Peripheral Neuropathy vs. Peripheral Artery Disease

Distinguishing the differences between peripheral artery disease (PAD) and peripheral neuropathy can be challenging because they have similar symptoms and causes. Both conditions can severely impact your quality of life, leading to discomfort and pain in the legs and limitations in mobility. However, with a better understanding and support from medical professionals, you can easily differentiate between the two conditions. Below, we’ll discuss how peripheral neuropathy and PAD differ, exploring their impact on your health and offering guidance on treatment options and pain management.

Peripheral Artery Disease (PAD)

Peripheral artery disease is a vascular condition that results in the narrowing of arteries due to plaque accumulation, which increases the risk of strokes, heart attacks, and amputation. This buildup, consisting of fats, cholesterol, calcium, and other substances from the bloodstream, typically impacts the legs. It is estimated that over 8.5 million Americans aged 50 or above suffer from PAD.

Stages of PAD

PAD is categorized into four distinct stages, each representing the severity of the condition.

• Stage 1 (Asymptomatic): Plaque buildup begins but symptoms often go undetected, usually detected through routine testing.
• Stage 2 (Claudication): Pain and weakness in the legs during physical activity or walking, which likely goes away with rest.
• Stage 3 (Critical Limb Ischemia): Poor blood flow resulting in severe pain at rest or throughout the night.
• Stage 4 (Acute Limb Ischemia): Rapid limb deterioration, causing severe tissue damage that results in a high likelihood of amputation. 

PAD Causes

PAD is generally caused by atherosclerosis, a vascular disease that occurs when fatty plaque builds up in the arteries. However, PAD can be influenced by several risk factors that contribute to the blockage and narrowing of arteries, including the following: 

• Age
• Diabetes
• Family history
• High blood pressure
• High cholesterol
• Obesity
• Race
• Smoking 

PAD Symptoms

Recognizing the signs and symptoms of PAD can make all the difference when it comes to managing your health. Like most medical conditions, PAD gets worse over time, especially if it remains undetected during the early stages. Common signs of PAD include the following: 

• Leg cramps during activity
• Slower hair and nail growth
• Numbness or weakness in the limbs
• Purple or blue skin discoloration 
• Resting foot or leg pain
• Wounds and sores that heal slowly 

PAD Diagnosis

Diagnosing peripheral artery disease typically starts with looking into your family history and a physical examination. If doctors suspect PAD may be present, a selection of tests will be used to confirm the diagnosis, including:

• Ankle-Brachial Index: The ABI test is a minimally invasive exam that compares blood pressure from your lower leg to your arms.

• Angiogram: An angiogram is a technique where a contrast dye is injected into the artery, which produces X-rays to help determine blood flow and locate blockages.
• CT Angiogram: A CT angiogram Creates detailed images of blood vessels in your abdomen, pelvis, and legs using X-rays and contrast dyes. 
• MR Angiogram: A type of MRI that produces cross-sectional images of the arteries without the use of X-rays.
• Duplex Ultrasound: Identifies blockages using sound waves to produce images of the arteries and blood flow.
• Blood Tests: Blood pressure, cholesterol, and glucose are checked to determine if they are elevated, which increases the risk of PAD.

PAD Treatments

PAD treatment focuses on improving blood flow, managing symptoms, and preventing complications. For early-stage PAD, medications, and lifestyle changes can effectively minimize symptoms of PAD. If these options are insufficient, vascular specialists may recommend minimally invasive procedures.

• Lifestyle Changes: Quit smoking, exercise regularly (especially walking), eat a heart-healthy diet, and maintain a healthy weight.
• Medications: A doctor may prescribe antiplatelet agents to reduce the risk of blood clots and cholesterol, and blood pressure medications to lower cholesterol levels and control blood pressure to reduce cardiovascular risk. 
• Minimally Invasive Procedures: These procedures include angioplasty and stenting to widen blocked arteries or an atherectomy to remove plaque buildup. 

Peripheral Neuropathy

Peripheral neuropathy is a condition characterized by damage or dysfunction in the peripheral nerves, which are responsible for transmitting messages between the brain and various parts of the body, such as the skin, muscles, and organs. Research indicates that approximately 2.4% of people are affected by neuropathy, with the prevalence increasing to 8% among older individuals.

Stages of Neuropathy

Peripheral neuropathy can be broken down into 5 stages, which categorize the progression of nerve damage, helping specialists tailor treatment plans to manage symptoms effectively.

