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1. What is Intermittent Claudication?
A narrowing or blockage in the main artery taking blood to your leg may cause pain in your leg when you walk. This is due to hardening of the arteries (atherosclerosis). The pain you feel in your legs is called intermittent claudication. The reason for it is as follows:
Over the years cholesterol and calcium build up inside the arteries. This occurs much earlier in people who smoke and those who have diabetes or high levels of cholesterol in the blood.
The blockage means that the blood flow is reduced. The circulation is sufficient when you are doing nothing, however when walking the calf muscles cannot obtain enough blood and cramp occurs. This is made better by resting for a few minutes. If greater demands are made on the muscles, such as walking uphill, the pain comes on more quickly.
2. Does the blockage ever clear itself?
No, unfortunately not, but the situation can improve due to opening up of smaller arteries (collateral circulation) which carry blood around the block. Many people notice some improvement, as the collateral circulation opens up, within six to eight weeks of the onset of claudication.
3. How can I help myself?
There are several things you can do which may help. The most important is to stop smoking, take regular exercise and lose weight.
Smoking. If you are a smoker you must make a sincere and determined effort to give up completely. Tobacco is harmful on two counts. Firstly, it speeds up the hardening of the arteries, which is the basic cause of the trouble and secondly, cigarette smoke clamps down the small collateral vessels and reduces the amount of blood and oxygen to the muscles. The best way to give up is to choose a day when you are going to stop completely rather than trying to cut down gradually. If you do have trouble giving up please ask your doctor who can give you advice on nicotine gum and patches or put you in touch with a support group.
Diet. It is very important not to put on weight, because the more weight the legs have to carry around the more blood they will need. Your doctor or dietician will give you advice with regard to a weight reducing diet. If your blood cholesterol is high you will need a low fat diet and may also require cholesterol lowering drugs.
Exercise. There is good evidence that people who take regular exercise (walking at an easy pace until pain comes, on then stopping and continuing again when the pain disappears) develop a better collateral circulation. Try and make it a little further each day, and you will almost certainly find that the distance you can manage without pain slowly but steadily increases.
4. What about treatment?
Most people with intermittent claudication do not require surgery but if your symptoms are very severe, or if they do not improve, further treatment may be necessary. An ultrasound scan (Duplex) of the arteries is usually performed first to assess the extent of the problem. Following this an x-ray of the arteries (arteriogram) may be performed to confirm the feasibility of treatment. Short blockages can be stretched open with a balloon (angioplasty) in the x-ray department. This is usually done under local anaesthetic and often involves an overnight stay in hospital.
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