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As you age, cholesterol-containing fatty deposits (plaques) may build up on the interior walls of arteries. The result can be a narrowing of the arteries (atherosclerosis) and a reduction in blood flow.
Atherosclerosis can interfere with blood supply to your heart or brain, increasing chances for a heart attack or stroke. It can also affect leg arteries, causing peripheral vascular disease. Intermittent claudication is a symptom of poor blood circulation involving your arteries.
Most people with atherosclerosis in the leg arteries have no symptoms. That’s because the body develops smaller blood vessels (collateral vessels) around the blockage.
However, with sustained activity collateral vessels may not keep up with your leg muscles’ need for oxygen-rich blood. That’s when your leg starts to hurt.
Intermittent claudication (from the Latin claudicare, to limp) usually occurs after a certain amount of exertion. You may experience cramping, aching, numbness, fatigue or heaviness in the muscles downstream from the obstruction.
Typical pain locations are the calf or thigh muscles or sometimes the buttocks. The pain can literally stop you in your tracks, only to disappear after a few minutes of rest.
In more advanced claudication, pain can occur even while you’re at rest. Left untreated, the lack of circulation may result in sores on your legs or feet that don’t heal. Tissue may even become gangrenous, requiring amputation.
Your risk of peripheral vascular disease increases if you:
- Smoke
- Are a man
- Are a woman beyond menopause
- Are at least 60 years old
- Have high blood pressure
- Have high blood cholesterol
- Are overweight
- Are sedentary
- Have diabetes
- Have a family history of atherosclerosis at an early age
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Don’t ignore the problem if you think you may have claudication. Make an appointment to see your doctor. The leg and foot problems from the condition can be serious.
In addition, the atherosclerosis that can cause claudication could also be narrowing your coronary and carotid arteries, setting you up for possible heart attack or stroke.
There’s no magic pill to cure claudication. Instead, the very activity that brings on pain — walking — is often the best medicine.
To manage claudication:
- Walk regularly. Walking until it hurts, resting, then walking some more conditions your muscles and stimulates the development of collateral vessels. Done on a regular basis, you’ll likely see marked improvement in how far you can walk without pain. Your doctor can help you set up an appropriate walking program.
- Don't smoke. Good evidence suggests that smoking cessation slows or even stops the narrowing of arteries, decreasing claudication symptoms.
- Limit dietary fat and cholesterol. Controlling fat to less than 30 percent of daily calories and cholesterol to no more than 300 milligrams daily can help reduce atherosclerosis.
- Control other risk factors. As appropriate, your doctor can work with you to control conditions, such as high blood pressure and diabetes, which can contribute to narrowing of arteries.
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- Pentoxifylline (Trental). This drug helps makes blood more slippery so it can slide more easily through narrowed arteries. It's the only drug approved for claudication. However, only about a third of those who take it are able to increase their walking distance.
- Aspirin. Your doctor may recommend regular aspirin use. Aspirin also can make blood more slippery. Occasionally, doctors prescribe warfarin (Coumadin), a stronger blood-thinning medication.
— October 25, 1999 —
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