Claudication: A Flag for Potentially Dangerous Health Conditions

I sat in the exam room, waiting for the the vascular surgeon to whom I'd been referred. Since I was pain-free at the moment, it felt as though the appointment was overkill. After taking my history, he said he was concerned that I might be suffering from claudication, a disorder that can signal potentially dangerous health problems.

Overview

Claudication hurts. According to the UC Davis Vascular Center, it's a condition marked by pain, aches or fatigue. It occurs in the muscles of an individual's buttocks, thighs and/or calf and is usually linked to exertion. The discomfort is the result of poor circulation caused by a blockage of the arteries in the extremity. What didn't fit in my case was that the throbbing in my legs seldom occurred during the day. Instead, it awakened me from sleep.

Around 12 percent of the population--nine million individuals--suffer from this disorder. Among those who are older than 70, the figure jumps to one in five.

The Mayo Clinic indicates that claudication can also affect the arms. And while the discomfort usually occurs while exercising, it affects some patients even when at rest.

In addition to the most common symptoms, other possible signs include a burning feeling, weakness and impotence in men. Toes or fingers might take on a bluish tinge or feel cold when touched. Some individuals develop sores on their toes, feet, lower legs, fingers or arms.

The risk factors for developing this condition match those for atherosclerosis, a hardening and narrowing of the arteries resulting from accumulated fat deposits known as plaque. Among them are smoking, having a total blood cholesterol level greater than240 mg/dL and suffering from high blood pressure or obesity. Those who have diabetes, are older than 70 or are older than 50 if they smoke or are diabetic face an elevated risk. Other risk factors include having a family history of atherosclerosis, peripheral artery disease (PAD) or claudication.

Why Claudication Spells "Danger"

While some medical experts consider claudication a disease itself, most recognize it as a symptom of a disease. The underlying illness is typically peripheral artery disease, which affects the arms and legs. In patients with PAD, damage has occurred to the arteries that supply blood to the limbs, often due to the existence of atherosclerosis, a potentially dangerous illness.

As the arteries of a patient with atherosclerosis get clogged with fat and other material, they narrow and harden, making it difficult for blood to flow to the extremities. When muscles in the legs or arms feel pain, it's due to a lack of sufficient oxygen, a direct result of reduced blood flow.

Individuals with very severe cases can experience pain or other discomfort even when at rest. In rare instances, patients experience poor healing of any skin injuries and ulcers and might ultimately develop gangrene.

Treatment

Physicians usually recommend that patients with claudication begin their treatment by adopting a healthier lifestyle. However, when this doesn't lessen the discomfort associated with this condition, they prescribe more formal treatments.

Medications. While aspirin helps reduce narrowing of the arteries, doctors often also prescribe medications to keep the blood from clotting and others to improve blood flow. Some patients need medication to lower their cholesterol levels.

Angioplasty. Serious claudication and PAD cases sometimes benefit from angioplasty. This surgical procedure uses an inflatable balloon to help open blood vessels and improve circulation.

Vascular surgery. Surgeons replace damaged blood vessels with those from another part of the body.

Hyperbaric chamber. Its oxygen-rich atmosphere helps heal ulcers and encourages the growth of cells.

Patients with claudication can help themselves by steering clear of unhealthy lifestyle practices such as smoking and by avoiding drugs like certain sinus and cold medications with pseudoephedrine, which is associated with constricting blood vessels. It's also important to be aware of cholesterol levels and make dietary changes to help correct unhealthy numbers. Other practical steps are avoiding any injury to the legs or feet and choosing appropriate footwear for each activity.

The goal for a claudication patient is always to prevent additional discomfort and to avoid the worsening of a potentially dangerous health problem.

Sources:

http://www.ucdmc.ucdavis.edu/vascular/diseases/claudication.html

http://www.mayoclinic.com/health/claudication/DS01052