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Recurrent blockage of leg arteries
Definition:
Recurrent blockage of leg arteries results from poor arterial circulation of blood in the legs. This produces an aching, tired, and sometimes burning pain in the legs that is brought on by exercise, and relieved by rest. Claudication refers to the limping that occurs from leg cramping.

Alternative Names:
Intermittent claudication; Vaso-occlusive disease of the legs; Arterial insufficiency of the legs; Recurrent leg pain; Recurrent leg cramping; Calf pain with exercise

Considerations:
Intermittent claudication may occur in both legs, and it often continues to worsen over time. However, some people complain only of weakness in the legs when walking, or a feeling of "tiredness" in the buttocks. Impotence is an occasional complaint in men. Pain at rest is uncommon.
Common Causes:

This condition is due to narrowing or blockage of the arteries (atherosclerosis or arteriosclerosis obliterans - peripheral vascular disease). Blockage of arteries can occur anywhere in the body. If they occur in the heart, a person may experience angina or even a heart attack. If they occur in the neck or the brain, a person may have a stroke.

Intermittent claudication is when the blockage occurs in the legs, most commonly in the calf or the foot. It occurs only at certain times, such as after a period of walking and is relieved by rest.

Atherosclerosis, or blockage of arteries, can occur for many reasons such as smoking, diabetes, and high cholesterol.
Home Care:

Talk to your doctor about the cause of your leg cramping and home care. A healthy diet is important to decrease progression of atherosclerosis.

A program of daily walking for short periods, and stopping for pain or cramping, may help improve function. It is essential to stop smoking.

Avoid applications of hot or cold items on legs. Avoid tight shoes.
Call your health care provider if:

There are many other causes of leg pain such as arthritis or low blood potassium. However, some causes of leg pain may be life threatening such a blood clot in the legs. Seek medical attention if you have:

  • Leg pain that does not go away.
  • Legs that may be red, hot or swollen.
  • Any chest pain or shortness of breath accompanying leg pain.
  • Diabetes.
  • If you are pregnant.
What to expect at your health care provider's office:
The medical history will be obtained and a physical examination performed.

Medical history questions documenting claudication in detail may include:
  • Time pattern
    • Do you have leg cramps at night (nocturnal cramps)?
    • How often does leg pain with cramping occur?
    • Is it getting worse?
  • Quality
    • Is the pain sharp?
    • Is there an aching pain with the cramps?
  • Aggravating factors
    • Is it worse after you exercise?
    • Is it worse after you are standing?
    • Do you smoke? How much?
    • Do you drink alcohol? How much?
    • Are you diabetic? How well is your blood sugar controlled?
  • Other
The physical examination may include evaluation of the femoral pulse (in the groin) and the other areas where the pulse can be felt in the legs.

Diagnostic tests that may be performed include: Intervention:
Surgical or angioplastic treatment may be indicated if claudication interferes appreciably with the patient's essential activities or work, and if the diseased arteries appear likely to improve after corrective treatment.

After seeing your health care provider:
If a diagnosis was made by your health care provider related to cramping leg pain, you may want to note that diagnosis in your personal medical record.
Review Date: 9/11/2001
Reviewed By: Poune Saberi, M.D., M.P.H., Family Practice and Community Medicine, University of Pennsylvania Medical Center, Philadelphia, PA. Review provided by VeriMed Healthcare Network.
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