For some people, PAD may produce no symptoms at all. Symptoms occur due to limited blood flow to the feet or legs. In the early stages, blood still gets through the blockage but is definitely decreased. So when the muscles of the legs are resting they feel fine. However when you begin to exert those muscles (for instance when you walk) they need more oxygen. Because of the limitations in blood flow from PAD, those muscles do not receive more oxygen and then begin to ache. Symptoms from this blockage usually occur in stages:

Patients describe walking a typical distance (usually 1 block or so) when they feel begin to feel tightness or cramping in the calf or calves. They stop walking and the pain goes away and they are able to begin again. Pain may also occur in the buttocks, hips or thighs. This kind of pain is called claudication.

As the blockage becomes more severe, the blood flow to the legs and feet may be hindered enough to prevent the tissues from getting enough oxygen to survive even when resting. When this happens, the tissues will ache even if you are not walking or exerting yourself. This often begins as pain in your feet while you lie in bed. This pattern of pain is called rest pain. Rest pain represents a potential threat to your leg.

Finally the blockage may be so complete as to cause the tissues of your feet or legs to lack enough oxygen to survive. When this occurs the skin can suffer from non-healing wounds (ulcers), infections, or even gangrene. Such conditions are all forms of limb threat – conditions that can lead to loss of the limb (amputation) if no action is taken.