Intermittent claudication Dr Rob Hicks In this condition, poor blood supply to the muscles of the legs causes pain and stops activity.

In this article

What is intermittent claudication? Symptoms

Causes and risk factors Treatment and recovery

This is a cramping pain felt in the calf, thigh or buttock during walking or other exercise. It is caused by lack of oxygen to the muscles because of a poor blood supply, and is relieved by rest.

The term claudication comes from the Latin for 'to limp'. The affected person doesn’t normally limp but as they walk, the pain starts to build and they limp to a standstill.

People affected describe intermittent claudication as an aching or cramping pain, accompanied by tightness or fatigue in the leg muscles or buttocks. For some, this pain arises only during strenuous activity; for others (with more severe disease of the arteries) it comes on after walking a few metres. The key factor is that the pain stops within a few minutes of resting.

Claudication is one of the most common symptoms of peripheral arterial disease (PAD), also known as peripheral vascular disease (PVD). In people with PAD the arteries of the extremities - the feet, legs, hands and arms - become hardened or furred up (a process called arteriosclerosis) as cholesterol plaques build up on the inside of the arteries walls. This in turn obstructs blood flow.

When we walk, our muscles demand more oxygen, which is delivered through the circulation of blood. If not enough blood can get through, the muscles don't receive enough oxygen and we experience pain.

When someone with intermittent claudication rests, the need for additional oxygen disappears and so does the pain

Intermittent claudication is much more common in men than women. It affects up to 10 per cent of people aged over 65 in developed countries. Most of those affected will also have significant disease of the coronary arteries and are at risk of heart attack and stroke.

The major risk factors for intermittent claudication include:

• Diabetes
• High cholesterol
• Smoking
• Hypertension
• Lack of physical activity
• High levels of a chemical called homocysteine
• Family history of arterial disease

The first step is to deal with or eliminate the risk factors for intermittent claudication. It’s vital that the person makes every effort to give up smoking – chemicals in cigarette smoke cause the arteries to narrow further and smokers with intermittent claudication are at particular risk of eventually having to have a limb amputated.

Exercise therapy can help increase the distance people can walk before experiencing symptoms. A programme of regular walking for 45-60 minutes a day (with rest every time pain arises), can improve exercise tolerance by 250 per cent .

Medication may also be recommended, including aspirin to reduce the risk of blood clotting in the narrowed arteries, cholesterol-lowering drugs and drugs to improve blood flow and control high blood pressure.

Sometimes it's necessary to perform surgery on the arteries to widen them or bypass a blockage so blood can flow more effectively.

This article was last medically reviewed by Dr Trisha Macnair in March 2009.