Pain caused by reduced blood flow to the muscles during physical exercise is called claudication. In most cases, it happens in the legs after walking at a certain pace, depending on the severity of the health problem.
Sometimes, this condition is called intermittent claudication because the pain is not constant. In mild cases, the pain appears when you exercise and goes away when you rest, while in severe cases, it may occur even when you rest.
Commonly, claudication is a symptom of another disease (usually of peripheral artery disease). It is a condition in which the arteries that supply blood to the limbs are narrowed.
The treatment goal is to reduce the risk of vascular disease and pain, prevent damage to the tissue, and improve mobility.
Symptoms
The term claudication refers to the pain in the muscles caused by decreased oxygen levels, which is usually triggered by physical exercise. Check below the symptoms:
- Discomfort, ache, or pain in the muscles each time they are used
- Fatigue (extreme tiredness)
- Pain in the hips, feet, buttocks, thighs, and calves
- It happens less frequently, pain in the biceps, forearms, and shoulders
- Pain usually improves with rest
When the disease progresses, it may cause pain even when you rest. Check below some symptoms of advanced peripheral artery disease:
- Cool skin
- Wounds that do not heal
- Skin discoloration
- Severe and persistent pain that may lead to numbness
It is advised to see a doctor if you suspect you have claudication because it may indicate poor cardiovascular health. Furthermore, peripheral artery disease is also a sign of possible cardiovascular problems, including myocardial infarction and stroke.
However, there are multiple health conditions that may cause pain in the leg or arm during exercise. That’s why it is advised to see a doctor for a diagnosis.
Causes
In most cases, claudication is a symptom of another disease called peripheral artery disease. Large blood vessels that deliver blood to the arms and legs are called peripheral arteries. Damage to these arteries reduces blood flow to the limbs. However, when you rest, limited blood flow does not cause symptoms, but when you are active, the muscles are not getting enough oxygen and nutrients to work properly.
Commonly, damage to the peripheral arteries occurs due to a condition called atherosclerosis. It is a buildup of cholesterol, fats, and other substances (also known as plaques) on the artery walls. These plaques narrow the arteries, restricting blood flow. Sometimes, when plaques burst, it may lead to a blood clot.
Risk Factors
Doctors identified some factors that may elevate your risk of developing claudication. Examples include:
- Age – People over 70 years old are more likely to develop this condition.
- Smokers or people with diabetes are also more likely to develop it, especially if they are over 50 years old.
- Chronic kidney disease
- Family history of atherosclerosis, peripheral artery disease, or claudication
- Diabetes
- Hypertension (high blood pressure)
- Obesity
- High cholesterol
Complications
Generally, claudication is considered a warning sign of atherosclerosis, stroke, and myocardial infarction. Check below other complications of peripheral artery disease caused by atherosclerosis:
- Gangrene (death of the muscle and skin tissue)
- Limb amputation
- Skin sores that do not heal themselves
How to Prevent Claudication?
To prevent this condition, it is usually enough to keep a healthy lifestyle and control existing health problems. Check below some tips that may help prevent the condition:
- Manage chronic health conditions (such as hypertension, diabetes, and others)
- Perform physical exercises to maintain a healthy weight
- Manage cholesterol
- Quit smoking or never begin (secondhand smoke also increases the risk of developing blood vessel problems and may cause lung damage)
- Dietary changes (include more fresh fruits, vegetables, and whole grains in your diet)
For more details, discuss it with your healthcare professional.
Diagnosis
In many cases, this condition is undiagnosed because people think the pain occurs as a natural part of aging. Others reduce the pain by stopping the activity to prevent it.
The diagnosis of this unpleasant condition is usually based on the medical history, questions about your symptoms, and a physical examination to check for irregularities linked with claudication. Check below some tests often used to confirm this condition:
- Pulse measurement in the feet and palms to check blood flow to the whole limb.
- Ankle-branchial index (it involves a comparison of blood pressure in the arms with the blood pressure in the ankles)
- Segmental blood pressure measurement – It involves multiple blood tests to check blood pressure in different parts of the arm or leg. These tests can identify the location of a damaged artery.
- Exercise testing – It helps determine the maximum distance you can walk without pain.
- Doppler ultrasound – This imaging test helps doctors see how your blood flows.
- Other imaging tests – These include MRI (magnetic resonance imaging) scans and CT (computerized tomography) scans to check for narrowed arteries.
Treatment
The goal of the treatment is to reduce pain and reduce the risk of cardiovascular diseases. However, an important part of the claudication treatment is exercise. They help lessen pain, increase exercise duration, and improve vascular health. Exercises may also manage weight and overall quality of life. Check below some recommended walking programs:
- Walk until you feel moderate pain
- Rest to lessen pain and then walk again
- Repeat these cycles for 30 to 45 minutes at least 3 days per week
At the beginning of the treatment, supervised exercise is recommended to prevent complications.
Medicines
The following medicines are recommended by doctors to reduce the risk of developing cardiovascular diseases and reduce pain. For example:
- Pain relievers – Physicians usually recommend Cilostazol to improve blood flow. It may reduce pain and help you exercise.
- High cholesterol – Doctors often prescribe statins to reduce cholesterol levels and improve walking distance.
- Hypertension medications – These drugs are used to reduce high blood pressure, which helps prevent strokes and myocardial infarctions.
- Other medicines – For example, anti-platelet drugs (to prevent blood clots and decrease the risk of heart attacks, strokes, and others). Healthcare professionals usually recommend Aspirin, Clopidogrel, and others.
Other Treatments
In severe cases, medicines may not be enough, and doctors may prescribe the following treatments. For example:
- Angioplasty – During this procedure, physicians will improve blood flow by widening the damaged artery.
- Vascular surgery – This surgery involves healthy blood vessels from other body parts and placing them instead of damaged ones. It allows the blood to flow around a narrowed or blocked artery.
Frequently Asked Questions
What is the main cause of claudication?
In most cases, people experience this condition due to reduced blood flow to the limbs. Claudication is a symptom of another disease called peripheral artery disease.
What can be mistaken for claudication?
There are some conditions that can be mistaken for claudication. For example:
- Nerve pain (also called neuropathy)
- Joint pain (osteoarthritis)
- Spinal stenosis
- Venous claudication
- Chronic compartment syndrome
- Popliteal artery entrapment syndrome
This article does not contain all possible conditions that can be mistaken for claudication.
What happens if claudication is left untreated?
If you ignore the symptoms and do not get treatment, you may experience some complications. These include:
- Worsening of the symptoms, which causes pain even when you rest
- Amputation
- Gangrene
- Non-healing wounds
- Elevated risk of cardiovascular diseases (such as myocardial infarction)
Ask your healthcare provider if you have any other questions.
