Got Pain In Your Legs and Feet? Get the Right Diagnosis!

Neuropathy not always the root of nerve issues.

Joy Pape By Joy Pape, RN, BSN, CDE, WOCN, CFCN

You hear so much about peripheral neuropathy that you and even your health care team may think your leg and foot pain is a nerve problem, when in fact it may be a circulation problem, better known as peripheral vascular disease (PVD). There is also a type of PVD called peripheral arterial disease (PAD) that is a common complication of diabetes. Although all are somewhat related, they are different. And, until you know the true cause of your problem, it is almost impossible to get the relief you are looking for.

The word peripheral relates to areas on the outer edge, or periphery. In the case of peripheral neuropathy, it's problems with your nerves outside of your brain and spine. PVD refers to diseases of the your blood vessels outside of your heart and brain. The vessels (arteries) that carry your blood to your stomach, kidneys, arms, and legs narrow, somewhat like a clogging tube or pipe. PAD is a type of PVD.

PAD is commonly seen in the arteries of your pelvis and legs. It is really atherosclerosis of these arteries. The word atherosclerosis comes from the Greek words, athero (meaning gruel or paste) and sclerosis (hardness). Together, these two words stand for a process that builds plaque in your arteries. Plaque is made up of fats, cholesterol, and other things. This plaque then causes the narrowing of your arteries, which then decreases your blood flow. A blood clot can then form from plaque that becomes hardened and break away or rupture. The narrowing of your arteries plus the blood clot further decreases the circulation to your legs and feet causing pain, difficulty walking, and changes in the hair growth and color of your legs and feet. This can also cause sores, ulcers, and changes in your nails. If your circulation is totally blocked, it can even cause gangrene and loss of your legs or feet. That's the bad news.

The good news is you can prevent complications like these by managing your ABCs of diabetes. The American Diabetes Association recommends:

A=Hemoglobin A1C should be < 7%
B=Blood Pressure be less than 130/80mm/Hg
Total Cholesterol < 200mg/dl
Triglycerides < 150mg/dl
HDL >40mg/dl for men, >50mg/dl for women
LDL <100mg/dl

It is important to recognize the symptoms of PAD.

  • Leg pain that doesn't stop when you stop exercising
  • Leg, foot, and toe wounds that don't heal or heal very slowly
  • Changes in the color of your lower legs and feet
  • Thickened toenails
  • Decreased temperature of your lower leg(s) and foot (feet)
  • Gangrene

Since many people who have these symptoms think they are symptoms of arthritis or peripheral neuropathy, it is easily misdiagnosed, then mistreated or not treated at all. If you have any of these symptoms, be an informed patient. Ask if this could be PAD and demand a work-up so you can receive the proper treatment, be comfortable, and keep your legs and feet for a lifetime.


Read Joy's bio here.

Read more of Joy Pape's columns.

NOTE: The information is not intended to be a replacement or substitute for consultation with a qualified medical professional or for professional medical advice related to diabetes or another medical condition. Please contact your physician or medical professional with any questions and concerns about your medical condition.

Last Modified Date: July 08, 2013

All content on is created and reviewed in compliance with our editorial policy.

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by Brenda Bell
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