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Neuropathy Or PAD? How To Know The Difference

One of the questions we’re often asked by patients is “Do I have Neuropathy or PAD?

Patients with diabetes often face two common complications: neuropathy and peripheral artery disease (PAD). In fact, around 1 in 10 Americans over the age of 30 experience some form of neuropathic pain while more than 12 million Americans are living with PAD.

We’ve put together an informative overview explaining the differences between neuropathy and PAD, so let’s dive in and take a closer look.

What are neuropathy and PAD?

In a nutshell, neuropathy involves nerve damage, typically in the feet and hands, while PAD restricts blood flow to the limbs. Although these conditions share some similarities, their underlying causes are distinct.

The causes of neuropathy and PAD

Neuropathy, also called diabetic peripheral neuropathy, arises from damage or malfunction in the peripheral nerves that communicate between the central nervous system and the body. This condition is often caused by prolonged high blood sugar levels associated with diabetes, but it can also result from infections, autoimmune diseases, and genetic predispositions.

On the contrary, peripheral artery disease (PAD) develops when arteries supplying blood to the lower limbs narrow or block. Atherosclerosis, the buildup of plaque in arterial walls, is its primary cause. Common PAD risk factors include diabetes, smoking, hypertension, and high cholesterol. Additionally, being overweight or elderly raises the risk of developing this condition.

Recognizing the symptoms

Neuropathy primarily produces sensory symptoms due to impaired nerve signal transmission. Common symptoms include numbness, tingling, burning pain, or a loss of sensation in the feet and legs. This discomfort usually starts in the toes and gradually moves upward into the legs and arms. Neuropathic pain and discomfort often persist even during periods of rest, unaffected by physical activity or exercise.

PAD symptoms stem from reduced blood flow and oxygen supply to the affected regions, resulting in leg pain, cramping, fatigue, and slow-healing wounds or ulcers. Unlike neuropathy, PAD discomfort is often triggered by physical activity or exercise and tends to subside with rest. This pattern, known as intermittent claudication, is a key symptom of PAD.

One significant contrast between neuropathy and PAD lies in their onset and progression. Neuropathy typically starts gradually, with symptoms advancing slowly over time. If left untreated, nerve damage can worsen progressively. On the other hand, PAD symptoms can emerge gradually or suddenly, depending on the severity of arterial blockage. The condition may accelerate if underlying atherosclerosis worsens.

Do I have neuropathy or PAD? Seeking a diagnosis

Seeking medical attention is essential due to the complexities involved in diagnosing neuropathy and PAD. Early detection and intervention can significantly improve outcomes for both conditions. Regular visits to your medical provider, especially for individuals with risk factors like diabetes, high blood pressure, or a history of smoking, are vital for timely identification and management.


To diagnose neuropathy, your doctor will examine you, assess your symptoms, and review your medical history. They may also conduct a neurological assessment and order specialized tests like nerve conduction studies to evaluate nerve function.

Peripheral arterial disease

For PAD diagnosis, a doctor will perform a physical examination, discuss your medical history and evaluate risk factors. They may also utilize non-invasive tests to confirm the diagnosis and evaluate its severity. These tests include:

Having both neuropathy and PAD simultaneously is possible and can lead to more severe symptoms and complications. Neuropathy's reduced sensation may mask PAD-related pain, delaying diagnosis and increasing complication risks. Moreover, PAD's impaired blood flow can exacerbate nerve damage in individuals with neuropathy, further compromising limb health.

Treatment options for neuropathy

Regular collaboration among healthcare providers, including neurologists, vascular specialists, and diabetic foot care podiatrists, is vital for optimizing treatment and reducing complications from both neuropathy and PAD.

While neuropathy has no cure, treatment aims to manage symptoms, provide pain relief, and slow its progression to prevent further nerve damage. Your medical provider may suggest the following:

Treatment options for PAD

Treatment options may include:

Possible complications of ignoring neuropathy or PAD

Untreated neuropathy and PAD can result in severe complications that impact health and well-being. These include:

Don’t risk the health of your legs and feet

If walking has become challenging due to PAD or neuropathy, it's advisable to undergo testing. At MINT STL, we offer minimally invasive treatments for peripheral artery disease. If you're unsure whether neuropathy or PAD is the cause of your leg pain, our specialists can assist you. Call us or schedule a consultation online.

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