• Stage 1 (Early): Mild pain and numbness in hands or feet.
• Stage 2 (Moderate): Pain becomes more consistent and harder to ignore.
• Stage 3 (Advanced): Intense pain, making simple daily tasks suddenly difficult.
• Stage 4 (Severe): Persistent numbness that significantly interferes with mobility. 
• Stage 5 (Critical): Complete loss of feeling that makes it difficult to walk.

Peripheral Neuropathy Causes

Peripheral neuropathy is triggered by a variety of underlying causes, with each playing a distinct role in damaging the nerves. The following are common factors that may increase the risk of developing neuropathy. 

• Diabetes 
• Genetic disorders
• Alcohol use
• Medicines
• Infections
• Autoimmune disease
• Vitamin deficiency 
• Previous nerve damage/injuries

Peripheral Neuropathy Symptoms

During the early stages of peripheral neuropathy, patients may experience symptoms, such as numbness, tingling, or prickling sensations in their toes. These initial indicators are often dismissed since they are manageable and infrequent. As this condition progresses, more noticeable symptoms can include:

• Sharp or burning pain
• Muscle weakness
• Loss of balance and coordination
• Difficulty walking or standing
• Sensitivity to touch
• Changes in skin color
• Constipation or diarrhea
• Dizziness or fainting 
• Heat intolerance

Neuropathy Diagnosis

Diagnosing neuropathy involves various tests to evaluate the severity of your condition and pinpoint its underlying causes. Common methods used for diagnosis include:

• Medical History: Review of family history, past health issues, drinking habits, and exposure to toxins. 
• Neurological Exam: Doctors will check your coordination and balance, reflexes, nerve function, and muscle strength.
• Image Testing: Using techniques like MRI or CT scans to pinpoint any abnormalities and nerve damage.
• Electrodiagnostic Testing: Measures electrical activity in nerves and muscles using nerve conduction studies (NCS) and electromyography (EMG).
• Lab Analysis: Conducting blood tests to help identify underlying conditions such as diabetes or vitamin deficiencies.

Peripheral Neuropathy Treatments

After neurologists and vascular specialists complete the diagnosis, recommended treatment plans will be based on your condition’s severity and specific needs. Since neuropathy isn’t curable, treatment options aim to manage your symptoms and slow their progression, which potentially involves:

• Medications: Pain relievers, antidepressants, and nerve blockers may be prescribed to manage symptoms and improve quality of life.
• Lifestyle Changes: Adopting healthier habits such as dietary changes, regular exercise, and cutting back on smoking or alcohol can help control symptoms.
• Surgical Procedures: In more extreme cases, surgical procedures like nerve decompression or spinal surgery may be recommended to relieve damaged nerves.
• Alternative Treatments: In conjunction with traditional treatments, alternative methods such as physical therapy, acupuncture, and electrical nerve stimulation can provide additional relief.

What’s the Difference Between Peripheral Neuropathy and Peripheral Artery Disease?

Both peripheral neuropathy and peripheral artery disease significantly impact the lower extremities, often resulting in severe pain and impairing mobility. However, the main difference is that PAD affects the arteries and neuropathy affects the nervous system. Despite a few similarities, these conditions differ in several other critical aspects.

• Origin: Peripheral neuropathy develops from damage to peripheral nerves, while PAD originates from narrowed or blocked arteries.
• Progression: Peripheral neuropathy often progresses slowly over extended periods, whereas PAD can progress more rapidly. 
• Cause: Peripheral neuropathy is typically caused by diabetes, autoimmune disease, infections, or injuries, and PAD is primarily caused by atherosclerosis or vascular disease.
• Symptoms: While both can cause similar symptoms, PAD symptoms such as leg cramping and pain are often triggered by physical activity and neuropathy often presents in the feet with numbness or tingling due to nerve damage. 

Take Control of Your Vascular Health Today!

At American Endovascular, we’re here to help you through each step of managing your PAD. We recognize the impact that PAD can have on your life, which is why our team is committed to delivering personalized care to assist you in navigating and overcoming the challenges posed by PAD. 

American Endovascular provides convenient access to expert PAD care through our outpatient vascular centers in New York and New Jersey. So don’t let PAD slow you down, take control of your health by scheduling an appointment with one of our vascular specialists at a location near you today!