The chief symptom of lower extremity PAD is called intermittent claudication. Intermittent claudication is usually caused by a blockage within an artery that interferes with the delivery of oxygen-rich blood to the muscles. Claudication refers to discomfort, pain or weakness in the legs caused by inadequate oxygen supply. Intermittent claudication refers to pain in one or more areas of the legs that comes and goes.

The pain is “intermittent” because it occurs when the muscles require more oxygen during physical activity. The pain most often occurs in the calf, although it can also occur in the foot, thigh or buttock.  Intermittent claudication affects the large muscle groups that are below the actual site of blockage.

Intermittent claudication only occurs during periods of physical activity (e.g., running or walking). When the leg muscles are at rest or under minimal stress, the blood and oxygen supply is sufficient to satisfy the muscles and there is no pain. In some patients, the lack of blood and oxygen supply is severe enough to cause constant pain, usually in the foot, and is called rest pain. In this case, even at rest, not enough blood can be delivered to the tissues in the leg. This pain is usually relieved only by hanging the foot down and is painful enough to wake the patient at night. In severe cases, symptoms may also include gangrene, or tissue death, of the extremities.

Other symptoms of PAD of the lower extremities include: