What is claudication?
Claudication refers to limping because of pain in the thigh, calf, and/or buttocks that occurs when walking. Claudication may be a symptom of peripheral arterial disease (PAD). PAD is caused by a narrowing or blockage of arteries in the legs and/or aorta (the largest artery in the body and the primary blood vessel leading from the heart to the body), which may cause decreased blood flow to the muscles of the calf, thigh, or buttocks. This decreased blood flow may cause claudication. The pain associated with claudication occurs with walking and typically disappears at rest.
Claudication may be a symptom of underlying systemic artery disease and is seen more often in persons who have blockages in other arteries, including the heart and brain. Because claudication is associated with an increased risk for heart attack or stroke, its presence signals the need for assessment and possible treatment.
Claudication generally occurs when walking the same distance. With progressive vessel disease, the initial claudication distance (that distance at which a person first experiences pain when walking) may decrease or the person may no longer be able to walk.
How common is claudication?
Please discuss with your doctor for further information. Please discuss with your doctor for further information.
What are the symptoms of claudication?
The common symptoms of claudication are:
- Pain when exercising. You may feel pain or discomfort in your feet, calves, thighs, hips or buttocks, depending on where you might have artery narrowing or damage. Claudication can also occur in your arms, although this is less common.
- Intermittent pain. Your pain may come and go as you do less-strenuous activities.
- Pain when at rest. As your condition progresses, you may feel pain in your legs even when you’re sitting or lying down.
- Discolored skin or ulcerations. If blood flow is severely reduced, your toes or fingers may look bluish or feel cold to the touch. You may also develop sores on your lower legs, feet, toes, arms or fingers.
- An aching or burning feeling
There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.
When should I see my doctor?
If you have any signs or symptoms listed above or have any questions, please consult with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.
What causes claudication?
Blockage of an artery in the legs may cause intermittent claudication. Atherosclerosis (a build-up of plaque, which is a deposit of fatty substances, cholesterol, cellular waste products, calcium, and fibrin in the inner lining of an artery) is the most common cause of artery blockage.
Blockages in the leg are most common in the thigh and behind the knee but may also occur at other sites in the body including the aorta, groin, or abdomen. A person may have more than one blockage.
What increases my risk for claudication?
There are many risk factors for claudication, such as:
- High cholesterol
- High blood pressure
- Obesity (a body mass index over 30)
- Age older than 70 years
- Age older than 50 years if you also smoke or have diabetes
A family history of atherosclerosis, peripheral artery disease or claudication
Diagnosis & treatment
The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.
How is claudication diagnosed?
In addition to a complete medical history and physical examination, diagnostic procedures for claudication may include any, or a combination, of the following:
- Ankle-brachial index (ABI). A test in which blood pressure is taken in the arms and in the legs. ABI is a comparison of the blood pressure in the ankle with the blood pressure in the arm using a regular blood pressure cuff and a Doppler ultrasound device. To determine the ABI, the systolic blood pressure (the top number of the blood pressure measurement) of the ankle is divided by the systolic blood pressure of the arm.
- Listening to the arteries of the belly (abdomen) or legs with a stethoscope to determine if a bruit is present.
- Doppler ultrasound. A noninvasive test that can depict blood flow. A Doppler probe within the ultrasound transducer evaluates the velocity and direction of blood flow in the vessel by bouncing high-frequency sound waves off of red blood cells. The transducer picks up the reflected waves and sends them to an amplifier, which makes the ultrasonic sound waves audible. Absence or faintness of these sounds may indicate an obstruction to the blood flow.
- Angiogram (also called an arteriogram). An X-ray image of the blood vessels that may be performed to help determine the presence and extent of blockage. It is performed to evaluate various vascular conditions, such as an aneurysm (ballooning of a blood vessel), stenosis (narrowing of a blood vessel), or blockages. The procedure involves inserting a thin, flexible tube into an artery in the leg and injecting a contrast dye into the artery. The contrast dye makes the arteries and veins visible on the X-ray.
How is claudication treated?
Treatment of claudication and peripheral artery disease can help prevent your disease from getting worse and reduce your symptoms. Lifestyle changes, such as quitting smoking and participating in a regular exercise regimen, are often the first steps in treating claudication.
If your claudication symptoms don’t improve after adopting a healthier lifestyle, your doctor may suggest other treatment options, including:
- Your doctor might recommend you take aspirin to reduce the chance of blood clots. He or she might also prescribe other medications that help keep your blood from clotting, such as clopidogrel (Plavix), dipyridamole (Persantine) and ticlopidine. The medication cilostazol (Pletal) may help improve blood flow and reduce your symptoms. If you can’t take cilostazol or if it doesn’t improve your symptoms, your doctor may recommend that you try pentoxifylline (Trental). Additionally, if necessary, your doctor will also prescribe a cholesterol-lowering drug (statin) to lower your cholesterol.
- Cases of claudication and peripheral artery disease that are more serious may require angioplasty. This is a procedure that widens damaged arteries using a narrow tube that travels through your blood vessels and has an inflatable balloon on the end that can help improve circulation. Once an artery is widened, your doctor may place a small metal or plastic mesh tube (stent) in the artery to keep it open.
- Vascular surgery. Your doctor may recommend surgery that takes a healthy blood vessel from another part of your body to replace the vessel that’s causing your claudication. This allows blood to flow around the blocked or narrowed artery.
Your doctor may also suggest a combination of treatments, such as medications and angioplasty.
Lifestyle changes & home remedies
What are some lifestyle changes or home remedies that can help me manage claudication?
The following lifestyles and home remedies might help you cope with claudication:
- Don’t smoke. Smoking is the most significant risk factor for the development and worsening of peripheral artery disease. Smoking increases the chance that you’ll eventually require an amputation or even die of the disease. Avoid secondhand smoke, too.
- You may wonder how exercise can be helpful if that’s what brings on the claudication pain. Actually, exercise helps condition your muscles so that they use oxygen more efficiently. So even if your muscles are getting less oxygen, they can use what they do get more effectively. That can eventually mean less pain during exertion. Your health care team can help develop a supervised exercise program that will enable you to gradually increase the distance you’re able to walk without pain and increase your overall mobility.
- Know and control your cholesterol levels. If your cholesterol levels aren’t what they need to be, your doctor may recommend medication to get them to the proper levels. A meal plan that includes a variety of low-fat foods, emphasizing fruits, vegetables, grains and legumes, can help, too. Combined with exercise, a healthy diet can help control your blood pressure and cholesterol levels, both of which can contribute to atherosclerosis.
- Avoid certain medications. Don’t use drugs that cause your blood vessels to constrict. Many sinus and cold medications sold over-the-counter contain pseudoephedrine, which is known to constrict blood vessels. Ask your doctor if there are any other medications you need to avoid.
- Avoid injury to your feet and legs. Reduced blood flow increases your risk of complications from injuries. Choose well-fitting shoes that will protect your feet if you are participating in activities or work that might lead to injury.
- Keep your legs below your heart. Doing so can help improve the circulation to your feet. To keep the blood flowing well to your legs and feet at night, it helps to raise the head of your bed by 4 to 6 inches.
If you have any questions, please consult with your doctor to better understand the best solution for you.
Hello Health Group does not provide medical advice, diagnosis or treatment.
Hello Health Group does not provide medical advice, diagnosis or treatment.