Intermittent Claudication

Blockage of leg arteries results from poor circulation of blood in the leg arteries. This produces an aching, tired, and sometimes burning pain in the legs that is brought on by exercise and made better by rest. Claudication refers to the limping that happens from leg cramps. It is also referred to as Vaso-occlusive disease of the legs, arterial insufficiency of the legs, recurrent leg pain, recurrent leg cramping and calf pain with exercise.

CAUSES

  • This condition is due to narrowing or blockage of the arteries (muscular vessels which carry blood away from the heart and around the body). Blockage of arteries can occur anywhere in the body. If they occur in the heart, a person may experience angina (chest pain) or even a heart attack. If they occur in the neck or the brain, a person may have a stroke. Intermittent claudication is when the blockage occurs in the legs, most commonly in the calf or the foot.

  • Atherosclerosis, or blockage of arteries, can occur for many reasons. Some of these are smoking, diabetes, and high cholesterol.

SYMPTOMS

Intermittent claudication may occur in both legs, and it often continues to get worse over time. However, some people complain only of weakness in the legs when walking, or a feeling of "tiredness" in the buttocks. Impotence (not able to have an erection) is an occasional complaint in men. Pain while resting is uncommon.

WHAT TO EXPECT AT YOUR HEALTH CARE PROVIDER'S OFFICE:

Your medical history will be asked for and a physical examination will be performed. Medical history questions documenting claudication in detail may include:

  • Time pattern

  • Do you have leg cramps at night (nocturnal cramps)?

  • How often does leg pain with cramping occur?

  • Is it getting worse?

  • What is the quality of the pain?

  • Is the pain sharp?

  • Is there an aching pain with the cramps?

  • Aggravating factors

  • Is it worse after you exercise?

  • Is it worse after you are standing for a while?

  • Do you smoke? How much?

  • Do you drink alcohol? How much?

  • Are you diabetic? How well is your blood sugar controlled?

  • Other

  • What other symptoms are also present?

  • Has there been impotence (men)?

  • Is there pain in the back?

  • Is there a darkening of the skin of the legs, feet or toes?

  • Is there weakness or paralysis of the legs?

The physical examination may include evaluation of the femoral pulse (in the groin) and the other areas where the pulse can be felt in the legs.

DIAGNOSIS

Diagnostic tests that may be performed include:

  • Blood pressure measured in arms and legs for comparison.

  • Doppler ultrasonography on the legs and the heart.

  • Duplex Doppler/ultrasound exam of extremity to visualize arterial blood flow.

  • ECG- to evaluate the activity of your heart.

  • Aortography- to visualize blockages in your arteries.

TREATMENT

Surgical treatment may be suggested if claudication interferes with the patient's activities or work, and if the diseased arteries do not seem to be improving after treatment. Be aware that this condition can worsen over time and you should carefully monitor your condition.

HOME CARE INSTRUCTIONS

  • Talk to your caregiver about the cause of your leg cramping and about what to do at home to relieve it.

  • A healthy diet is important to lessen the likeliness of atherosclerosis.

  • A program of daily walking for short periods, and stopping for pain or cramping, may help improve function.

  • It is important to stop smoking.

  • Avoid putting hot or cold items on legs.

  • Avoid tight shoes.

SEEK MEDICAL CARE IF:

There are many other causes of leg pain such as arthritis or low blood potassium. However, some causes of leg pain may be life threatening such as a blood clot in the legs. Seek medical attention if you have:

  • Leg pain that does not go away.

  • Legs that may be red, hot or swollen.

  • Ulcers or sores appear on your ankle or foot.

  • Any chest pain or shortness of breath accompanying leg pain.

  • Diabetes.

  • You are pregnant.

SEEK IMMEDIATE MEDICAL CARE IF:

  • Your leg pain becomes severe or will not go away.

  • Your foot turns blue or a dark color.

  • Your leg becomes red, hot or swollen or you develop a fever over 102°F.

  • Any chest pain or shortness of breath accompanying leg pain.

MAKE SURE YOU:

  • Understand these instructions.

  • Will watch your condition.

  • Will get help right away if you are not doing well or get worse.