Claudication

Medical Author: John P. Cunha, DO
Medical Editor: William C. Shiel, Jr., MD, FACP, FACR

• What is claudication?
• Why does claudication come and go?
• What can cause the artery narrowing that leads to claudication?
• Who typically is affected by claudication?
• What is the prognosis and treatment for patients with intermittent claudication?

What is claudication?

Claudication is pain and/or cramping in the lower leg due to inadequate blood flow to the muscles. The pain usually causes the person to limp. The word "claudication" comes from the Latin "claudicare" meaning to limp. Claudication typically is felt while walking, and subsides with rest. It is commonly referred to as “intermittent” claudication because it comes and goes with exertion and rest. (In severe claudication, the pain is also felt at rest.)

Why does claudication come and go?

The usually intermittent nature of the pain of claudication is due to a temporary inadequate supply of oxygen to the muscles of the leg. The poor oxygen supply is a result of narrowing of the arteries that supply the leg with blood. This limits the supply of oxygen to the leg muscles and is especially noticeable when the oxygen requirement of these muscles rises with exercise or walking.

What can cause the artery narrowing that leads to claudication?

Intermittent claudication can be due to temporary artery narrowing due to spasm of the artery (vasospasm), permanent artery narrowing due to atherosclerosis, or the complete blockage of an artery of the leg.

Who typically is affected by claudication?

Intermittent claudication is more common in men than in women. The condition affects 1%-2% of the population under 60 years of age, increasing in incidence with age, to affect over 5% of persons over 70 years of age.

What is the prognosis and treatment for patients with intermittent claudication?

The prognosis with intermittent claudication is generally favorable because the condition often stabilizes or improves in time. Conservative treatment is advised initially.

• Walking (to gain stamina) often helps increase the distance that the patient can walk without symptoms.
  
  
• Drugs that are approved for the management of intermittent claudication include pentoxifylline (Trental) and cilostazol (Pletal).
  
  
• If medication is inadequate, correction of the narrowing in the affected artery might be suggested. Procedures used to correct the narrowing of arteries include surgery (bypass grafting) and interventional radiology (balloon angioplasty or stents).

When claudication is severe and persistent, these procedures may be required to ultimately relieve the condition and the pain. Not all persons with severe claudication can benefit from these procedures. The potential to benefit depends on the exact location and degree of artery disease and the overall health status of the patient.

References: CNN; Claudication: When circulation problems cause leg pain. Vascular Disease Foundation; PAD: Intermittent Claudication

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