Intermittent claudication (Latin: claudicatio intermittens) is a clinical diagnosis given for muscle pain (ache, cramp, numbness or sense of fatigue), classically in the calf muscle, which occurs during exercise, such as walking, and is relieved by a short period of rest.

Claudication derives from the Latin verb claudicare, "to limp".

Signs

One of the hallmarks of arterial claudication is that it occurs intermittently. It disappears after a brief rest and the patient can start walking again until the pain recurs.
The following signs are general signs of atherosclerosis of the lower extremity arteries:

• cyanosis
  Cyanosis
  Cyanosis is the appearance of a blue or purple coloration of the skin or mucous membranes due to the tissues near the skin surface being low on oxygen. The onset of cyanosis is 2.5 g/dL of deoxyhemoglobin. The bluish color is more readily apparent in those with high hemoglobin counts than it is...
  
  
• atrophic changes like loss of hair, shiny skin
• decreased temperature
  Temperature
  Temperature is a physical property of matter that quantitatively expresses the common notions of hot and cold. Objects of low temperature are cold, while various degrees of higher temperatures are referred to as warm or hot...
  
  
• decreased pulse
  Pulse
  In medicine, one's pulse represents the tactile arterial palpation of the heartbeat by trained fingertips. The pulse may be palpated in any place that allows an artery to be compressed against a bone, such as at the neck , at the wrist , behind the knee , on the inside of the elbow , and near the...
  
  
• redness when limb is returned to a "dependent" position

All the "P"s

• Increase in Pallor
• Decrease in Pulses
• Perishing cold
• Pain
• Paraesthesia
• Paralysis

Treatment

Exercise can improve symptoms; increased blood flow enhances the creation of collateral vessels to the affected muscle. However, if movement increases claudication then excessive movement is difficult if not impossible.

Pharmacological options exist as well. Medicines that control lipid profile, diabetes and hypertension

Hypertension

Hypertension or high blood pressure is a cardiac chronic medical condition in which the systemic arterial blood pressure is elevated. What that means is that the heart is having to work harder than it should to pump the blood around the body. Blood pressure involves two measurements, systolic and...

 may increase blood flow to the affected muscles and allow for increased activity levels. Angiotensin converting enzyme (ACE) inhibitors, beta-blockers, antiplatelet agents (aspirin

Aspirin

Aspirin , also known as acetylsalicylic acid , is a salicylate drug, often used as an analgesic to relieve minor aches and pains, as an antipyretic to reduce fever, and as an anti-inflammatory medication. It was discovered by Arthur Eichengrun, a chemist with the German company Bayer...

 and clopidogrel

Clopidogrel

Clopidogrel is an oral, thienopyridine class antiplatelet agent used to inhibit blood clots in coronary artery disease, peripheral vascular disease, and cerebrovascular disease. It is marketed by Bristol-Myers Squibb and Sanofi-Aventis under the trade name Plavix. The drug works by irreversibly...

), pentoxifylline and cilostazol (selective PDE3 inhibitor) are used for the treatment of intermittent claudication. However, medications will not remove the blockages from the body. Instead, they simply improve blood flow to the affected area.

Catheter

Catheter

In medicine, a catheter is a tube that can be inserted into a body cavity, duct, or vessel. Catheters thereby allow drainage, administration of fluids or gases, or access by surgical instruments. The process of inserting a catheter is catheterization...

 based intervention is also an option. Atherectomy

Atherectomy

Atherectomy is a minimally invasive surgical method of removing, mainly, atherosclerosis from a large blood vessel within the body. Today, it is generally used to effectively treat peripheral arterial disease of the lower extremities...

, stenting

Stent

In the technical vocabulary of medicine, a stent is an artificial 'tube' inserted into a natural passage/conduit in the body to prevent, or counteract, a disease-induced, localized flow constriction. The term may also refer to a tube used to temporarily hold such a natural conduit open to allow...

, and angioplasty

Angioplasty

Angioplasty is the technique of mechanically widening a narrowed or obstructed blood vessel, the latter typically being a result of atherosclerosis. An empty and collapsed balloon on a guide wire, known as a balloon catheter, is passed into the narrowed locations and then inflated to a fixed size...

 to remove or push aside the arterial blockages are the most common procedures via catheter based intervention. These procedures can be performed by interventional radiologists, interventional cardiologists, vascular surgeons and thoracic surgeons, among others.

Surgery is the last resort; vascular surgeons can perform either endarterectomies

Endarterectomy

Endarterectomy is a surgical procedure to remove the atheromatous plaque material, or blockage, in the lining of an artery constricted by the buildup of soft/hardening deposits. It is carried out by separating the plaque from the arterial wall....

 on arterial blockages or perform an arterial bypass

Coronary artery bypass surgery

Coronary artery bypass surgery, also coronary artery bypass graft surgery, and colloquially heart bypass or bypass surgery is a surgical procedure performed to relieve angina and reduce the risk of death from coronary artery disease...

. However, open surgery

Invasive procedure

Invasive procedure may refer to:* "Invasive Procedures" , the fourth episode of the second season of the television series Star Trek: Deep Space Nine* Invasive Procedures , a 2007 novel by Orson Scott Card and Aaron Johnston...

 poses a host of risks not present with catheter-based interventions.

Causes

Most commonly, intermittent (or vascular or venous) claudication is due to peripheral arterial disease which implies significant atherosclerotic blockages

Atherosclerosis

Atherosclerosis is a condition in which an artery wall thickens as a result of the accumulation of fatty materials such as cholesterol...

 resulting in arterial insufficiency. It is distinct from neurogenic claudication

Neurogenic claudication

Neurogenic claudication is a common symptom of lumbar spinal stenosis, or inflammation of the nerves emanating from the spinal cord. Neurogenic means that the problem originates with a problem at a nerve, and claudication, from the Latin for limp, because the patient feels a painful cramping or...

, which is associated with lumbar spinal stenosis.

Epidemiology

Atherosclerosis affects up to 10% of the Western population older than 65 years and for intermittent claudication this number is around 5%. Intermittent claudication most commonly manifests in men older than 50 years.