Intermittent 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.

What causes claudication?

Several medical problems can cause claudication, but the most common is peripheral artery disease. Peripheral artery disease (PAD) is caused by atherosclerosis, which is a hardening of the arteries from accumulation of cholesterol plaques that form on the inner lining of the arteries. This is especially common at branching points of the arteries in the legs. Blockage of the arteries from these plaques causes low blood flow to the muscles in the legs. When walking or exercising the muscles in the legs require more blood flow to increase oxygen to the cells. Atherosclerotic plaques cause decreased blood flow and decreased oxygen. The muscles of the legs can ache and burn as a result of inadequate oxygen. This is felt as cramping in the legs.

What are the symptoms of claudication?

Pain and cramping in the legs is the main symptom of claudication. Pain can be sharp or dull, aching or throbbing, or burning. The severity of the peripheral artery disease, the location of the plaque, and the activity of the muscles determine the severity of symptoms and location of pain. Calf pain is the most common location for leg cramps. This is because the atherosclerotic plaques often begin in the arteries farthest from the heart. If the blockage or plaque formation is farther up the leg, the pain from claudication may be felt in the thigh. If the blockage is in the aorta (the main artery from the heart to the legs) then symptoms may include pain in the buttocks or groin or erectile dysfunction in men.

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. Claudication that comes and goes is often referred to as intermittent claudication.

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 from the complete blockage of an artery of the leg.