Intermittent Claudication, Arteriosclerosis obliterans, Vaso-occlusive disease of the legs, Blockage of leg arteries, Peripheral vascular disease, (PVD), Recurrent leg pain and with cramps, Tired legs, Arterial insufficiency of the limbs, Calf pain with physical exercise.


Claudication is a condition where the person experiences pain due to inadequate blood flow especially during physical exercises. The condition is commonly seen affecting the blood vessels in the legs, but cases showing claudication in arms are also reported. The condition may worsen and affect a person even during the resting period. Claudication is a symptom of peripheral arterial disease rather than a disease itself.

Peripheral artery disease causes narrowing and later on hardening of the arteries (arteriosclerosis) that supply legs and feet with blood.

Claudication is said to affect roughly 10% of the western population that are older than 65 years. The figure is 5% in the case of intermittent Claudication. Though men were thought to be at high risk, recent researches show no gender specificity.


The condition as stated earlier is considered a symptom of peripheral artery disease, where the arteries that supply blood down to the legs are damaged as a result of atherosclerosis.

Atherosclerosis causes the hardening and narrowing of the arteries in the legs as a result of cholesterol and other fatty deposits in the intima of vessel wall. These deposits form atherosclerotic plaques which reduces lumen of the supplying artery.  All these changes results in reduction of blood flow. Reduced circulation of blood through to the legs causes the pains during exercise.

Risk factors:
  • Raised lipid levels especially cholesterol
  • Heart disease like coronary artery disease (CAD)
  • Hypertension or High Blood pressure
  • Diabetes
  • Patient on hemodialysis
  • Family History of similar conditions
  • Smoking
  • Stroke


Symptoms brought about by Claudication include:
  • Frequent pains when exercising or in strenuous physical activity. The pain is around the feet, calves, thighs all the way up to the hips and gluteus muscles depending on where the artery has narrowed
  • Intermittent pain that comes and goes when a person performs less strenuous activities
  • Pain at night
  • Pain at rest where the person experiences pain in their legs especially when sitting or lying down
  • Ulcerations and discoloring of the skin may also be experienced in the case of severe Claudication. The fingers or toes may feel quite cold to the touch and may appear bluish. In rare occasions, the person may also develop sores around the lower legs, toes, feet arms and fingers.
  • Tingling in the legs, with extreme discomfort
  • Pain on leg elevation, relieving with legs down position
 According to studies on the condition, other rare but serious symptoms include:
  • General physical weakness
  • Possible impotence in men
  • A burning feeling


The symptoms are self explanatory and physical examination will help to arrive at provisional diagnosis.
  • Pulse in the feet: Low pulse
  • Ankle-brachial index (ABI): Comparison among blood pressure at the level of arm and ankle. ABI ratio of less than 0.90 directs a good diagnostician to advise further investigations to rule out other conditions. 
  • Segmental Blood pressure: Measuring blood pressure at various levels in the leg to find out the level of blockage.


These are performed to rule out pain of any other origin.
  • Doppler ultrasound: To detect, level and severity of blocks
  • Computed tomography (CT) and magnetic resonance angiography (MRA): These tests are performed to visualize an arterial tree and to find the location and severity of block/s.
  • Treadmill test:  Extremely poor performance with treadmill test.


  • Claudication is one of the symptoms of Peripheral vascular disease. So a prompt treatment is essential to avoid further complications.
  • Plenty of physical exercise coupled with rest period can help to improve the condition and reduce the severity of the symptoms. Collateral vessels are created with regular exercises, which increase the blood flow especially to the most affected muscles.
  • Control over blood sugar and lipid  level, Blood pressure regulation, weight reduction program will boost the medical treatment.
  • Cessation of smoking is important, which will increase the amount of Oxygen rich blood in the body.
Medical Treatment:
  • Aspirin is started to control blood vessel narrowing.
  • Medicines to reduce blood viscosity and to dilate artery lumen are started.
  • Drugs to control Blood pressure, Lipid level and Diabetes are given as per the requirement.
  • Medicines to relive pain (painkillers)
  • Medications are only important to improve the blood flow and not to remove the blockage. Surgery is performed if required.
Surgical Management:
  • A vascular surgeon may perform procedure, to relieve symptoms which are not responding to the medical treatment.
  • The options available are:
  • Angioplasty: A balloon is used in the blocked artery, inflating which widens the lumen of the blood vessel, improving the blood flow.
  • Stent: It’s a Wire mesh used to hold dilated portion of the blood vessel in the position after the angioplasty is performed.
  • Bypass in the affected artery: It involves bypassing the original vessel with a graft from patient’s vein or artificial tube. It is used to improve blood flow in the affected area.
  • Blood tests: To know the fasting and post prandial sugar level and lipid profile.


Complications that may arise from Claudication include:
  • Gangrene of the toes
  • Impotence
  • Cellulitis of the legs
  • Skin ulcers
  • Stasis dermatitis
  • Varicose veins


The prognosis of the condition due to atherosclerosis is quite poor. Intermittent claudication caused by atherosclerosis is more likely to cause death from a cardiovascular disease. This is because the same condition in their legs is much similar to the condition in the heart.


Preventing the occurrence of claudication includes:
  • Avoiding tobacco and the use of cigarettes
  • Avoiding exposure to secondary smoke
  • Following an exercise plan as per the doctor’s advice.
  • Eating healthy by using the least cholesterol with low fat and high nutrients
  • Diabetes treatment
  • High cholesterol treatment
  • High blood pressure treatment


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