Leg pain while walking is a complaint I hear almost every day. Many patients are told it is “just nerve pain” or “age-related.” Sometimes that is correct. However, in a significant number of cases, the pain is due to reduced blood flow to the legs, a condition called Peripheral Arterial Disease (PAD). The challenge is knowing the difference early.
In my clinical practice at Trinity Hospital and Heart Foundation, I focus on identifying whether pain is coming from nerves, joints, or circulation—because the treatment paths are completely different.
What Is Peripheral Arterial Disease (PAD)?
PAD occurs when arteries supplying blood to the legs become narrowed due to plaque buildup. As a result, muscles do not receive enough oxygen during activity. This causes pain, cramping, or heaviness while walking, which typically eases with rest.
PAD is common in people with:
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Diabetes
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Smoking history
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High cholesterol
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High blood pressure
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Age above 50
Many patients have PAD without realizing it.
How Blood Flow-Related Leg Pain Feels (Claudication)
When pain is caused by reduced circulation, it has a characteristic pattern:
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Starts after walking a fixed distance
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Felt commonly in the calf, sometimes thigh or buttock
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Relieved within minutes of resting
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Returns again with walking
This pattern is very different from nerve-related pain.
How Nerve Pain Feels (and How It Differs)
Nerve-related leg pain usually:
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Radiates from the lower back or hip
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Can occur even at rest
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Feels like burning, tingling, or electric shocks
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Is not consistently related to walking distance
Understanding this distinction helps avoid months of incorrect treatment.
Why PAD Is Often Missed
PAD is underdiagnosed because:
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Symptoms appear gradually
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Pain disappears with rest
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Many patients attribute it to fatigue or arthritis
However, PAD is not just a leg problem. It is a marker of overall vascular health and may coexist with heart or brain vessel disease.
How I Evaluate Leg Pain While Walking
My approach is structured and objective:
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Symptom pattern analysis – walking distance, recovery time
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Pulse examination – feet and ankle pulses
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Ankle-Brachial Index (ABI) – a simple test comparing arm and ankle blood pressure
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Doppler scan (if needed) – to assess blood flow and blockages
These steps help confirm whether pain is vascular or non-vascular.
When PAD Needs Attention
PAD should not be ignored if:
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Walking distance is progressively reducing
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Pain limits daily activity
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There are skin color changes or slow-healing wounds
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Diabetes or smoking history is present
Early identification allows non-surgical management in many cases.
Can PAD Be Managed Without Surgery?
Yes, in early stages. Management may include:
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Lifestyle modification
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Supervised walking programs
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Medical management for circulation and risk factors
Advanced cases may need endovascular or surgical treatment, which is decided after proper evaluation.
Frequently Asked Questions
Is leg pain while walking always due to poor circulation?
No. It can be due to nerves, joints, or muscles. The pattern of pain helps identify the cause.
Can PAD affect only one leg?
Yes. Blockages can be unilateral, especially in early disease.
Does resting relieve PAD pain?
Typically yes. Pain improves within minutes of stopping activity.
Who should get checked for PAD?
People with diabetes, smokers, or those with consistent walking-related leg pain.
A Clinical Note
If leg pain repeatedly limits walking or daily activity, understanding its cause early helps prevent progression. I consult at Trinity Hospital and Heart Foundation, Basavanagudi, where vascular evaluation is available in a structured clinical setting.
For consultation availability, Call or WhatsApp via the hospital profile.
Next in this series:
Varicose Veins: Surgery vs Laser vs Glue – Which Option Is Right and How I Decide