What is peripheral arterial disease (PAD) and how does it affect the feet?

Peripheral arterial disease (PAD) is narrowing of arteries in the legs and feet due to atherosclerosis, reducing blood flow. In the feet, PAD causes: cold or pale feet, cramping pain with walking (claudication), poor wound healing, hair loss on lower legs, and in severe cases, tissue death (gangrene). PAD significantly increases risk of foot ulcers and amputation, especially in diabetics.

What are the symptoms of poor circulation in feet?

Symptoms of poor circulation include: feet that are cold or blue/purple, cramping leg pain when walking that resolves with rest (claudication), shiny/thin skin on feet, slow-healing wounds, hair loss on legs and feet, and weak or absent foot pulses. Severe PAD may cause rest pain (pain even without activity) — this is a vascular emergency requiring urgent evaluation.

Can podiatrists treat poor circulation?

Podiatrists are critical in identifying and managing foot complications of PAD, but treatment of the underlying arterial disease requires a vascular specialist. Podiatrists coordinate with vascular surgeons and cardiologists for comprehensive care, manage wounds and skin conditions associated with poor circulation, prescribe appropriate footwear to protect at-risk feet, and monitor patients regularly for early detection of complications.

How is peripheral arterial disease diagnosed?

PAD is diagnosed with: Ankle-Brachial Index (ABI) — comparing blood pressure in ankles vs. arms; Doppler ultrasound to visualize blood flow; CT angiography or MR angiography to map arterial blockages. A simple ABI test can be performed in a podiatry office. Symptoms warranting evaluation include cold feet with no obvious cause, non-healing wounds, or rest pain in legs and feet.

What are the signs of peripheral arterial disease in the feet?

PAD (peripheral arterial disease) symptoms in the feet and legs: claudication (cramping leg pain during walking that resolves with rest); cold or bluish feet; feet that are paler than normal when elevated; feet that become red when dangled (dependent rubbing); slow or absent foot pulses; thin, shiny skin on the legs and feet; slow-growing or absent toenails; hair loss on the legs; and non-healing wounds. PAD is more common in people with diabetes, high blood pressure, high cholesterol, and smokers. A podiatrist can perform ankle-brachial index (ABI) testing.

How is PAD diagnosed?

PAD diagnosis involves: ankle-brachial index (ABI) — compares blood pressure in the ankle to the arm (normal >1.0; PAD <0.9); toe-brachial index for diabetics with calcified arteries (ABI may be falsely normal); vascular Doppler ultrasound; CT angiography or MR angiography for severity mapping; and clinical exam (pulse quality, capillary refill). Balance Foot & Ankle performs ABI testing and works with vascular surgery and cardiology specialists to coordinate comprehensive care for PAD patients in Michigan.

Yes — PAD treatment options: lifestyle changes (smoking cessation most important, exercise therapy — supervised walking programs improve symptoms dramatically); medications (antiplatelet therapy, statins, medications to improve walking distance); angioplasty and stenting (minimally invasive catheter procedure to open blocked arteries); bypass surgery (for severe blockages); and wound care for non-healing ulcers. Early PAD treatment prevents progression to critical limb ischemia (risk of amputation). Balance Foot & Ankle coordinates with vascular surgeons in Livingston and Oakland County.

Does PAD increase the risk of amputation?

Yes — PAD significantly increases amputation risk, especially combined with diabetes. The risk pathway: PAD → reduced blood flow → slow wound healing → non-healing ulcers → infection → gangrene → amputation. About 20% of people with both PAD and diabetes will need an amputation in their lifetime without proper care. The good news: with appropriate treatment, most PAD-related amputations are preventable. Smoking cessation, blood sugar control, foot protection, and regular podiatric care are the most important preventive measures.

What is peripheral arterial disease (PAD) and how does it affect Michigan patients' feet?

