Summary about Disease
Claudication is pain caused by too little blood flow to your muscles, most often during exercise. This condition primarily affects the legs, but it can occur in other areas, like the arms. It's often a symptom of peripheral artery disease (PAD), where arteries become narrowed due to plaque buildup (atherosclerosis).
Symptoms
The primary symptom is pain, aching, cramping, numbness, or fatigue in the muscles of the legs (or arms) that occurs during activity (usually walking) and subsides with rest. The location of the pain depends on the artery affected (e.g., calf pain, thigh pain, buttock pain). Other symptoms can include:
Weakness in the legs or feet
Coldness in the lower leg or foot
Sores or wounds on your toes, feet, or legs that heal slowly or don't heal
Changes in skin color or shiny skin on the legs
Slower growth of toenails
Decreased hair growth on your legs or feet
Erectile dysfunction, especially in men who have diabetes
Causes
The most common cause of claudication is peripheral artery disease (PAD), specifically atherosclerosis. Atherosclerosis is a condition in which plaque, made up of fat, cholesterol, calcium, and other substances, builds up inside the arteries, narrowing them and restricting blood flow. Other less common causes include:
Inflammation of blood vessels (vasculitis)
Injury to the limbs
Abnormal anatomy of muscles or ligaments
Blood clots
Spinal stenosis
Medicine Used
Medications used to treat claudication focus on improving blood flow, reducing the risk of blood clots, and managing underlying conditions like high blood pressure or cholesterol. Common medications include:
Antiplatelet medications: Aspirin, clopidogrel (Plavix) to prevent blood clots.
Cilostazol (Pletal): A vasodilator that improves blood flow and reduces leg pain.
Pentoxifylline (Trental): Helps red blood cells become more flexible and increases blood flow.
Statins: To lower cholesterol levels and stabilize plaque in the arteries.
Medications to treat high blood pressure: ACE inhibitors, beta-blockers, etc.
Is Communicable
Claudication itself is not communicable. It is a result of underlying conditions, primarily atherosclerosis, which are not infectious or contagious.
Precautions
Precautions to manage and prevent worsening of claudication include:
Quit smoking: Smoking significantly worsens PAD and claudication.
Manage blood pressure and cholesterol: Follow your doctor's recommendations for diet, exercise, and medication.
Control blood sugar: If you have diabetes, maintain good blood sugar control.
Regular exercise: Supervised exercise programs (walking) can improve blood flow and reduce symptoms.
Foot care: Inspect your feet daily for sores or injuries, and seek prompt treatment for any problems.
Healthy diet: Eat a heart-healthy diet low in saturated fat, cholesterol, and sodium.
Avoid prolonged sitting or standing: Take breaks to move around and improve circulation.
Stay warm: Cold temperatures can constrict blood vessels and worsen symptoms.
How long does an outbreak last?
Claudication isn't an "outbreak" in the traditional sense of an infectious disease. It's a chronic condition. The pain associated with claudication lasts for the duration of the activity that triggers it. When the individual rests, the pain usually subsides within a few minutes. However, without management, the underlying PAD will likely worsen over time, potentially leading to more frequent and severe claudication symptoms.
How is it diagnosed?
Diagnosis of claudication typically involves:
Medical history and physical exam: The doctor will ask about your symptoms, risk factors, and examine your pulses in your legs and feet.
Ankle-Brachial Index (ABI): Measures blood pressure in your ankles compared to your arms. A low ABI indicates PAD.
Doppler ultrasound: Assesses blood flow in the arteries of your legs and feet.
Angiography: Uses X-rays or MRI with contrast dye to visualize the arteries and identify blockages or narrowing. This can be done by catheter (conventional angiography), CT scan (CT angiography) or MRI (MR angiography).
Exercise testing: Walking on a treadmill to reproduce the symptoms and measure the distance you can walk before pain occurs.
Timeline of Symptoms
The timeline of claudication symptoms can vary significantly from person to person. It usually starts gradually.
Early stages: Pain may only occur after walking a significant distance or during strenuous activity.
Progression: As PAD worsens, the pain may occur with shorter distances or even at rest (rest pain, a sign of severe PAD).
Complications: If blood flow becomes severely restricted, complications such as non-healing wounds, infection, or tissue death (gangrene) can develop.
Important Considerations
Claudication is a significant risk factor for heart attack and stroke, as PAD often indicates widespread atherosclerosis.
Early diagnosis and treatment are crucial to manage symptoms, prevent complications, and improve quality of life.
Lifestyle changes, medications, and, in some cases, surgical procedures can effectively manage claudication.
Patients with claudication should be under the care of a physician specializing in vascular disease.
Ignoring claudication symptoms can lead to serious complications, including limb amputation.