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What is Claudication?

Claudication is pain caused by too little blood flow to your muscles during exercise. The condition is also called intermittent claudication because the pain usually isn’t constant. It begins during exercise and ends with rest. As claudication worsens, however, the pain may occur during rest.

Claudication is technically a symptom of peripheral artery disease (PAD), a narrowing of arteries in the limbs that restricts blood flow.

Treatments typically focuses on lowering the risks of vascular disease, reducing pain, increasing mobility and preventing damage to tissues.

How is Claudication Diagnosed?

A diagnosis of claudication and peripheral artery disease is based on a review of symptoms, a physical exam, evaluation of the skin on the limbs, and tests to check blood flow.

Some common tests used to diagnose claudication may include:

  • Pulse measurement in your palms or feet to assess blood flow to the entire limb
  • Ankle-brachial index, a comparison of blood pressure in the ankles with the blood pressure in the arms
  • Segmental blood pressure measurement, a series of blood pressure measurements at different areas on the arm or leg to help determine the amount and location of damage to the arteries
  • Exercise testing to determine the maximum distance you can walk or the maximum exertion without pain
  • Doppler ultrasound to see the flow of blood
  • Magnetic resonance imaging (MRI) or computed tomography (CT) angiography to look for narrowed blood vessels

Symptoms and Risk Factors

Symptoms include the following:

  • Pain, ache, discomfort or fatigue in muscles every time those muscles are used
  • Pain in the calves, thighs, buttocks, hips or feet
  • Less often, pain in shoulders, biceps and forearms
  • Pain that gets better soon after resting
  • The pain may become more severe over time. You may even start to have pain at rest.

Signs or symptoms of peripheral artery disease, usually in more-advanced stages, include:

  • Cool skin
  • Severe, constant pain that progresses to numbness
  • Skin discoloration
  • Wounds that don’t heal

Potential risk factors for peripheral artery disease and claudication include:

  • A family history of atherosclerosis, peripheral artery disease or claudication
  • Age older than 50 years if you also smoke or have diabetes
  • Age older than 70 years
  • Chronic kidney disease
  • Diabetes
  • High blood pressure
  • High cholesterol
  • Obesity (a body mass index, or body mass index (BMI), over 30)
  • Smoking

Other complications of peripheral artery disease due to atherosclerosis include:

  • Skin lesions that don’t heal
  • Death of muscle and skin tissues (gangrene)
  • Amputation of a limb

Treatment and Prevention

The goals of treating claudication and PAD are to reduce pain and manage the risk factors.

Exercise is an important part of treatment; it reduces pain, increases exercise duration, improves vascular
health in the affected limbs, and contributes to weight management and an improvement in quality of life.

  • Recommended walking programs include:
  • Walking until you feel moderate pain or as far as you can
  • Resting to relieve pain
  • Walking again
  • Repeating the walk-rest-walk cycle for 30 to 45 minutes
  • Walking three or more days a week

Supervised exercise is recommended for beginning the treatment, but long-term exercise at home is important for ongoing management of claudication.

Medications may be used to manage the following:

  • Pain
  • High cholesterol
  • High blood pressure.
  • Other cardiovascular risks

Surgery or other procedures
When PAD is severe and other treatments don’t work, surgery may be required. Options include:

Endovascular Procedures including possible angioplasty, atherectomy, or stent. This procedure improves blood flow by widening a damage artery. A surgeon guides a wire and then a device through the blood vessels. The devices may soften the blockage before inflating a balloon and/or placing a stent to keep the vessel open.

Bypass surgery. During this type of surgery, a surgeon takes a healthy blood vessel from another part of the body to replace the vessel that’s causing claudication. This allows blood to flow around the blocked artery.