by Kimberly Allen, RN
Intermittent claudication is described as a “tight, aching or squeezing pain in the calf, foot, thigh or buttocks that occurs during exercise.” The reason it’s called intermittent is because the pain disappears after resting. Claudication is the pain that occurs with exercise. So basically intermittent claudication is pain that comes and goes.
The most common cause of intermittent claudication is peripheral artery disease or PAD. PAD develops when there is a build up of cholesterol plaques in your arteries. This build up causes your arteries to narrow impairing the blood flow to your muscles. When the blood flow is impaired that means the oxygen flow is impaired, it’s the lack of oxygen to the muscle that causes the pain.
Although PAD is the most common cause of intermittent claudication it is not the only cause. Arthritis and spinal stenosis as well as peripheral neuropathy can also cause intermittent claudication. Conditions that cause inflammation like tendinitis and stress fractures even a pulled muscle can cause the area to become inflamed and put pressure on blood vessels in the area which in turn impairs blood flow. There are also things that can occur suddenly that causes the blood flow to the muscles to become impaired like a blood clot or compartment syndrome.
Frequently intermittent claudication is the first symptoms of PAD. Most people with intermittent claudication describe the pain as an aching deep in the muscle that worsens the longer they exercise. The pain is affected by several factors including how fast you are walking. Whether or not you are walking uphill or downhill as well as if you are on a flat surface can all affect not only how severe the pain gets but how far you can go before the pain starts. As the blockage worsens the shorter the distance you are able to walk before the pain starts and the pain becomes more intense sooner. The average person can walk 100 to 200 yards before they start feeling the pain when they have a blockage in one large arterial segment. As you develop more blockages your pain will begin to start sooner and sooner until you can only walk a couple of yards before needing to stop and rest. When the arterial blockage is advanced you will start to have pain at rest. The pain then becomes more prominent at night when your legs are up and is usually relieved by dangling your feet off the side of your bed as gravity then assists the blood flow carrying fresh oxygen to your feet. As your PAD worsens the claudication sometimes interferes with sleep and can make your leg sensitive to touch. You can also develop a bluish tint to your legs as well as ulcerations due to inadequate circulation.
Treatment of intermittent claudication involves treating the underlying cause which is usually PAD. In most cases your doctor will recommend lifestyle changes like quitting smoking if you’re a smoker and exercise regularly. People with diabetes need to maintain good control of their blood sugar levels. Whether or not you have diabetes it’s important to keep your cholesterol level with in normal limits as well as keep your blood pressure well managed. If your blood pressure is elevated your doctor may recommend medication to lower it. It’s also important to eat a healthy well balance diet and maintain a healthy weight. If your symptoms continue even after making needed life style changes your doctor may recommend you take an aspirin daily in order to decrease the chance of blood clots. If needed the doctor may prescribe medications that keep your blood from clotting like Plavix. More serious cases of claudication and PAD may require surgery like angioplasty or vascular surgery. Depending on the severity of your claudication your doctor may also recommend a combination of treatments.
Kimberly Allen is a registered nurse with an AND in nursing. She has worked in ACF, LCF and psychiatric facilities, although she spent most of her career as a home health expert. She is now a regular contributor to HealthAndFitnessTalk.com, dispensing advice and knowledge about medical issues and questions. You can reach her with any comments or questions at firstname.lastname@example.org.