Intermittent Claudication: Causes, Symptoms, Treatment and Exercises

Intermittent claudication is actually a symptom produced while walking. Person suffering from intermittent claudication experiences pain in calf, thigh, or all over the lower limb while walking a short distance. However, the pain gets relieved as the person rests and allows him to walk further. This occurs when the muscles in the leg do not get enough blood while exercising.

This occurs because the blood vessels supplying blood to the lower limb become narrow. The most probable reason for this narrowing is arthrosclerosis in the lower leg arteries (peripheral artery disease). People who smoke or suffer from diabetes and high blood pressure are more likely to suffer from peripheral artery disease and resulting intermittent claudication. Treatment consists of lifestyle modification and medications to improve circulation in the arteries. If the person follows proper treatment he can live a productive life without pain.

Causes:

Intermittent claudication as mentioned earlier is not a disease but a symptom of an underlying condition. It is mainly a symptom of peripheral artery disease (PAD).

Peripheral artery disease is a condition in which the arteries of the lower limb become narrow. Arteries supply blood to the muscles and tissues. When the muscles of lower leg do not receive enough blood supply due to narrowing, person experiences pain and cramps in muscles. This occurs particularly during walking or climbing stair or exercising. PAD is caused due to atherosclerosis, a condition caused due to too much of cholesterol circulating in blood. Atherosclerosis can cause narrowing and blockage in any artery including the coronary arteries. As the blood vessels become narrow, oxygenated blood does not reach sufficiently to the muscles which are active while walking. Thus if the muscles do not get enough fuel in the form of oxygen and nutrients they start aching. Atherosclerosis is not the only condition to cause atherosclerosis. Other conditions such as lumbar canal stenosis, and peripheral neuropathy can also cause atherosclerosis. The risk factors for this condition are:

• Excessive smoking.
• Diabetes
• High cholesterol in blood
• High blood pressure
• Obesity
• Elderly age group
• Person who smoke, have high cholesterol and high blood pressure and have diabetes.
• Family history of peripheral artery disease.

Symptoms:

The classical symptom of intermittent claudication is cramp like pain in calf muscles while walking or constant amount of exercise. Pain is relieved as soon as the patient rests. This symptom develops due to muscle ischemia. It means the muscle do not get enough oxygenated blood. The pain is felt in any muscles of lower limb, but mostly the calf muscles are painful because they are most active during walking. Pain sometimes can also occur in arms if the vessels of arms are narrow. The pain comes during active exercise such as walking even hundred yards. Soon the pain is relieved as you rest. However, with progression of the condition, person may feel pain in legs even while sitting or lying down.

If the flow of blood is extremely sluggish the color of skin of involved extremity changes to pale or blue. In advanced cases where blood flow is severely restricted, patient may develop non healing ulcers in lower leg. Cold feet, numbness and tingling or weakness are some other symptoms that may develop together with pain.

Treatment:

The treatment of intermittent claudication depends on the underlying cause.

If it is caused due to peripheral arterial disease, a meticulous program which consists of change in lifestyle, diet and proper intake of medication is beneficial.

• Patient must stop smoking tobacco.
• Person must restrict fat and cholesterol in his diet.
• Weight reduction
• Take prescribed medicines to reduce high cholesterol level.
• Control diabetes and high blood pressure
• Eat a balance diet.

Exercises:

Exercise is important for patient suffering from intermittent claudication. Patient must walk for 30 to 45 minutes daily for at least 5 days in a week. This improves blood flow in the calf muscles as well as all muscles of lower limb due to increased collateral circulation. There is increase in exercise tolerance as well. Patient must follow this routine for at least six months.

In majority of cases conventional treatment is effective. However, in severe cases surgical intervention may be necessary to improve the circulation.