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Claudication (Intermittent and Venous) Print E-mail

Dr. Kennedy Intermittent claudication is an aching, crampy, tired, and sometimes burning pain in the legs that comes and goes. It typically occurs with walking and goes away with rest and is due to poor circulation of blood in the arteries of the legs. In very severe claudication the pain is also felt ar rest. Intermittent claudication may occur in one or both legs and often continues to worsen over time. However, some people complain only of weakness in the legs when walking or a feeling of "tiredness" in the buttocks. Impotence is an occasional related complaint in men. The usually intermittent nature of the pain is due to narrowing of the arteries that supply the leg with blood, limiting the supply of oxygen to the leg muscles, a limitation that is felt especially when the oxygen requirement of these muscles rises with exercise. Intermittent claudication can be due to temporary artery narrowing due to vasospasm (spasm of the artery), permanent artery narrowing due to atherosclerosis, or complete occlusion (closure) of an artery to the leg. Another unrelated cause of intermittent claudication is what has been come to be called a "procoagulant" condition of the blood. This results from severe stress or infection and may not disappear after the stress or infection is gone. The blood tends to "sludge" and not flow through the capillary system freely. The condition is quite common, more so in men than women. It affects 1-2% of the population under 60 years of age, 3-4% of persons age 60 to 70 and over 5% of people over 70. The pulses in the legs and feet are evaluated on the clinical exam. Diagnostic tests include blood pressure measurements to compare the arms and legs, Doppler ultrasonography on the legs, duplex Doppler/ultrasound exam of the extremities to visualize arterial blood flow, an ECG, and arteriography (injecting dye that can be visualized in the arteries). By far the best treatment of intermittent claudication is intravenous chelation therapy with EDTA as this addresses both the condition of the blood and the condition of the arterial system. Enzymes and occasionally herparin are used to treat hypercoagulability.

Venous claudication is a limping and/or pain due to inadequate venous drainage, poor return of blood by the veins of the legs. This is usually due to varicose veins and can be successfully treated by sclerotherapy and/or surgery.



The information in this article is not meant to be medical advice.�Treatment for a medical condition should come at the recommendation of your personal physician.

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