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.

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

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.

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, certain musculoskeletal conditions and deep venous thrombosis.

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

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.

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.
Jan. 31, 2015
References
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  2. Peripheral artery disease. The Merck Manual Professional Edition. http://www.merckmanuals.com/professional/cardiovascular_disorders/peripheral_arterial_disorders/peripheral_arterial_disease.html. Accessed Nov. 18, 2014.
  3. White C. Intermittent claudication. New England Journal of Medicine. 2007;356:1241.
  4. Rooke TW, et al. 2011 ACCF/AHA focused update of the guideline for the management of patients with peripheral artery disease (updating the 2005 guideline). Journal of the American College of Cardiology. 2011;58:2020.
  5. Rudisill HM, et al. Effective therapies for intermittent claudication. American Family Physician. 2011;84:699.
  6. Vodnala D, et al. Medical management of the patient with intermittent claudication. Cardiology Clinics. 2011;39:363.
  7. Nordanstig J, et al. Improved quality of life after 1 year with an invasive versus a noninvasive treatment strategy in claudicants: One-year results of the Invasive Revascularization or Not in Intermittent Claudication (IRONIC) Trial. Circulation. 2014;130:939.
  8. Mazari FAK, et al. Randomized clinical trial of percutaneous transluminal angioplasty, supervised exercise and combined treatment for intermittent claudication due to femoropopliteal arterial disease. British Journal of Surgery. 2012;99:39.