PAD is narrowing of arteries supplying the legs and feet, typically from atherosclerosis. In Michigan patients, PAD causes claudication (leg pain walking), cold feet, non-healing wounds, and in severe cases gangrene. Balance Foot & Ankle diagnoses PAD and coordinates treatment with Michigan vascular specialists. Call (810) 206-1402.

How does Balance Foot & Ankle diagnose PAD in Michigan patients?

Balance Foot & Ankle measures the ankle-brachial index (ABI) — a simple non-invasive test comparing blood pressure in the ankle versus arm. An ABI below 0.9 indicates PAD; below 0.4 suggests critical limb ischemia requiring urgent vascular evaluation. We perform this testing at both Howell and Bloomfield Hills clinics. Call (810) 206-1402.

Can Michigan PAD patients heal foot wounds without vascular surgery?

Mild-to-moderate PAD patients can sometimes heal wounds with optimal wound care, offloading, MLS laser therapy, and risk factor modification. Balance Foot & Ankle manages these cases aggressively. Severe PAD with critical ischemia typically requires revascularization before wounds will heal — we coordinate this with Michigan vascular surgeons. Call (810) 206-1402.

What foot care does Balance Foot & Ankle recommend for Michigan PAD patients?

PAD patients in Michigan should receive daily foot inspection, gentle moisturizing, properly fitted protective footwear, avoidance of going barefoot, professional nail and callus care (never self-treat), avoidance of extreme temperatures, and regular monitoring by Balance Foot & Ankle. Call (810) 206-1402.

What PAD-related foot symptoms require emergency care for Michigan patients?

Michigan PAD patients should go to the ER immediately for sudden severe foot or leg pain at rest with pallor and coldness (acute arterial occlusion), rapidly progressing foot infection with fever, blackening or gangrene of a toe. Contact Balance Foot & Ankle at (810) 206-1402 for urgent non-emergency PAD foot issues.

When should I see a podiatrist?

For persistent foot/ankle pain, difficulty walking, numbness, non-healing wounds, skin changes, or deformities. Dr. Biernacki offers same-day appointments. Call 810-206-1402.

Does Dr. Biernacki accept insurance?

Balance Foot & Ankle accepts most major plans including BCBS, Aetna, United, Cigna & Medicare. Call 810-206-1402 to verify coverage. Affordable self-pay options available.

What to expect at your first podiatry visit?

Comprehensive evaluation including history, exam, biomechanical assessment, and in-office X-rays. Same-day diagnosis and treatment when possible. Most visits take 30-45 minutes.

Peripheral Arterial Disease & Your Feet — What Every Michigan Patient Should Know

What Is Peripheral Arterial Disease?

Peripheral arterial disease (PAD) is a narrowing of the arteries that carry blood from the heart to the legs and feet. It’s caused by the same process of plaque buildup (atherosclerosis) that causes heart attacks and strokes — but the consequences show up first in your feet. At Balance Foot & Ankle in Howell and Bloomfield Hills, PAD management is a critical part of the high-risk foot care we provide to Michigan patients.

How Common Is PAD?

PAD affects approximately 8–12 million Americans, with millions more undiagnosed. It becomes significantly more common with age — affecting roughly 1 in 5 adults over age 70. Despite its prevalence, many patients have never discussed PAD with their doctor or podiatrist.

PAD Warning Signs in the Feet

The feet and legs are often the first place PAD becomes noticeable. Warning signs include: leg pain or cramping when walking that goes away with rest (claudication), cold or numb feet, wounds or sores on the feet or toes that won’t heal, changes in foot color (pale or bluish), shiny skin on the legs or feet, slow toenail growth, and hair loss on the legs.

Treatment at Balance Foot & Ankle: Diabetic Foot & Circulation Screening →

In severe cases, patients experience rest pain — burning or aching in the feet at night, often relieved by hanging the leg off the bed (gravity helps blood flow). This is a sign of critical limb ischemia and requires urgent evaluation.

PAD Risk Factors

The most significant risk factors for PAD are smoking (the #1 modifiable cause — smokers have 2-4 times the risk of non-smokers), diabetes, high blood pressure, high cholesterol, age over 50, family history of heart disease or stroke, and being overweight or sedentary.

