Symptoms & Causes
Intermittent Claudication Symptoms
Claudication refers to muscle pain caused by a lack of oxygen that is triggered by activity and relieved by rest. Symptoms include the following:
Pain, suffering, discomfort, or fatigue in muscles every time you use those muscles
Pain in the calves, thighs, buttocks, hips, or feet
Pain in shoulders, biceps, and forearms
Pain that gets better or improves soon after resting
The pain might become more serious over time. You might even begin to have pain at rest.
Signs or symptoms of peripheral artery disease, generally in more advanced stages, include:
Serious, constant pain that progresses to numbness
Wounds that do not heal
When should you see a doctor?
Talk to your doctor or primary care physician if you have pain in your legs or arms when you exercise. Claudication could lead to a cycle that results in worsening cardiovascular health. Pain might make exercise intolerable, and a lack of exercise results in poorer health.
Peripheral artery disease is a sign of poor cardiovascular health and an elevated risk of heart attack and stroke.
Other conditions involving the blood, nerves, and bones could contribute to leg and arm pain during exercise. It is important to have a complete examination and appropriate tests to diagnose potential causes of pain.
Intermittent Claudication Causes
Claudication is most usually a symptom of peripheral artery disease. The peripheral arteries are the large vessels that deliver blood to the network or system of vessels in your legs and arms.
Peripheral artery disease is damage to an artery that limits the flow of blood in an arm or leg (a limb). When you are at rest, the restricted blood flow is usually still enough. When you are active, although, the muscles are not getting enough oxygen and nutrients to work well and remain healthy.
Damage to peripheral arteries is generally caused by atherosclerosis. This is the build-up of cholesterol and other fats, blood cells, and other cellular debris into unusual structures or plaques on the lining of an artery.
Plaques cause a narrowing and stiffening of the artery, restricting the flow of blood. If the plaques rupture, a blood clot could form, further lowering blood flow.
Intermittent Claudication Risk factors
The risk factors for peripheral artery disease and claudication involve the following:
High blood pressure
Obesity (a body mass index (BMI), over 30)
Chronic kidney disease
Age older than 70 years
Age greater than 50 if you smoke or are diabetic
A familial history of atherosclerosis, peripheral artery disease, or claudication
Intermittent Claudication Complications
Claudication is usually considered a warning of significant atherosclerosis in the circulatory system, indicating an elevated risk of heart attack or stroke. Additional complications of peripheral artery disease caused by atherosclerosis include:
Skin lesions that do not heal
Death of muscle and skin tissues or gangrene
Amputation of a limb
The best way to prevent or stop claudication is to maintain healthy living and control specific medical conditions. That means:
Quit smoking if you are a smoker
Eat a healthy, well-balanced diet
Maintain a healthy weight
If you have diabetes, keep your blood sugar in good control
Keep cholesterol and blood pressure within normal values
Intermittent Claudication Diagnosis
Claudication might go undiagnosed or unidentified because many people believe the pain to be an unwelcome but normal part of aging. Some people simply lower their activity level to circumvent the pain.
A diagnosis of claudication and peripheral artery disease is based on a review of your symptoms, a physical examination, an assessment of the skin on your damaged limbs, and tests to examine blood flow.
Some common tests used to diagnose claudication might include:
Pulse measurement in your palms or feet to analyze blood flow to the entire limb
Ankle-brachial index, comparison or analysis of blood pressure in your ankles with the blood pressure in your arms
Segmental blood pressure measurement, a series of blood pressure measurements at different regions on your arm or leg to help determine the amount and location of arterial damage
Exercise testing to determine the maximum distance you could walk or the maximum exertion without pain
Doppler ultrasound to view the flow of blood
Magnetic resonance imaging (MRI) or computerized tomography (CT) angiography to seek narrowed blood vessels
Intermittent Claudication Treatment
The aims of treating claudication and peripheral artery disease are to lower pain and manage the risk factors that contribute to vascular disease.
Exercise lowers pain, increases exercise duration, improves vascular health in the damaged limbs, and contributes to weight management and an overall improvement in your quality of life.
Recommended walking programs involve:
Walking till you feel moderate or pain
Resting to ease pain
Repeating the walk-rest-walk cycle for thirty to forty-five minutes
Walking 3 or more days a week
Supervised exercise is suggested for starting the treatment, but long-term exercise at home is crucial for ongoing disease management.
Medications to manage risk factors
Your primary care physician might prescribe one or more medications to control pain and manage risk factors for vascular disease. These involve drugs to manage the following:
Pain - The drug cilostazol, which improves blood flow, might lower pain during exercise and allow you to walk further.
High cholesterol - Statins are a type of drug that helps lower cholesterol, a key factor in the formation of plaques in arteries. Taking statins might improve the walking distance.
High blood pressure - Various classes of drugs might be prescribed to lower blood pressure and lower the risk of heart attack or stroke.
Other cardiovascular risks - Anti-platelet drugs, which help stop the formation of blood clots, might lower the risk of heart attack, stroke, or clots blocking blood flow to limbs. These drugs include aspirin, clopidogrel (Plavix), and other types of drugs.
Talk to your primary care physician about over-the-counter medications, supplements, or other medications that you should not take with your prescribed treatment.
Intermittent Claudication Surgery
When peripheral artery disease is serious and other interventions do not work, surgery might be needed. Options include:
Angioplasty - This is a procedure to improve blood flow by widening an affected artery. A primary care physician guides a narrow tube through your blood vessels to deliver an inflatable balloon that expands the artery. Once the artery is widened, your primary care physician might place a small metal or plastic mesh tube or stent in the artery to keep it open.
Vascular surgery - During this type of surgery, the primary care physician takes a healthy blood vessel from another part of your body to replace the vessel that is causing claudication. This enables blood to flow around the blocked or narrowed artery.
If you or anyone you know suffers from intermittent claudication, the best option for you is treatment by Dr. Ahsan Ali. Call us at 469-808-0000 to book an appointment