effective tools we have against atherosclerosis and its complications.

(References)

  • * Norgren L, Hiatt WR, Dormandy JA, Nehler MR, Harris KA, Fowkes FG; TASC II Working Group. Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC II). Eur J Vasc Endovasc Surg. 2007 Jan;33 Suppl 1:S1-75. doi: 10.1016/j.ejvs.2006.09.024. PMID: 17161895.

  • * Hirsch AT, Gornik HL. Intermittent claudication and critical limb ischemia: mechanisms of disease and current therapeutics. Am Heart J. 2010 Sep;160(3):413-23. doi: 10.1016/j.ahj.2010.06.007. PMID: 20826252.

  • * Gerhard-Herman MD, Gornik HL, Barrett CB, Barshes NR, Corriere FM, Drachman DE, Fleisher AD, Fowkes FG, Hamburg MS, Kinlay SH, Lookstein AS, Macmillan MJ, McDaniel MD, Misra S, Olin JW, Smith SC Jr, Treat-Jacobson MA, Walsh ME; American Heart Association Council on Peripheral Vascular Disease; American College of Cardiology; American Heart Association Task Force on Clinical Practice Guidelines. 22016 AHA/ACC Guideline on the Management of Patients With Lower Extremity Peripheral Artery Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2017 Mar 21;135(12):e726-e779. doi: 10.1161/CIR.0000000000000471. Erratum in: Circulation. 2017 Sep 12;136(11):e195. PMID: 27852077.

  • * Sigvant B, Wanhainen A, Huhtakangas J, Kragsterman B, Bergqvist D, Björck M, Danielsson B. Peripheral artery disease in older adults: prevalence, diagnosis, and management. Vasc Health Risk Manag. 2018 Sep 20;14:261-267. doi: 10.2147/VHRM.S164102. PMID: 30288015; PMCID: PMC6158229.

  • * Song P, Rudan D, Zhu Y, Chen Y, Zheng P, Wang X, Li M, Yuan S, Tan W, Huang Z, He J. Global and regional prevalence, incidence, and risk factors of peripheral artery disease: A systematic review and meta-analysis. Front Cardiovasc Med. 2024 Jan 15;10:1286694. doi: 10.3389/fcvm.2023.1286694. PMID: 38283733; PMCID: PMC10822601.

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