PERIPHERAL VASCULAR DISEASE Peripheral vascular disease (PVD) is a condition characterized by decreased blood flow in vessels in the legs, and sometimes in the arms causing pain the affected area. It can occur in any blood vessel outside of the heart, but is most common in the limbs and extremities, especially the fingers and toes. Peripheral vascular disease, and the resulting pain caused by insufficient blood flow (ischemic limb pain), has several causes, such as coronary artery disease or atherosclerosis, diabetes or frostbite. Symptoms include numbness, swelling, and sometimes pain, in the affected area. In general, treatment for ischemic limb pain caused by PVD that can not be treated surgically, will follow the chronic pain treatment continuum, and may include spinal cord neurostimulation in selected patients.