What is Claudication?
Claudication, also known as intermittent claudication, is the pain you feel when your leg muscles do not receive sufficient blood while you walk or exercise and is relieved during rest. Most often the pain occurs in the legs after walking at a specific pace and for a specific period of time, depending upon the severity of the condition.
The condition is also referred to as intermittent claudication because the pain typically comes and goes. It begins while exercising and ends with rest. However, as claudication worsens, the pain may occur while at rest too.
Causes of Claudication
The most common cause of intermittent claudication is peripheral artery disease (PAD), a condition characterised by narrowed or blocked blood vessels supplying the limbs. When walking and exercising, the leg muscles need more oxygen to function, but the reduced blood flow does not carry enough oxygen, resulting in claudication.
Risk Factors
Potential risk factors for claudication and peripheral artery disease include:
- Smoking
- Obesity (a BMI or body mass index of over 30)
- High cholesterol
- High blood pressure
- Diabetes
- Sedentary lifestyle
- Age older than 70 years
- A family history of PAD, atherosclerosis, or claudication
- Age older than 50 years with a history of smoking or diabetes
Signs and Symptoms of Claudication
Signs and symptoms of claudication include:
- Pain in the hips, buttocks, thighs, calves, or feet
- Ache, pain, discomfort, or fatigue in muscles each time those muscles are utilised
- Less frequently, pain in the forearms, biceps, and shoulders
- Pain that improves soon after resting
- Cramping
- Numbness
- Tingling
Diagnosis of Claudication
When you present to your physician with these symptoms, your physician will diagnose claudication with imaging tests (ultrasound, CT, and MRA scans), and by measuring and comparing blood pressures in the leg and arm (ankle-arm index), and in different parts of the leg (segmental blood pressure).
Treatment for Claudication
To treat intermittent claudication, your doctor prescribes medications to dilate blood vessels and decrease the viscosity (thickness) of blood to increase the flow of blood. Surgery or minimally invasive procedures may be necessary if you do not respond to conservative treatment. These procedures may include:
- Peripheral Arterial Angioplasty and Stenting: This is a surgical procedure that widens narrowed or blocked peripheral arteries by inflating a small balloon attached to the tip of a thin tube (catheter) that is inserted at the groin and passed through the blocked artery. Once the artery is expanded, a stent (wire mesh tube) is placed within the artery to hold the artery open. The stent maintains the patency of the artery and prevents it from future narrowing.
- Bypass Surgery: Your surgeon may perform a bypass surgery, where a graft (a healthy blood vessel removed from another part of the body) is attached to re-route blood away from the block. Once in position, the bypass offers sufficient blood flow to avert intermittent claudication.
- Atherectomy: This procedure employs a catheter device to clear plaque accumulation from the inside of blocked or narrowed arteries.
Prevention of Claudication
The ideal method to prevent claudication is to control certain medical conditions and maintain a healthy lifestyle by:
- Exercising regularly
- Eating a well-balanced, healthy diet
- Maintaining a healthy weight
- Quitting smoking if you are a smoker
- Managing blood pressure and cholesterol
- Keeping blood sugar under control if you are diabetic
