February 7, 2017

Claudication is a common condition in which pain occurs in the legs with exercise. The pain is the result of a reduction in the blood flow to the muscles of the legs.

Claudication is defined as reproducible ischemic muscle pain, is one of the most common manifestations of peripheral arterial occlusive disease (PAOD) caused by atherosclerosis. Claudication occurs during physical activity and is relieved after a short rest. Atherosclerosis is the hardening and narrowing of the arteries over time through the buildup of fatty deposits, called plaque, along the artery walls. As plaques grow, they increasingly block the flow of blood through the arteries. Pain develops because of inadequate blood flow.

Claudication may occur in one or both legs, depending on where the blockage occurs. The pain is brought on by walking or exercise and disappears with rest. Claudication can range from being a mild nuisance to a disabling limitation. Claudication generally occurs when walking the same distance. With progressive vessel disease, the initial claudication distance (that distance at which a person first experiences pain when walking) may decrease or the person may no longer be able to walk.

About 9 million Americans, about 12 percent of the population, experience occasional claudication. Of those who are age 70 or more, about 20 percent are affected. About 25 percent of people who have hardening of the arteries (arteriosclerosis) in the legs experience 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. Claudication is a symptom of PAD, which is caused by atherosclerosis.

Risk factors for claudication are the same as those for atherosclerosis, and include –

  • Smoking
  • Diabetes
  • Overweight
  • Sedentary lifestyle
  • High cholesterol
  • High blood pressure
  • Family history of atherosclerosis or claudication
  • Older age (55 for men, 60 for women)
  • Having a family history of heart or vascular disease.


Typical symptoms of claudication include –

  • Pain, a burning feeling, or a tired sensation in the legs and buttocks while walking
  • Shiny, hairless, blotchy foot skin that may get sores
  • Paleness in the limb when elevated and reddened when lowered
  • Cold feet
  • Impotence in men
  • Leg pain that occurs at night when in bed
  • Pain that occurs at rest may be a sign of increasing severity of arterial disease in the leg(s)

The symptoms related to claudication may look like other medical conditions or problems. Always consult your doctor for a diagnosis.


  • Smoking cessation
  • Regular exercise, which is essential for patients with mild-to-moderate PAD
  • Heart-healthy diet, low in saturated fat, to reduce unhealthy cholesterol levels
  • Medications to help control high blood pressure and cholesterol. Other drugs that may help include antiplatelet medications to prevent blood clots.
  • In severe cases, procedures may be needed to open blocked blood vessels.

Angioplasty (stretching the artery where it is narrowed with a balloon) may help to improve walking distance for some people. Overall it is less effective in the longer term than simple exercise. Angioplasty is usually limited to narrowings or short complete blockages (usually less than 10cm) in the artery.

Bypass surgery is usually reserved for longer blockages of the artery, when the symptoms are significantly worse. There may be very short distance claudication, pain at rest, ulceration of the skin in the foot, or even gangrene in the foot or toes.

Alternative Treatment

L-carnitine appears to be of some benefit in intermittent claudication. Although it does not increase blood flow, carnitine appears to increase walking distance by improving energy utilization in the muscles.

Inositol hexaniacinate, a special form of vitamin B 3, appears to be helpful for intermittent claudication.

Mesoglycan is a substance found in many tissues in the body, including the joints, intestines, and the lining of blood vessels.

Ginkgo is an effective supplement for claudication.

Grape seed extract – Grapes, including the fruit, leaves and seeds, have been used medicinally since the time of the ancient Greeks. Grape seed extract is rich in oligomeric proanthocyanidins, antioxidants that integrative practitioners in Europe use to treat varicose veins, chronic leg ulcers and other symptoms of PAD.

Hesperidin – This flavonoid is found in unripe citrus fruits, such as oranges, grapefruits, lemons and tangerines.

Horse chestnut seed extract – The seeds, leaves, bark and flowers of this tree, which is native to Europe, have been used for centuries in herbal medicine.

Policosanol – This is a natural cholesterol-lowering compound made primarily from the wax of cane sugar. Comparative studies show that policosanol treats intermittent claudication as effectively as the prescription blood thinner ticlopidine (Ticlid) and more effectively than the cholesterol-lowering statin lovastatin (Mevacor).

Acupuncture – This practice involves the insertion of tiny needles into specific areas of the body. This is said to unblock the body’s flow of energy, promote healing and reduce pain.

Massage – Massage therapy can help to relax tense muscles and reduce the pain of spinal stenosis.

Pilates – This form of exercise serves to strengthen the muscles in the back and abdominals. Stronger muscles can provide the neck and back with better support, which may help to ease the symptoms of spinal stenosis.


Reference –,P08251/