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Peripheral Vascular Disease: Intermittent Claudication


Intermittent Claudication


 Your GP or a Specialist may have diagnosed you as having Intermittent Claudication. This page contains information about the condition and answers to frequently asked questions about the diagnosis, treatment and risks of peripheral arterial disease.

What is Intermittent Claudication (IC) ?

Intermittent Claudication is really a symptom, and not a disease. It is a sign that the blood flow to the muscles is being restricted, usually by furring up of the arteries in the leg due to Peripheral Arterial Occlusive Disease (PAOD, or PVD)


How does it usually affect people ?

The classic symptom of IC is pain, often described as a cramp, in the calf muscles which occurs on walking. It will come on every time you exercise, usually occurs at a very similar distance each time, but may come on sooner if walking uphill or quickly. It always settles quickly when you rest. It is never present at rest, or while in bed.


Can it affect other areas ?

The same symptoms can occur in the heart, where it is called angina. Arterial disease rarely affects the arms for some reason, so these can be affected but it is unusual. Occasionally the pain may affect the thigh or buttock muscles, if the arteries are blocked above the groin. Usually however this is more tiredness and heaviness than a cramping pain. It can be difficult to tell circulation symptoms from other causes.


Why have I got it ?

The arteries to your leg are probably narrowed or blocked. This is called atherosclerosis. The same problem can affect the arteries to the heart and would cause angina. The cause of the arteries furring up (atherosclerosis) is a combination of smoking, high blood pressure, diabetes, high cholesterol, your family history and just getting older. Not everyone has every risk factor, some of these can be improved, some can't.


Will my symptoms get worse ?

Probably not, if you can follow the advice. Regular exercise has been shown to increase the distance people can walk before the pain comes on but this process may take up to a year to complete. Very few people improve significantly unless they stop smoking. If you are overweight, you will see a difference by losing weight, as the muscles don't have to work as hard with each step and can go on for longer before needing a rest.


Am I going to lose my leg ?

Probably not, if you follow the advice. The chances of you losing your leg are less than 1% if you manage to give up smoking, unless you are diabetic or have kidney disease.


What can I do to get better ?

Stop smoking, take regular exercise and avoid being overweight. If you have high blood pressure or diabetes you should make sure these are well controlled. Aspirin is very important at preventing heart attacks, but doesn't really affect intermittent claudication.In the long term, reducing your cholesterol with a statin is also beneficial.


Will I need an operation ?

Not usually. Intervention can be an operation or a balloon stretch, but is only needed when the symptoms do not imporve over a few months and are significantly impacting on your lifestyle.If you have an operation and continue smoking, it will fail and you may get much more severe symptoms including a risk of losing the leg.


What should I worry about ?

Claudication is not a sign that any harm is being done to the muscles or tissues. It is a sign that you have arterial disease and this may also affect other parts of the circulation such as the neck or the heart. nly a very small number of people go on to constant pain, and are in danger of amputation. The major complication that patients with PAOD are prone to is a heart attack, but the same measures that are recommended for claudication will also offer some protection against this occurring.


My pain doesn't follow the pattern 

If your pain comes on when you're not exercising, or affects more than just the muscles, or doesn't settle quickly on resting then it may not be circulation related. Nerve pain (sciatica), joint or muscle problems (arthritis, fibromyalgia) can also cause pain in the leg.