Walking is miraculous medicine. For a common cardiovascular condition, it can help you avoid surgery. But you’ll need some true grit to make it work.

 The condition is peripheral artery disease (PAD), a buildup of plaque in the arteries that feed the legs and arms and the rest of the body. It affects one in 20 people over age 55, is more common in women and frequently hurts—in particular, it can be marked by debilitating leg pain.

 If you have it, your doctor will likely suggest that you get some exercise and will prescribe medications. If that doesn’t help, the go-to treatment usually is revascularization—surgery to insert stents into blocked arteries. It can be effective, but surgery always has risks, entails recuperation and is expensive.

Walking is healthier. The problem, of course, is that if it hurts to walk, you won’t want to do it. But the more you walk, the longer you will be able to walk without pain, according to a recent clinical trial of PAD patients with moderate-to-severe leg pain (claudication).

In addition to standard medical treatment, patients had one of three protocols—revascularization…a supervised exercise program…or no additional treatment (placebo). The exercise program consisted of treadmill-walking sessions three times a week for six months—followed by a year-long maintenance phase in which participants were encouraged through telephone calls to continue exercising.

Results: At the end of the 18-month study, those who got regular care could walk for only a mere 12 seconds, on average, without pain. Those who had stenting could last 3.2 minutes. But the exercisers could walk for five minutes, on average, without pain.

Walking, of course, also improves overall health and quality of life. When you have PAD, it’s not easy…but it’s worth the effort.