A reliable symptom of peripheral artery disease is leg pain or leg numbness that is relieved by dependency or gravity such as sitting on the edge of the bed with feet hanging over the edge. Early on in PAD, long before ulcers arise, patients first experience exercise-induced pain. In more advanced PAD, patients will begin to experience limb pain when resting at night. In the latest stages, skin ulceration may occur due to a complete lack of oxygen to the skin overlying the bony surfaces. PAD can also present as limb numbness.

How do I tell whether my ulcer is from venous insufficiency or arterial insufficiency? Raising the legs (typically swollen) above the heart helps symptoms of venous insufficiency where lowering the legs off the side of the bed helps the pain of arterial insufficiency. A simple ultrasound performed in our office or a transcutaneous oximetry (TCOM) test can easily identify arterial insufficiency as well as possible coexisting venous insufficiency.