How does it occur?

The pain is caused by narrowing or blockage of the arteries supplying the painful muscles. The blockage is usually caused by atherosclerosis. Atherosclerosis, also called "hardening of the arteries," occurs when fatty substances build up in the artery wall. The main fatty substance in this buildup is cholesterol. This buildup makes the artery stiffer than normal and causes partial or complete blockage of the flow of blood and oxygen to the body. There may be enough blood flow and oxygen for the muscle at rest, and that is why you may not have discomfort at rest. However, when the muscle exercises, the lack of enough blood flow and oxygen causes pain.

How is it diagnosed?

Your symptoms will suggest claudication as a possible diagnosis. Your health care provider will check how strong the pulses are in your arms, wrists, groin, behind your knees, below your ankles, and on the tops of your feet. If the pulses are weak or absent, a decreased blood supply is likely. Blood pressures in the arms and legs on both sides of your body may be compared to look for blockage in the arteries. If the blood pressure in your legs is lower than in your arms, you may have blockages in the arteries going to your legs.

Your doctor may order a Doppler ultrasound. This is a test that can measure both the amount of blockage and the speed of blood flow in your arteries. If the blockage is severe, your doctor may recommend angiography of the arteries. Angiography is procedure in which a special dye is injected into the artery and x-ray pictures of the blood vessel are taken to pinpoint the location and extent of the blockage.

How is it treated?

• Exercise under the guidance of your provider. Exercise may improve your ability to do physical activities without symptoms. You may need to limit physical activity to what you can do without causing symptoms.

• Have your blood pressure and blood cholesterol checked regularly.

• If you smoke, quit. Tell your provider if you need help quitting.

• If you are overweight, talk to your provider about losing weight.

• Switch to a low-fat, low-cholesterol, high-fiber diet. Your provider or a dietician can tell you which foods to avoid.

• Take the medicine prescribed and follow your health care provider’s advice for lifestyle changes. There are several medicines available that may reduce symptoms and increase your ability to exercise.

If your symptoms cannot be controlled or they seriously interfere with activity, you may need surgery to remove or bypass the blockage. Balloon angioplasty, in which a small balloon is inserted into the artery and expanded at the area of blockage, also works. Sometimes balloon angioplasty is combined with inserting a stent. A stent is a device that keeps the artery open to improve blood flow.

What are the results of treatment?

How well treatment works depends mostly on how fast your atherosclerosis gets worse. It is very important for someone with intermittent claudication to do everything possible to control atherosclerosis. Exercise programs and surgery or angioplasty can improve symptoms a lot.

This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.

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