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Saturday, October 5, 2019

Does anyone know the treatment of Claudication


Claudication is pain caused by too little blood flow, usually during exercise. Sometimes called intermittent claudication, this condition generally affects the blood vessels in the legs, but claudication can affect the arms, too.
At first, you'll probably notice the pain only when you're exercising, but as claudication worsens, the pain may affect you even when you're at rest.
Although it's sometimes considered a disease, claudication is technically a symptom of a disease. Most often, claudication is a symptom of Peripheral artery disease, a potentially serious but treatable circulation problem in which the vessels that supply blood flow to your legs or arms are narrowed.Fortunately, with treatment, you may be able to maintain an active lifestyle without pain.


Claudication symptoms include:
  • Pain when exercising. You may feel pain or discomfort in your feet, calves, thighs, hips or buttocks, depending on where you might have artery narrowing or damage. Claudication can also occur in your arms, although this is less common.
  • Intermittent pain. Your pain may come and go as you do less-strenuous activities.
  • Pain when at rest. As your condition progresses, you may feel pain in your legs even when you're sitting or lying down.
  • Discolored skin or Ulcerations. If blood flow is severely reduced, your toes or fingers may look bluish or feel cold to the touch. You may also develop sores on your lower legs, feet, toes, arms or fingers.
Other possible symptoms include:
  • An aching or burning feeling
  • Weakness


Claudication is most often a symptom of Peripheral artery disease. In Peripheral artery disease, the arteries that supply blood to your limbs are damaged, usually as a result of atherosclerosis. Atherosclerosis can develop in any of your arteries, especially those in your heart. When atherosclerosis affects your arms and legs, it's called Peripheral artery disease.
Atherosclerosis narrows the arteries and makes them stiffer and harder. That's because the arteries get clogged with clumps of fat, cholesterol and other material, called atherosclerotic plaques. These plaques can make arteries so narrow that less blood can flow through them. You feel pain because your leg muscles are not getting enough oxygenated blood. Oxygen is the fuel that muscles need to contract.
Atherosclerosis isn't the only possible cause of your symptoms of claudication. Other conditions associated with similar symptoms that need to be considered include Spinal stenosis, Peripheral neuropathy, certain musculoskeletal conditions and deep venous thrombosis.


The risk factors for claudication are the same as those for developing atherosclerosis, including:
  • Smoking
  • High cholesterol
  • High blood pressure
  • Obesity (a body mass index over 30)
  • Diabetes
  • Age older than 70 years
  • Age older than 50 years if you also smoke or have Diabetes
  • A family history of atherosclerosis, Peripheral artery disease or claudication


In extreme cases, the circulation in your legs or arms can be so limited that you feel pain even when you aren't exercising, and your legs or arms might feel cool to the touch. Severe Peripheral artery diseasecan lead to poor healing of skin injuries and ulcers. These cuts and ulcers can develop Gangrene and require limb amputation.


Claudication may go undiagnosed because many people consider the pain an unwelcome but inevitable consequence of aging, and some people just reduce their activity level to avoid the pain. But the tests your doctor may use to diagnose your condition are often noninvasive and can get you back on your way to resuming an active life.
Some common tests used to diagnose claudication include:
  • Checking the pulses in your feet
  • Ankle-brachial index to compare the blood pressure in your ankles to the blood pressure in your arms
  • Doppler ultrasound, which monitors blood flow in the area affected
  • Magnetic resonance imaging (MRI) or computerized tomography (CT) angiography to show if your blood vessels are narrowed with plaque
The pain in your legs could be due to another condition, such as spine, joint or muscle problems. Your doctor can make a diagnosis based on your symptoms and a medical history, physical exam and appropriate tests.


Treatment of claudication and Peripheral artery disease can help prevent your disease from getting worse and reduce your symptoms. Lifestyle changes, such as quitting smoking and participating in a regular exercise regimen, are often the first steps in treating claudication.
If your claudication symptoms don't improve after adopting a healthier lifestyle, your doctor may suggest other treatment options, including:
  • Medications. Your doctor might recommend you take aspirin to reduce the chance of blood clots. He or she might also prescribe other medications that help keep your blood from clotting, such as clopidogrel (Plavix), dipyridamole (Persantine) and Ticlopidine. The medication cilostazol (Pletal) may help improve blood flow and reduce your symptoms. If you can't take cilostazol or if it doesn't improve your symptoms, your doctor may recommend that you try pentoxifylline (Trental). Additionally, if necessary, your doctor will also prescribe a cholesterol-lowering drug (statin) to lower your cholesterol.
  • Angioplasty. Cases of claudication and Peripheral artery disease that are more serious may require angioplasty. This is a procedure that widens damaged arteries using a narrow tube that travels through your blood vessels and has an inflatable balloon on the end that can help improve circulation. Once an artery is widened, your doctor may place a small metal or plastic mesh tube (stent) in the artery to keep it open.
  • Vascular surgery. Your doctor may recommend surgery that takes a healthy blood vessel from another part of your body to replace the vessel that's causing your claudication. This allows blood to flow around the blocked or narrowed artery.
Your doctor may also suggest a combination of treatments, such as medications and angioplasty.


The best way to prevent claudication is to maintain a healthy lifestyle. That means:
  • Quit smoking if you're a smoker.
  • If you have Diabetes, keep your blood sugar in good control.
  • Exercise regularly.
  • Lower your cholesterol and blood pressure levels, if necessary.
  • Eat foods that are low in saturated fat.
  • Maintain a healthy weight.


There aren't any alternative medicine treatments that have been proved effective for claudication.
Several treatments have had mixed results, proving beneficial in some studies, but then showing no benefit in others. These include:
  • Ginkgo
  • Propionyl-L-carnitine
Another treatment, L-arginine, appeared to help relieve symptoms of claudication.
Vitamin E and omega-3 fatty acids have also been suggested as treatments for claudication, but when studied in clinical trials, these treatments didn't help relieve symptoms.

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