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Symptoms, Signs & Causes of Poor Circulation


Cold feet? Achy legs? Learn what causes poor circulation and how to get help.

If your legs get tired from walking down the street or your feet never seem to warm up, you might have poor circulation. That means blood isn’t flowing easily through your arteries, an important step in bringing oxygen and nutrients to your limbs. This could be caused by peripheral artery disease, or PAD.

“If someone complains of cold feet or achy legs after walking, we can test blood flow using the ankle-brachial index, which measures the blood pressure in a person’s ankle and compares it to the blood pressure in his or her arm,” says Ehrin Armstrong, MD, an interventional cardiologist and vascular medicine specialist at Adventist Health St. Helena. “Differing blood pressure in your legs and arms might be a sign of PAD.”

PAD occurs when there is a blockage, or buildup of plaque, in the arteries of your legs, reducing blood flow to your extremities.

“In its most extreme form, PAD can even lead to an ulcer on the foot that can’t heal because the limb isn’t getting enough blood flow, which could require amputation,” Dr. Armstrong says.

Dr. Armstrong often recommends aspirin or supervised exercise therapy to reduce PAD symptoms.

“If those conservative measures don’t work, the next step might be to do an angioplasty or stent to improve the blood flow to the legs,” he says. During this procedure, a small tube is inserted in the blocked or narrowed artery to open it.

To prevent or manage PAD, stay active, eat low-cholesterol food and get regular exercise. “Walking is always helpful, even if it’s just a few blocks at a time,” Dr. Armstrong says.

Meet cardiologist Ehrin Armstrong, MD

Ehrin Armstrong, MD, joined the team of expert cardiovascular specialists at Adventist Heart & Vascular Institute in June. Dr. Armstrong is passionate about preventing limb loss in patients with vascular diseases.

“A lot of people don’t realize there are cutting-edge procedures that can prevent amputation,” Dr. Armstrong says. “I’m always trying to educate people and make them aware so we can treat their symptoms early.”

Dr. Armstrong will also serve as medical director of the Adventist Heart & Vascular Institute, a state-of-the-art cardiology center with expertise in a wide range of heart conditions, including arrhythmias, valve disease, heart failure and peripheral artery disease.

Get whole-body care

Talk to the team of experts at Adventist Heart & Vascular Institute about a personalized heart care plan. Visit to learn more.