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Intermittent Claudication

Intermittent Claudication is the term used to describe the symptom of muscle cramp like pain which comes on with excercise. It most often occurs as a pain in the calf, thigh or buttock after walking a certain distance and is relieved by rest. It is caused by narrowing or blockage in the arteries taking blood to the leg. This is due to a build up of plaque reducing the blood flow. Build up of plaque is known as atherosclerosis.

Intermittent claudication is usually the first symptom of reduced blood flow to the legs resulting in insufficient blood flow to supply muscles for exercise. More severe disease may result in blood flow being inadequate for maintaining tissue viability at rest, this is called critical ischaemia. Most patients presenting with intermittent claudication will not go on to develop critical ischaemia, but it is important for them to control their risk factors for atherosclerosis and to receive appropriate treatment to help prevent progression.

The diagnosis of claudication is made by taking a careful record of symptoms, excluding other causes of leg pain, physical examination and non-invasive (no needles) tests with ultrasound.

Treatments for intermittent claudication include risk factor control, exercise, endovascular procedures and open surgical operations.

Risk factor control: The risk factors for atherosclerosis are; smoking, high blood pressure, diabetes, high cholesterol and family history. Control involves optimising medical treatment for any of these underlying conditions with tablets including lipid lowering agents (statins) and smoking cessation.

Regular exercise will often help reduce the symptoms of intermittent claudication by building up blood flow in smaller arteries.

Endovascular intervention: Using minimally invasive techniques under local anaesthetic, narrowings or blockages in arteries can be stretched up using a balloon or stent.

Open surgery: An operation can be performed to remove the plaque or insert a bypass graft to carry blood around a blockage.