Medically Reviewed by Dr. Tom Biernacki, DPM | Double Board-Certified Podiatrist | Last Updated: April 2026

PAD & Circulation Screening in Michigan

Peripheral arterial disease affects 1 in 14 American adults—and most don’t know they have it. Early detection through a simple, painless screening can prevent serious complications including heart attack, stroke, and limb loss. Our board-certified podiatrists use the gold-standard Ankle-Brachial Index (ABI) test to identify circulation problems before they become emergencies.

1 in 14 US Adults Has PAD—And Most Don’t Know It

Peripheral arterial disease silently narrows the arteries that carry blood to your feet and legs. Without screening, PAD can lead to heart attacks, strokes, and in severe cases, amputation. The good news: early detection through a simple, painless test can prevent these life-altering complications. If you have risk factors—diabetes, high blood pressure, high cholesterol, or a smoking history—screening is critical.

Watch: Best Shoes for Diabetics (PAD & Circulation)

Dr. Tom Biernacki, DPM explains the clinical basics — then covers what we do differently in our Howell and Bloomfield Hills clinics. Subscribe on YouTube for weekly walkthroughs.

What Is Peripheral Arterial Disease (PAD)?

Peripheral arterial disease occurs when plaque builds up inside arteries that supply blood to your legs and feet—a condition called atherosclerosis. This buildup narrows the blood vessels, reducing blood flow and oxygen delivery to your lower extremities. Over time, this can cause pain, numbness, slow-healing wounds, and in severe cases, tissue death (gangrene) requiring amputation.

PAD is not just a foot problem—it’s a marker of systemic cardiovascular disease. People with PAD have significantly higher rates of heart attack and stroke. In fact, if you have PAD in your legs, there’s a good chance plaque is building up in your heart and brain arteries too.

The same risk factors that cause heart disease cause PAD: smoking, diabetes, high blood pressure, high cholesterol, family history of heart disease, and advanced age. Early screening and aggressive risk factor management can slow PAD progression and prevent life-threatening complications.

Warning Signs of Poor Circulation

If you notice any of these signs, schedule a circulation screening immediately:

• Cold feet or legs even in warm weather or indoors
• Leg pain, cramping, or fatigue when walking (claudication) that resolves with rest
• Wounds or sores on feet that heal slowly or don’t heal
• Shiny, smooth skin on lower legs with loss of normal texture
• Hair loss on legs and feet
• Weak or absent pulse in the feet or ankles
• Pale or bluish skin color in lower extremities

Who Should Be Screened for PAD?

The American Heart Association recommends PAD screening for these groups:

• Anyone over 50 with diabetes
• Anyone over age 65
• Current or former smokers ages 50–69
• People with high blood pressure or high cholesterol
• Those with family history of peripheral or cardiovascular disease
• Patients with slow-healing wounds or foot problems
• Diabetic patients at any age

Even without symptoms, if you fall into any of these categories, screening is strongly recommended. PAD often progresses silently—symptoms may not appear until significant blockage has developed.

The ABI Test: Quick, Painless, Potentially Life-Saving

The Ankle-Brachial Index (ABI) test is the gold standard for screening peripheral arterial disease. It’s simple, non-invasive, and takes only 15 minutes. Here’s what happens:

• Blood pressure measured in both arms and both ankles using a standard cuff and ultrasound Doppler probe
• ABI calculated by dividing ankle systolic pressure by arm systolic pressure
• Results available immediately with detailed interpretation
• Completely painless with no needles, dye, or radiation

ABI Interpretation Guide:

Our Partnership with Vassallo Medical Group

When circulation screening reveals PAD or other vascular concerns, Balance Foot & Ankle Specialists works closely with Vassallo Medical Group in Howell and board-certified vascular surgeons throughout Livingston and Oakland Counties. This coordinated approach ensures you receive comprehensive care—our team manages foot health while vascular specialists address underlying arterial disease. You don’t have to navigate the healthcare system alone.

⚠️ Don’t Ignore Cold Feet or Slow-Healing Wounds

A 15-minute PAD screening could detect a serious vascular problem before it becomes a crisis. If you notice circulation problems, don’t wait. Schedule your screening today.

Book Today — Same-Day Appointments Available

Schedule your circulation screening at Balance Foot & Ankle Specialists. Our board-certified podiatrists can typically see you within days.

Call us: (810) 206-1402

What Happens During a PAD Screening at Our Office

Here’s the step-by-step process when you come in for circulation screening:

1. ABI Measurement

Blood pressure cuffs are placed on both arms and both ankles. A handheld ultrasound probe (Doppler) detects blood flow in the ankle arteries. The pressure readings are recorded and compared—taking about 10-15 minutes with zero discomfort.

2. Skin & Nail Assessment

We examine your feet and lower legs for signs of poor circulation: skin color changes, temperature differences, hair loss, shiny or smooth texture, toenail changes, and wound healing ability. These visual clues often correlate with ABI findings.

3. Pulse Assessment

We manually check pulses in the posterior tibial artery (inside ankle) and dorsalis pedis artery (top of foot) to detect weak or absent pulses—another sign of reduced blood flow.

4. Results & Next Steps

Results are available immediately. If your ABI suggests mild-to-moderate or severe PAD, we discuss findings and coordinate a referral to a vascular surgeon or cardiologist for further evaluation and treatment planning. If results are normal or borderline, we discuss lifestyle modifications to reduce cardiovascular risk.

Frequently Asked Questions About PAD Screening

🧦 Dr. Tom’s Pick: DASS Medical Compression Socks

Dr. Tom Biernacki recommends medical-grade compression socks for patients with poor circulation. DASS compression socks feature:

• Medical-grade 15-20 mmHg graduated compression
• Improves blood flow and reduces swelling
• Moisture-wicking, breathable fabric
• Comfortable for all-day wear

Affiliate disclosure: This link is a sponsored Amazon link. We may receive a small commission if you purchase through this link, at no extra cost to you.

Related Foot & Circulation Treatments

Ready to Check Your Circulation?

Don’t wait for symptoms to become serious. Schedule a painless, non-invasive PAD screening today.

(810) 206-1402

Visit Balance Foot & Ankle Specialists

Board-Certified Podiatrists

Medical References

This page is based on clinical evidence and guidelines from leading medical organizations. The information presented reflects current best practices in vascular screening and podiatric medicine.

• Criqui MH, Aboyans V. Epidemiology of peripheral artery disease. Circ Res. 2015;116(9):1509-1526.
• Gerhard-Herman MD, et al. 2016 AHA/ACC Guideline on the Management of Patients With Lower Extremity Peripheral Artery Disease. Circulation. 2017;135(12):e726-e779.
• Aboyans V, et al. Measurement and Interpretation of the Ankle-Brachial Index: A Scientific Statement From the American Heart Association. Circulation. 2012;126(24):2890-2909.
• American Diabetes Association. Peripheral Arterial Disease in People With Diabetes. Diabetes Care. 2003;26(12):3333-3341.
• Hirsch AT, et al. Peripheral Arterial Disease Detection, Awareness, and Treatment in Primary Care. JAMA. 2001;286(11):1317-1324.