Claudication is muscle pain caused by improper blood flow to muscles during exercise. Usually, pain develops in the legs after walking at a certain speed and for a specific duration, which depends on the severity of the condition. This problem is also termed intermittent claudication as the pain is not constant. It starts during exercise and ends with rest. As claudication aggravates, the pain may develop during rest. Claudication is essentially a symptom of disease, most often peripheral artery disease, that impedes the blood flow in the limbs due to the narrowing of arteries. The main aim of the treatment is to lower the risk of vascular disease, mitigate pain, improve mobility, and avert tissue damage.
Types Of Claudication:
Vascular claudication is typically a sign of blood flow issues, mainly resulting in peripheral artery disease.
Neurogenic Claudication is caused by issues with the spine and nervous system.
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Symptoms
Some of the symptoms observed include:
- Pain, discomfort or weakness in muscles, when those muscles are used
- Calves, thighs, buttocks, hips or feet aches
- Occasional pain in shoulders, biceps and forearms
- Pain that eases immediately after resting
- Pain that becomes more intense over time and begins to pain even at rest
Symptoms of peripheral artery disease are generally seen in more-advanced stage and include:
- Cold skin
- Constant, throbbing pain that progresses to numbness
- Skin discolouration
- Slow healing wounds
Causes
This muscle disease is t often a symptom of peripheral artery disease. The peripheral arteries are the large vessels that carry blood to the legs and arms. Peripheral artery disorder is damage to an artery that impedes the flow of blood to the upper and lower extremities. While at rest, minimal blood flow is sufficient. But when a person is active, the muscles need adequate oxygen and nutrients to function well and stay healthy. Damage to the peripheral artery is caused by atherosclerosis.
Also Read: Atherosclerosis - Causes, Symptoms And Treatment
Risk Factors
Possible risk factors include:
- History of atherosclerosis, peripheral artery disease among family
- Age 50 years and above and if you smoke or have diabetes
- Age 70 years
- Chronic kidney disease
- Diabetes
- High blood pressure
- High cholesterol
- Obesity
- Smoking
Complications
Claudication is usually a warning sign of atherosclerosis, that denotes an increased risk of heart attack or stroke. Other complications of peripheral artery disease include:
- Skin lesions that don't heal
- Gangrene
- Amputation of a limb
Diagnosis
This condition is often undiagnosed as most people consider the pain to be part of ageing and some people just decrease their activity to avert pain.
Usually, diagnosis of claudication is based on an assessment of symptoms, complete physical examination, evaluation of the skin on the limbs and test to monitor the blood flow.
Recommended Tests
Certain tests suggested to diagnose the condition include:
- Pulse measurement in palms or feet to check blood flow to the limb
- The ankle-brachial index is a comparison of blood pressure in the ankles with arms
- Segmental blood pressure measurement is a sequence of blood pressure measurements at several regions on the arm or leg to monitor the extent and area of the damage to the arteries
- Exercise testing is done to evaluate the maximum distance a person can walk without pain
- Doppler ultrasound to check blood flow
- MRI or CT angiography to check for narrowed blood vessels
Also Read: Doppler Ultrasound: What Is It and What To Expect?
Treatment
The main aim of treatment is to mitigate the pain and manage risk factors that contribute to heart and blood vessel disease.
Certain exercises are recommended as the primary part of treatment. Exercise lessens pain, increases duration, promotes vascular health in the affected limbs, and impacts weight management and the overall betterment of life.
Suggested walking programs include:
- Walking until the pain is moderate or walk as fast as possible
- Resting to ease pain
- Walking again
- Then repeat the walk-rest-walk pattern for 30-45 minutes
- Walking thrice a week
A guided exercise program is suggested for starting the treatment, however, long-term exercise at home is vital for continuing the management of the condition.
Medications
The physician may prescribe one or more medications to manage pain and risk factors for heart disease. For instance, medications may be suggested to control the following:
Pain relieving drugs to ease the pain while exercising and walking.
Medication to lower cholesterol and control high blood pressure.
Anti-platelet medications prevent blood clots and reduce the risk of heart attack, stroke or clots blocking the flow to limbs.
Surgery
Surgery is often suggested when peripheral artery disease is more serious and other treatment options don’t help. Angioplasty and vascular surgery are usually recommended by the doctor.
