Claudication
What is it?
Claudication is a cramping pain in the calf or thigh muscle. Intermittent claudication comes and goes, and is triggered by walking or exercising. The pain goes away upon resting, and takes about the same amount of time to occur and go away each time. The word “claudication” has its roots in the Latin word “claudicare”, which means “to limp.” When claudication is caused by a blocked leg artery, the pain occurs even at rest.
Who gets it?
People who have high blood pressure, diabetes, or high cholesterol, as well as those who smoke cigarettes, are at a higher risk for claudication. It also tends to affect the eldery. It affects only 1 to 2 percent of those under the age of 60, 3 to 4 percent of people between the ages of 60 and 70, and over 5 percent of those over 70. Intermittent claudication is more common in men than women. People with atherosclerosis (fatty deposits under the inner lining of the arterial wall) in other arteries in the body are also more likely to experience claudication, as are those who have had a heart attack or stroke.
What causes it?
Claudication occurs because too little blood is flowing to the muscle. Sometimes, because of age or risk factors for
atherosclerosis, an artery narrows, which reduces the amount of blood that can get through. Narrowing of the artery usually occurs gradually, so the pain is intermittent at first. Because the muscle needs more blood and the oxygen it carries during exercise, the pain occurs then. As you rest, the muscle’s need for blood lessens, and the pain goes away.
What are the symptoms?
With intermittent claudication, the calf muscles hurt during physical activity, especially walking. Walking faster or up a hill makes the pain occur faster and more severe. You may also feel the pain in the foot, thigh, hip, or buttocks, depending upon the location of the narrowed arterey. A few minutes of resting will usually relieve the pain, but it will occur again after covering the same distance. As the leg artery becomes narrower, the distance you can walk without pain becomes shorter. In severe cases, the pain occurs even at rest, is worse when the leg is elevated, and interrupts sleep. Complications include sores on the toes, heel, or lower leg; muscle shrinkage; and gangrene (tissue death).
How is it diagnosed?
Your doctor will evaluate your symptoms and check the pulses in the arteries in your legs. A narrowed artery is signalled by low or no pulse sounds below a certain point in the leg. To confirm the diagnosis, your doctor may perfrom a test called a Doppler study to check the blood flow in your legs. Blood pressure cuffs are placed at four different locations on your legs to measure the blood pressure from the top of your leg to your ankle. The sound of the blood flow tells the doctor if there is an obstruction and how severe it is. A fifth blood pressure cuff on your arm allows your doctor to compare its blood pressure with the blood pressures in your leg. Normal blood pressure at the ankle is 90 percent of the arm pressure, but it will be less if there is narrowing of the leg arteries. If your doctor feel your treatment will require surgery, he may also recommend a color Doppler study, which is an ultrasound technique that creates a picture of the narrowed artery, with different colors to show different blood flow rates. Another method of seeing the rate of blood flow and any narrowing is through an arteriography or angiography. After a dye is injected into the artery, an x-ray is taken. The x-ray shows the path the dye is able to take, so your doctor can see any blockages.
What is the treatment?
If you have intermittent claudication, your doctor will recommend a regular exercise program. To begin, he or she will ask you to exercise at least 30 minutes each day. If the pain occurs during exercise, you should simply stop and rest until the pain is gone, then gradually begin again. Because exercise improves your muscle tone and endurance, it can help make other blood vessels that supply the muscle grow larger and take on some of the work of the narrowed artery. You may also need to change your lifestyle to eliminate the risk factors for claudication. This includes not smoking, following a healthy diet to lower your cholesterol level, and carefully monitoring your blood sugar level if you have diabetes. In some cases, your doctor may prescribe a drug that helps improve the delivery of oxygen to the muscles. Surgery may also be recommended to open a severely narrowed artery. One commonly used surgery is called baloon angioplasty, where a catheter with a balloon on the tip is inserted into the narrowed artery. The balloon is then inflated to clear the blockage.
Self-care tips
You can lower your risk of claudication by not smoking, and by controlling high blood pressure, diabetes, or high cholesterol, if you have these conditions.
This information has been designed as a comprehensive and quick reference
guide written by our health care reviewers. The health information written
by our authors is intended to be a supplement to the care provided by your
physician. It is not intended nor implied to be a substitute for
professional medical advice.
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