Peripheral Artery Disease & Foot Health in Michigan | PAD & Poor Circulation

Quick answer: Peripheral Artery Disease Foot Michigan is a clinical condition that responds to evidence-based treatment when caught early. Symptoms include pain, swelling, and altered function. Diagnosis requires clinical exam, often imaging. Treatment ladder: conservative care first (4-6 weeks), then targeted interventions if needed. Book online, or call (810) 206-1402.

Medically reviewed by Dr. Tom Biernacki, DPM — Board-Certified Podiatric Surgeon — Balance Foot & Ankle, Howell & Bloomfield Township, MI. Last updated April 2026.

Peripheral artery disease (PAD) is the narrowing and hardening of the arteries that supply blood to the lower extremities — most commonly caused by atherosclerosis related to smoking, diabetes, hypertension, hyperlipidemia, and advancing age. PAD affects approximately 8–12 million Americans and is significantly underdiagnosed because its symptoms — leg pain with walking (claudication), rest pain, cold feet, and non-healing wounds — are often dismissed as normal aging or attributed to other causes. At Balance Foot & Ankle in Southeast Michigan, Dr. Tom Biernacki routinely screens for and assesses PAD as part of comprehensive foot and ankle evaluation, particularly in high-risk patients.

How PAD Affects the Foot

The foot is the most distal part of the lower extremity circulation — when arterial inflow is reduced, the foot is the first structure to suffer. Signs of PAD in the foot include: absent or diminished pedal pulses (dorsalis pedis, posterior tibial); cool skin temperature, particularly in the toes; hairless, shiny, atrophic skin; and slow capillary refill. Claudication — cramping leg pain that occurs with walking and resolves with rest — indicates insufficient arterial flow to meet the metabolic demands of exercising muscle. In advanced PAD, rest pain (constant aching in the forefoot at night or when supine, relieved by hanging the foot over the bedside) indicates critical limb ischemia (CLI). CLI is a limb-threatening emergency requiring urgent vascular evaluation. Any foot wound in a patient with PAD heals slowly or not at all without first restoring adequate arterial flow through vascular surgical intervention (angioplasty, stenting, bypass).

Vascular Screening in the Podiatry Office

The ankle-brachial index (ABI) is the primary screening test for PAD performed in the office. It compares the systolic blood pressure at the ankle to the arm, with a ratio below 0.9 indicating significant PAD and below 0.4 indicating critical ischemia. Toe pressures (toe-brachial index, TBI) are more accurate in diabetic patients with calcified non-compressible vessels. Skin perfusion pressure and transcutaneous oxygen measurements (TcPO2) assess tissue oxygenation relevant to wound healing capacity. When these tests suggest significant PAD, Dr. Biernacki coordinates urgent vascular surgery referral — no wound management program can succeed without adequate blood flow, and revascularization is the foundation of diabetic limb salvage.

Foot Care for PAD Patients

Patients with PAD require careful foot care to prevent minor injuries from becoming catastrophic wounds. Key preventive measures include: never trimming calluses, corns, or nails at home without professional guidance; wearing properly fitted therapeutic footwear at all times; keeping feet warm (but never using heating pads, which can burn insensate or poorly perfused skin); daily skin inspection for any breaks, blisters, or color changes; keeping the skin moisturized (but not between the toes, where moisture promotes fungal breakdown); and stopping smoking — smoking is the single most modifiable risk factor for PAD progression, and cessation slows atherosclerosis progression dramatically. Regular podiatric evaluation (every 2–3 months for high-risk patients) allows early detection of developing wounds and avoids the progressive deterioration that leads to amputation.

Frequently Asked Questions

Poor circulation is a serious risk factor for diabetic and non-diabetic foot complications. Contact Balance Foot & Ankle to schedule a vascular screening and foot evaluation with Dr. Biernacki in Southeast Michigan.

Visit Balance Foot & Ankle — Same-Day Appointments Available

Our podiatry team serves patients throughout Michigan including Howell, Brighton, and Bloomfield Township. If you’re dealing with heel pain, ingrown toenails, or a foot injury, we have same-day appointment availability.

Frequently Asked Questions

What causes this condition?

Causes include mechanical stress, biomechanical imbalance, age-related changes, and sometimes systemic disease. Our clinical exam plus imaging identifies the specific driver.

Can it go away on its own?

Mild cases sometimes resolve with rest and supportive footwear. Persistent symptoms past 4-6 weeks rarely resolve without active treatment.

Is surgery required?

Most patients resolve with non-surgical care. Surgery is reserved for refractory cases or structural deformity.