Easing Peripheral Artery Disease Pain, One Step at a Time

Jenny Nothaft doesn't take a single step for granted.

A simple act for most, walking was once extremely painful for the 76-year-old, but it ultimately proved to be the best medicine.

ASK ALEXA: Add the Michigan Medicine News Break to Your Flash Briefing

The reason? Nothaft has peripheral artery disease (PAD), which occurs when plaque builds up in the arteries and prevents blood from getting to the muscle and tissue.

She's also a poster child for nonoperative PAD treatment, says Michigan Medicine vascular surgeon Jonathan Eliason, M.D.

That's because a strong commitment to lifestyle changes, including walking, is key for helping PAD patients improve their health, according to Eliason.

The fact that Nothaft quit smoking years ago is also an important part of her journey — one that she's happy to share with other PAD patients. Adopting healthful habits is hard work, she admits, "but with perseverance, you can do it."  

Signs and risks of peripheral artery disease

Nearly 12 million people in the United States have PAD. This plaque buildup can occur in arteries throughout the body, although it is most commonly found in the legs.

MORE FROM MICHIGAN: Sign up for our weekly newsletter

PAD is typically associated with calf pain that occurs with activity and subsides when the activity ends. Other symptoms include numbness or loss of sensation in the affected limb, sores that heal slowly or not at all, and foot pain at rest.

Although it isn't life-threatening, PAD can impact quality of life. It can also be a warning sign of a more serious condition such as coronary artery disease (affecting the heart) or cerebrovascular disease, which can cause stroke.

PAD is diagnosed with a noninvasive ankle-brachial pressure index, a test that measures the difference between the systolic blood pressure in the arms and ankles.

Ways to improve PAD symptoms

Eating a healthy diet and controlling blood pressure and cholesterol are lifestyle changes that can improve PAD symptoms, along with regular exercise (particularly walking) and smoking cessation.

People with PAD often don't get enough blood flowing to their leg muscles, resulting in leg pain during exercise. But increasing the amount of walking can train the muscles to work with less oxygen, essentially functioning better with reduced blood flow.

"This is why the government now reimburses for supervised exercise therapy for symptomatic PAD," Eliason says.

Smoking plays a significant role in PAD initiation and progression because it causes dysfunction of the lining of the arteries as well as chronic inflammation that can lead to plaque formation, Eliason says.

"This raises an individual's risk for PAD, along with other conditions such as high blood pressure and high cholesterol," he notes.

Taking steps toward better health

Nothaft began experiencing PAD-related pain in her legs nearly 15 years ago, but she tried not to let it deter her from her daily walks.

SEE ALSO: Good News: Exercise Doesn't Have to Be as Long (or as Painful) as You Think

Eventually, however, she found herself experiencing more and more pain while walking for even brief periods of time, putting a damper on her exercise routine.

At the recommendation of Eliason, Nothaft recently took up walking again, increasing her distance and the time she spent on the treadmill.

Quitting smoking 25 years ago was also important in Nothaft's recovery efforts. Her secret? "I told myself I could have a cigarette in a year, then after that year, I put off having a cigarette for another year." After a few years, Nothaft says she knew she had kicked the habit for good.  

As she discovered, lifestyle changes — including "walking through the pain" — relieved her PAD symptoms and greatly improved her quality of life.

"I increased my walking from one hour to two hours a day, and the pain has subsided, without medication," Nothaft says, noting that she prefers using a treadmill and that her husband helps keep her accountable.

Nothaft is monitored annually with a clinic visit, a symptom questionnaire and ankle-brachial pressure measurements.

Her advice to others seeking to get more active: "You just have to keep doing it, even if you have to stop to stretch or rest for a while.

"The walking has really helped me to maintain a regular lifestyle."