AKA: Claudication

 

 

Intermittent claudication is a cramping leg pain mostly at the level of the calf that develops when walking and is relieved with rest. It is caused by lack of oxygen due to inadequate blood flow to the leg muscles because of atherosclerosis (fatty deposits blocking blood flow through the arteries).

People with mild-to-moderate claudication are advised to keep walking, stop smoking and reduce cardiovascular risk factors. Other treatments include antiplatelet therapy and pentoxifylline, angioplasty (inserting a balloon into the artery to open it up) and bypass surgery.

Many studies show that exercise programmes clearly improve walking time and distance for people considered fit for exercise regimens. This benefit appears to be sustained over two years.

Comparisons of exercise with surgical intervention, angioplasty, antiplatelet therapy, pentoxifylline, iloprost and pneumatic foot and calf compression were limited because of small numbers of trials and participants. Exercise programmes are relatively inexpensive and low risk compared with other more invasive therapies for improving leg pain on walking and related quality of life. People with intermittent claudication are often elderly and have other pre-existing medical conditions, which would compromise an exercise programme or make it impractical.

Exercise

Taking exercise by regular walking is the best treatment for most patients with intermittent claudication and will help symptoms to improve. Walking distance can improve a lot because exercise encourages small arteries in the leg to carry more blood and helps the muscles to work more efficiently. Walking 3 times a week for an hour is recommended. You can stop and rest as often as you need to during these exercise sessions.

You will do no harm by trying to walk as far as your comfort allows. Some people find they can "walk through" the pain, but it is unwise to continue if your leg becomes very painful, and especially if exercise makes you feel unwell in other ways (for example, with shortness of breath or chest pain). You will get further if you walk slowly, and if you stop for rests before the pain gets too bad.

Treatment for claudication:

Walking through the pain - walk a little further each day till you can manage to walk briskly for 20 - 30 minutes 5 times a week. Keeping this up has been proved to be of great benefit. This may seem impossible at present but the majority of people with intermittent claudication find that with perseverance they can improve their symptoms dramatically. Keeping a diary of activities and symptoms may help you see an improvement.

Eating a low fat diet: We will give you a fact sheet to help you choose a healthy diet.

Stop Smoking: Stopping smoking is the single most effective way you can improve your health. If you are still smoking you are strongly advised to give it up. If you would like help with this, we can refer you to a smoking cessation advisor, who can offer the support that you may need to give up.

This treatment and self-help will have other benefits too:

1. Improved walking distance
2. Disappearance of night cramps
3. Warmer feet
4. Less breathlessness or angina on exertion
5. General fitness improvementBetter sleep patterns
6. Increased confidence and feel good factor

 

An exercise program will be of lasting benefit, if you can keep it up. You should aim to exercise at least 30 minutes five times a week and include dynamic exercise, of the sort that involves movement (often referred to as aerobic), especially if you have heart symptoms as well.

Avoid exercises that involve excessive force, such as weight lifting or sudden bursts of activity such as squash. If you are taking warfarin avoid contact sports.

Brisk walking is very useful in preventing claudication recurring, but if you enjoy swimming, cycling dancing and gentle jogging, all these are good exercises for the calf muscles.

Do not exercise:

1. If you have chest pain
2. ithin one hour of a meal (it is better to exercise before meals)
3. If you feel unwell or have a temperature
4. In excessively hot or cold conditions.

 

Stop exercising if you get chest pain, excessive shortness of breath, palpitations, dizziness or light-headedness, nausea or excessive sweating.

If you enjoy circuit training (doing different forms of exercise, one after the other) you can make up one at home with dumbbells and an exercise bike or you could join a local leisure or health club.

When exercising always start gently and warm up and stretch the major muscle groups prior to any increased activity. Cool down and stretch after you have worked your muscles, drink plenty of water during and after activity and wear sensible clothes and shoes.

More on exercise therapy

Vascular Disease Foundation

 

 

| 25.01.2011 | Read more | Print |