What is the first symptom of peripheral arterial disease (PAD)?

Claudication is recognized as the first symptom of peripheral arterial disease (PAD) due to its characteristic manifestation of muscle pain or cramping that typically occurs in the legs during physical activity, such as walking or climbing stairs. This symptom arises when there is insufficient blood flow to the muscle tissues, primarily because of atherosclerosis affecting the arteries that supply the lower extremities.

Patients with claudication often describe it as a reproducible discomfort that resolves with rest, leading to a distinctive pattern that can help in diagnosing PAD. It is an indicator of functional limitation caused by ischemic muscle, signaling that the body's demand for oxygen exceeds the supply due to narrowed or blocked arteries. While other symptoms of PAD, such as skin ulceration, gangrene, or rest pain, can occur later as the disease progresses, claudication is usually the earliest and most common symptom that prompts individuals to seek medical evaluation.