PAD and Diabetes: A Dangerous Combination

Diabetes and PAD together dramatically increase the risk of foot complications. Diabetes causes neuropathy (loss of sensation) while PAD reduces healing capacity. A patient with both conditions may injure their foot without feeling it, and then lack the circulation needed to heal — creating the perfect conditions for a serious infection or ulcer.

🤝 Coordinated Care: Balance Foot & Ankle + Vassallo Medical Group
Our Howell office works closely with Vassallo Medical Group (3399 E Grand River Ave — just minutes away on the same road) for patients with diabetes, vascular disease, and other systemic conditions. Dr. John Vassallo, MD, board-certified internist and past president of the Livingston County Medical Society, coordinates the medical side while we protect your feet.
📞 (810) 206-1402 | 4330 E Grand River Ave, Howell

⚡ Advanced Technology at Balance Foot & Ankle
✅ MLS Dual-Wavelength Laser — FDA-cleared
✅ EPAT Shockwave Therapy — 80%+ success
✅ 3D-Scanned Custom Orthotics
✅ Toenail Fungus Laser
✅ In-Office X-Ray & Ultrasound
📞 (810) 206-1402 | Howell & Bloomfield Hills

Get Evaluated Before a Problem Develops

If you have risk factors for PAD — especially diabetes, smoking history, or vascular disease — a podiatric vascular evaluation can identify problems before they become emergencies. Call Balance Foot & Ankle: (810) 206-1402. We serve Livingston County from our Howell office and Oakland County from Bloomfield Hills.

Professional Podiatric Care in Michigan: Balance Foot & Ankle’s Comprehensive Services

At Balance Foot & Ankle, Michigan patients receive comprehensive podiatric care across the full spectrum of foot and ankle conditions. Our fellowship-trained podiatrists provide conservative and surgical treatment for all foot and ankle pathology — from plantar fasciitis, bunions, and nail disorders to complex reconstructive surgery, diabetic foot care, and sports injuries. Our clinical approach prioritizes accurate diagnosis, evidence-based treatment selection, and honest communication with patients about realistic outcomes.

We serve patients in Livingston and Oakland counties from two convenient Michigan locations: our Howell office at 4330 E Grand River (serving Brighton, Hartland, Pinckney, Howell, and all of Livingston County) and our Bloomfield Hills office at 43494 Woodward Ave #208 (serving Troy, Birmingham, West Bloomfield, Farmington Hills, and all of Oakland County). Both offices offer in-office X-ray, same-week new patient appointments, and a full range of diagnostic and treatment services. We accept Blue Cross Blue Shield, Aetna, UnitedHealthcare, Cigna, Medicare, and most Michigan insurance plans. Call Balance Foot & Ankle at (810) 206-1402 to schedule your appointment.

Related Treatment Guides

Michigan patients from throughout the region — Livingston County communities including Howell, Brighton, Hartland, Pinckney, and Fowlerville, and Oakland County communities including Bloomfield Hills, Troy, Birmingham, West Bloomfield, Farmington Hills, Pontiac, and Rochester — can access expert podiatric care at Balance Foot & Ankle. Our clinical team is committed to providing the highest standard of foot and ankle care available in Southeast Michigan, from routine preventive care to complex surgical intervention. Call (810) 206-1402 to schedule — we look forward to serving you at our Howell or Bloomfield Hills location.

Medical References & Sources

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Our board-certified podiatrists treat this condition at two convenient locations. Same-day appointments often available.

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Howell Office

3980 E Grand River Ave, Suite 140

Howell, MI 48843

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Bloomfield Hills Office

43700 Woodward Ave, Suite 207

Bloomfield Hills, MI 48302

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Your Board-Certified Podiatrists

Dr. Tom Biernacki, DPM

Board-Certified · FACFAS

Dr. Carl Jay, DPM

Board-Certified Podiatrist

Dr. Daria Gutkin, DPM

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