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  • Writer's pictureTina Dang

Understanding Peripheral Arterial Disease and Its Impact on Feet


Peripheral arterial disease (PAD) is a common circulatory condition affecting millions worldwide. It occurs when there is a narrowing or blockage of the blood vessels responsible for supplying oxygen-rich blood to the legs and feet. PAD can significantly impact foot health, leading to various complications. Podiatrists play a crucial role in the early intervention; assessment and management of PAD. In this blog post, we will explore peripheral arterial disease and delve into how podiatrists can aid in its diagnosis and treatment.


Understanding Peripheral Arterial Disease:


  • Peripheral arterial disease is primarily caused by atherosclerosis, a condition characterised by the build-up of fatty deposits (plaques) in the arteries, leading to reduced blood flow.

  • Common risk factors for PAD include smoking, diabetes, high blood pressure, high cholesterol, obesity, and a sedentary lifestyle.

  • As the disease progresses, individuals may experience symptoms such as leg pain, cramping, numbness, weakness, and difficulty walking. The feet are particularly vulnerable due to their distance from the heart, making them more susceptible to inadequate blood supply and related complications.


Impact on the Feet


When peripheral arterial disease affects the feet, it can lead to a range of foot-related problems. These include:

  1. Foot Pain: Reduced blood flow to the feet can result in persistent pain, particularly during physical activity. This pain, known as intermittent claudication, often manifests as a cramping sensation in the calf muscles, usually within 200 meters of walking. It typically subsides with rest and returns during activity. Sometimes, more severe cases of PAD also get pain in their calves or legs during rest or in their sleep.

  2. Non-Healing Wounds and Ulcers: Inadequate blood supply slows down the healing process, making it difficult for wounds and ulcers to heal properly. This can result in chronic, non-healing wounds, particularly in areas that are prone to pressure, such as the heels or toes. Without timely intervention, these ulcers can lead to infection and tissue damage.

  3. Changes in Skin and Nail Health: Poor blood flow to the feet can cause the skin to become dry, thin, and shiny. The nails may become brittle, thickened, or grow at a slower rate. Skin colour changes, such as paleness or bluish discoloration, may also be observed.


Doppler Ultrasound Assessments:


Podiatrists play a critical role in diagnosing and managing peripheral arterial disease in the feet. One of the essential tools we use is Doppler ultrasound assessment. Doppler ultrasound uses sound waves to evaluate blood flow through the arteries and identify any blockages or abnormalities. It helps podiatrists determine the severity of arterial narrowing or occlusion in the feet.



During a Doppler ultrasound assessment, the podiatrist places a handheld device, known as a Doppler probe, on various points of the feet. The probe emits sound waves that bounce off blood cells and create a waveform, which is then interpreted by the podiatrist. This non-invasive test allows for quick and accurate evaluation of blood flow, helping to guide treatment decisions.

A podiatrist is doing a doppler ultrasound assessments
A podiatrist is doing a doppler ultrasound assessments

Podiatry Intervention:

Podiatrists can offer various interventions to manage peripheral arterial disease and its effects on the feet. These interventions may include:

  1. Foot Care and Education: Podiatrists can provide comprehensive foot care guidance, emphasising the importance of maintaining good foot hygiene, moisturising the skin, and protecting the feet from injuries. They can also educate patients about the warning signs of complications and the need for regular foot examinations.

  2. Wound Care: Podiatrists are skilled in managing non-healing wounds and ulcers associated with peripheral arterial disease. They can debride and dress wounds, recommend offloading techniques, and utilise advanced wound care modalities to promote healing.

  3. Vascular Referral: In cases where arterial blockages are severe or require further intervention, podiatrists can refer patients back to the general practitioner or a vascular specialist for further evaluation and management.

Conclusion:

Peripheral arterial disease can significantly impact foot health, leading to pain, non-healing wounds, and other complications. By offering early diagnosis, effective treatments, and ongoing foot care, podiatrists play a vital role in improving the quality of life for those affected by this condition. If you suspect you have peripheral arterial disease or are experiencing foot-related symptoms, it is essential to seek the expertise of a podiatrist for proper evaluation and management.

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