PAD and Claudication
Claudication is pain in the legs caused by too little blood flow. It is generally associated with conditions such as peripheral artery disease or arteriosclerosis. While it primarily occurs in the legs, claudication may also affect the arms. If left untreated, claudication may have serious medical consequences.
Causes of Claudication
Patients experience claudication when their leg muscles are not getting enough oxygenated blood. This lack of proper circulation results from two primary factors:
Arteriosclerosis - Arteriosclerosis is a normal part of aging during which makes arteries harden and narrow.
Atherosclerosis - Atherosclerosis is a condition in which the arteries become clogged with plaque. This may result from a combination of genetic, dietary and medical factors. Arterial plaque is composed of fat, cholesterol, calcium and other substances. In atherosclerosis, plaque is deposited on the arterial walls, impeding blood flow.
Causes of atherosclerosis, which in turn may result in claudication, include:
- Family history of atherosclerosis or peripheral artery disease
- High cholesterol
Symptoms of Claudication
Patients with claudication may experience one or more of the following symptoms:
- Pain that worsens during exercise
- Discolored skin
- Weakness, burning of ulcers of the skin in the affected area
Diagnosis of Claudication
There are several methods for diagnosing claudication. During careful medical examination, the physician may check the pulses in the feet and also perform an ankle-brachial index, comparing the blood pressure of the ankles with that of the arms. In addition, the doctor may request a Doppler ultrasound to measure blood flow to the affected area or an MRI or CT scan angiography to observe possible damage to blood vessels
Other conditions, including neuropathy and certain musculoskeletal conditions, may cause symptoms similar to those of claudication, so a careful diagnosis must be made.
Treatment of Claudication
In order to relieve pain and slow the progression of peripheral artery disease, patients are required to make lifestyle changes. These may include:
- Regular exercise
- Cessation of smoking
- Lowering cholesterol through diet and/or medication
- Wearing supportive shoes
If claudication does not respond to lifestyle changes, other treatments for the condition may include:
- Vascular surgery
- Hyperbaric chamber treatment
Risks of Claudication
There are serious risks to untreated claudication. Circulation in the legs or arms may become so limited that pain is persistent and ongoing, even at rest. In addition, the patient's legs or arms may feel cool to the touch. Poor healing of skin injuries and development or exacerbation of ulcers may occur. In the most extreme cases, the patient may develop gangrene and require amputation of an affected limb.