Pain can be part of daily life for those with peripheral arterial disease. But researchers say it no longer needs to be a part of the treatment.

Approximately 8.5 million people in the United States have PAD, including 12-to-20% of those older than age 60, according to the Centers for Disease Control and Prevention. Around 30% have pain and cramping in their legs when they walk.

Exercise has long been a key component of PAD management, but for many years the standard exercise prescription for these patients has been to “walk towards, and push past, moderate to severe pain,” said study author Edward Lin, of the University of Toronto. While symptoms do indeed improve on this regimen, the problem is that many patients with the disease do not exercise at all, and pain is the likely deterrent, he told the European Society of Cardiology.

Lin’s study, published in the European Journal of Preventive Cardiology, compared completion and adherence rates between traditional versus alternative exercise programs for four weeks. Non-traditional exercise included walking without pain, arm ergometer (an exercise bike for the arms), resistance training, circuit training, lower limb aerobic exercise, and walking with poles.

Completion of the alternative exercise program was 6% higher vs. traditional walking with pain, and adherence (percentage of exercises done) was 8% higher vs. walking with pain, Lin wrote.  

“Walking to pain is effective, but only if patients actually do it. Many clinicians and vascular surgeons still prescribe this type of exercise, but it’s important to consider other types of activity, which have also been shown to work,” Lin said.