Narrowing and blockage of the arteries is responsible for the pain of angina and heart attacks, and the majority of strokes. In the same way the arteries in the legs can become narrowed and when this is the case the condition is called peripheral vascular disease (PVD). Pain felt in the legs not only prevents normal daily activities but is also a warning sign that without attention someone may end up losing one or both of them.

Atherosclerosis is the process by which the arteries become narrowed, or "furred up" as it is often described. Smoking, high blood pressure, and high cholesterol all contribute to the development of thick plaques on the inside of the blood vessels that narrow the space available for the blood to flow through.

Other contributing risk factors include diabetes, inactivity, and an unhealthy diet that is high in fat and low in the antioxidant vitamins C and E.

Without a doubt smoking is the most important risk factor for developing PVD. It is believed that the process of atherosclerosis and artery narrowing is almost guaranteed to have begun in anyone who has smoked regularly for more than a few months.

Since the seed of future problems is sewn so early on, stopping smoking is vital if the possible complications are to be avoided. Over the years, after stopping smoking the circulation is likely to improve so fewer attacks of pain occur. If someone is thinking of starting smoking then it's a very good reminder to think again.

But it's not just the pain whilst walking (intermittent claudication) that can cause problems, although this can certainly stop someone from getting on with the every day things such as going to buy a newspaper, things that most people do without thinking and take for granted. Major surgery may be needed to improve circulation in the leg and sometimes, when the blood supply cannot be restored to a limb, it may need to be amputated.

Daily exercise helps by encouraging the development of a collateral circulation. These are smaller new blood vessels that grow to try and provide the muscles with the blood supply they need. Patients are advised to walk until the pain occurs, rest until it disappears, and then to walk again. By doing this in regular cycles the distance someone is able to walk before the pain occurs becomes longer.

Diet should be adapted to ensure that it is low in fat, and has enough of the anti-oxidant vitamins C and E. Eating five portions of fruit and vegetables each day will help to achieve this.

High cholesterol, high blood pressure, and diabetes if present should all be treated to keep them at safe levels so that the risk of further damage to the arteries is reduced.

Aspirin is used on recommendation of the doctor when appropriate as it helps to thin the blood and prevent further clots forming. Other medicines may be used to try and improve the circulation but often their benefits are only minimal. Recently, however, studies have shown that the use of certain herbal treatments can improve poor circulation. Gingko biloba is one of these, and another is a combination of Tibetan herbs that has been shown to increase the distance sufferers can walk before they experience pain. As with any herbal treatments it's important to consult with the pharmacist or doctor as to whether it's safe for an individual to take them, particularly when the individual is taking other medicines prescribed by their doctor or purchased from their pharmacist.

In certain situations it is possible to widen the narrowed part of the artery. This is called angioplasty and is done by blowing up a small balloon in the narrowed portion of the artery. When the narrowing is more extensive and involves more than one part of the artery it may need to be by-passed. This is done with a graft using a vein from the leg or a synthetic material designed specially for this purpose.