Overview

Claudication is pain caused by too little blood flow, usually during exercise. Sometimes called intermittent claudication, this condition generally affects the blood vessels in the legs, but claudication can affect the arms, too.

At first, you'll probably notice the pain only when you're exercising, but as claudication worsens, the pain may affect you even when you're at rest.

Although it's sometimes considered a disease, claudication is technically a symptom of a disease. Most often, claudication is a symptom of peripheral artery disease, a potentially serious but treatable circulation problem in which the vessels that supply blood flow to your legs or arms are narrowed.

Fortunately, with treatment, you may be able to maintain an active lifestyle without pain.

Source: http://www.mayoclinic.com

Symptoms

Claudication symptoms include:

• Pain when exercising. You may feel pain or discomfort in your feet, calves, thighs, hips or buttocks, depending on where you might have artery narrowing or damage. Claudication can also occur in your arms, although this is less common.
• Intermittent pain. Your pain may come and go as you do less-strenuous activities.
• Pain when at rest. As your condition progresses, you may feel pain in your legs even when you're sitting or lying down.
• Discolored skin or ulcerations. If blood flow is severely reduced, your toes or fingers may look bluish or feel cold to the touch. You may also develop sores on your lower legs, feet, toes, arms or fingers.

Other possible symptoms include:

• An aching or burning feeling
• Weakness of your legs or arms
• Cold feet

When to see a doctor

Talk to your doctor if you have pain in your legs or arms when you exercise. If left untreated, claudication and peripheral artery disease can reduce the quality of your life and lead to potentially life-threatening complications. Claudication may limit your ability to participate in social and leisure activities, interfere with work, and make exercise intolerable.

Source: http://www.mayoclinic.com

Causes

Claudication is most often a symptom of peripheral artery disease. In peripheral artery disease, the arteries that supply blood to your limbs are damaged, usually as a result of atherosclerosis. Atherosclerosis can develop in any of your arteries, especially those in your heart. When atherosclerosis affects your arms and legs, it's called peripheral artery disease.

Atherosclerosis narrows the arteries and makes them stiffer and harder. That's because the arteries get clogged with clumps of fat, cholesterol and other material, called atherosclerotic plaques. These plaques can make arteries so narrow that less blood can flow through them. You feel pain because your leg muscles are not getting enough oxygenated blood. Oxygen is the fuel that muscles need to contract.

Atherosclerosis isn't the only possible cause of your symptoms of claudication. Other conditions associated with similar symptoms that need to be considered include spinal stenosis, peripheral neuropathy and certain musculoskeletal conditions.

Source: http://www.mayoclinic.com

Diagnosis

Claudication may go undiagnosed because many people consider the pain an unwelcome but inevitable consequence of aging, and some people just reduce their activity level to avoid the pain. But the tests your doctor may use to diagnose your condition are often noninvasive and can get you back on your way to resuming an active life.

Some common tests used to diagnose claudication include:

• Checking the pulses in your palms and feet
• Exercise testing to determine the maximum distance you can walk without pain
• Ankle-brachial index to compare the blood pressure in your ankles to the blood pressure in your arms
• Doppler ultrasound, which monitors blood flow in the area affected
• Magnetic resonance imaging (MRI) or computerized tomography (CT) to show if your blood vessels are narrowed with plaque

The pain in your legs could be due to another condition, such as spine, joint or muscle problems, or other vascular conditions. Your doctor can make a diagnosis based on your symptoms and a medical history, physical exam and appropriate tests.

Source: http://www.mayoclinic.com

Complications

In extreme cases, the circulation in your legs or arms can be so limited that you feel pain even when you aren't exercising, and your legs or arms might feel cool to the touch. Severe peripheral artery disease can lead to poor healing of skin injuries and ulcers. These cuts and ulcers can develop gangrene and require limb amputation.

Source: http://www.mayoclinic.com

Prevention

The best way to prevent claudication is to maintain a healthy lifestyle. That means:

• Quit smoking if you're a smoker.
• If you have diabetes, keep your blood sugar in good control.
• Exercise regularly.
• Lower your cholesterol and blood pressure levels, if necessary.
• Eat foods that are low in saturated fat.
• Maintain a healthy weight.

Alternative medicine

There aren't any alternative medicine treatments that have been proved effective for claudication.

Several treatments have had mixed results, proving beneficial in some studies, but then showing no benefit in others. These include:

• Ginkgo
• Propionyl-L-carnitine

Another treatment, L-arginine, appeared to help relieve symptoms of claudication.

Vitamin E and omega-3 fatty acids have also been suggested as treatments for claudication, but when studied in clinical trials, these treatments didn't help relieve symptoms.

Source: http://www.mayoclinic.com

Lifestyle and home remedies

The plaques that have damaged your arteries are often the result of unhealthy lifestyle habits. So a key part of treatment is stopping any unhealthy habits and adopting healthy ones.

If you have claudication or peripheral artery disease, make sure you:

• Don't smoke. Smoking is the most significant risk factor for the development and worsening of peripheral artery disease. Smoking increases the chance that you'll eventually require an amputation or even die of the disease. Avoid secondhand smoke, too.

• Exercise. You may wonder how exercise can be helpful if that's what brings on the claudication pain. Actually, exercise helps condition your muscles so that they use oxygen more efficiently. So even if your muscles are getting less oxygen, they can use what they do get more effectively. That can eventually mean less pain during exertion.

  Your health care team can help develop a supervised exercise program that will enable you to gradually increase the distance you're able to walk without pain and increase your overall mobility.

• Know and control your cholesterol levels. If your cholesterol levels aren't what they need to be, your doctor may recommend medication to get them to the proper levels. A meal plan that includes a variety of foods low in animal fats or saturated fats, low in partially hydrogenated fats or trans-fats, emphasizing fruits, vegetables, grains and legumes, can help, too.

  Combined with exercise, a healthy diet can help control your blood pressure and cholesterol levels, both of which can contribute to atherosclerosis.

• Control your blood sugar. Diabetes is a major risk factor for claudication. It is very important for you to control your blood sugar levels. Preventing diabetes, or having the condition under control, is essential to avoiding claudication, especially if your blood sugar is abnormal or in the prediabetes range.
• Avoid certain medications. Don't use drugs that cause your blood vessels to constrict. Many sinus and cold medications sold over-the-counter contain pseudoephedrine, which is known to constrict blood vessels. Ask your doctor if there are any other medications you need to avoid.
• Avoid injury to your feet and legs. Reduced blood flow increases your risk of complications from injuries. Choose well-fitting shoes that will protect your feet if you are participating in activities or work that might lead to injury.
• Keep your legs below your heart. Doing so can help improve the circulation to your feet. To keep the blood flowing well to your legs and feet at night, it helps to raise the head of your bed by 4 to 6 inches.

Source: http://www.mayoclinic.com

Coping and support

It can be frightening to learn that the reason you're having pain is that your blood vessels are narrowing. Learning all you can about what's causing your claudication can put you in control, and you'll know exactly what steps to take to ease your pain.

Some people also find it helpful to talk with other people who are going through the same thing that they are. In a support group, you may find encouragement, advice and maybe even an exercise partner or two. Ask your doctor if there are any support groups in your area.

Source: http://www.mayoclinic.com

Risk factors

The risk factors for claudication are the same as those for developing atherosclerosis, including:

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

Source: http://www.mayoclinic.com