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The symptoms and signs of arterial disease vs venous disease are very opposite.  Many people, patients and providers alike confuse the difference of the two.


Acute symptoms are easy to remember as they are the 5 P’s.  Pain, Polar aka COLD, Paresthesia, Pallor aka lack of color, and Pulselessness.  On the inside of the ankle bone called the medial malleolus is a place just under the bone and slightly back and on the top part of the foot where your artery pulsates and you can feel the pulse with every oscillation of the heartbeat, if there is a lack of pulse that is of concern.  This is best to be checked by your physician.

With chronic arterial disease claudication is a symptom.  This is when walking a patient experiences pain, or a burning feeling during walking that is eliminated when the patient stops walking.  This is due to a lack of oxygen to the muscles due to possible sclerosis of the arteries.  The pain can be experienced anywhere from the buttocks to the calf area. More often than not the symptoms like deep vein thrombosis, are in one leg also called unilateral.  The skin of the ankle/foot area can sometimes appear shiny, the toenails will be thickened and there will be a lack of hair growth.  Ulcers on the feet, usually found on the tips of toes, in the webspaces between toes, medial side of the big toe . They will have a “punched out” circular appearance with smooth edges, and are more often than not painful.  Sometimes patients will experience pain with the leg in an elevated position, so if sitting or sleeping in a chair reduces the pain to the affected leg this may also be an indication.



Typically for deep venous thrombosis the symptoms are unilateral (one sided) leg pain, swelling and redness.  Acute deep venous thrombosis is concerning depending on the location of the thrombus and if it’s poorly attached to the vein wall which can be visualized by ultrasound.

The risk factors for deep vein thrombosis are 1) Age – typically men over the age of 40 2) Extended bed rest 3) Cancer due to radiation therapy 3) Dehydration 4) Injury and/or surgery 5) Birth control pills 6) History/Family History of DVT 7) Clotting disorders.

Deep versus Superficial Venous Thrombosis

A superficial thrombus is located usually in the great saphenous vein which travels all the way from the groin to the foot on the inside of the leg and/or it’s tributaries which can be varicose and/or spider veins.  Being so close to the surface of the skin it causes the area of the vein to be extremely tender, painful, red, hot and swollen. Sometimes it will feel like there is a cord in the area of the thrombosis.  While this can seem scary, more often than not it is completely fine. The treatments for superficial venous thrombosis is usually heat and/or aspirin.

A deep venous thrombosis is deeper to the surface of the skin so technically you are not able to “feel” a deep vein.  It will cause a number of symptoms and sometimes none.  Usually, a single leg or arm will swell up, look red in color and feel hot to the touch.  Best rule of thumb, if it doesn’t feel right, it is not.  It is beneficial to wear compression hose when traveling especially long distance or extreme altitude change from lower to higher elevations, this reduces the risk for deep venous thrombosis, stay hydrated and do not sit for too long.

Get out walk, run, jog, hike, anything as long as you are not sitting. It is kind and beneficial to your arteries and veins.  If you have any questions feel free to call us and set up a free consultation with Renee Lane, MS, RN, ANP at our office.  She also offers skin laser treatment and laser hair removal.  We also offer vascular screenings at our office where we will screen the carotid artery, the aorta and the lower extremity arteries.

Author Kristen Gallup, RVT

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