Understanding Intermittent Claudication

by Dr. Emily Splichal, DPM MS

Intermittent claudication is pain and cramping in the calf that is induced with walking or exercise and is relieved by rest.  Considered a type a circulatory condition or more specifically peripheral arterial disease (PAD), intermittent claudication occurs as a result of muscle ischemia (decreased oxygen) caused by obstruction to arterial flow.  

Almost a fifth of the population over the age of 65 has intermittent claudication, with cigarette smoking being the most potent risk factor for developing peripheral atherosclerosis and intermittent claudication.  

How is it Diagnosed?

The diagnosis of intermittent claudication is based on clinical presentation with a history of cramping muscle pain that occurs after the same degree of exercise associated with a certain distance walked, such as a number of blocks.

Occasionally patients will present with absent pulses in their feet and will have a decrease in arterial pressure which measured as ankle-brachial-pressure index.  

How is it Treated?

Although the natural course of intermittent claudication itself is fairly benign, it is typically associated with greater cardiovascular diseases such as atherosclerosis and risk of heart attacks. 

Treatment for intermittent claudication falls into two categories:   

1.  Reducing overall cardiovascular risk factors

2. Reducing the symptoms of intermittent claudication

Some of the most common ways of reducing cardiovascular risk include:

• Smoking cessation
• Anti-platelet medication
• Blood pressure medication
• Cholesterol medication

To reduce the direct symptoms of intermittent caudation, options include:

• Exercise to encourage collateral circulation
• Angioplasty to improve circulation
• Bypass surgery

Intermittent claudication is often the first clinical manifestation of peripheral arterial disease, which in most cases is itself a manifestation of atherosclerosis or blocked arteries.   

The condition should be taken seriously and considered one that is a sign of overall cardiovascular disease.  

To learn more about intermittent claudication and the risk factors please consult with your medical doctor.