Claudication is muscle pain that happens when you’re active and stops when you rest. It’s usually described as cramping, aching, tingling or numbness. Most cases are caused by circulatory problems like peripheral artery disease, but it can also be caused spine conditions. Better outcomes are seen in cases that are diagnosed and treated early.
Claudication is the name for muscle pain that happens when you’re active and stops when you rest (it’s sometimes called “intermittent claudication”).
The most common types of claudication are:
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Claudication pain is usually described as cramping, but some people describe the pain as dull or aching. Others experience weakness, numbness or tingling.
All the cells in your body require oxygen to function. When you’re more active, even just for a light walk, the cells in your muscles need more oxygen to do their job. People who have circulation problems can experience pain when they’re more active because their muscles need more oxygen than their circulation provides. The pain goes away when they rest because their circulation can again keep up with the lower oxygen demand. This type of pain is most common in your legs, but can also happen in your arms.
Claudication is a classic symptom of peripheral artery disease (known as PAD for short), which is a narrowing of the blood vessels in your legs, and atherosclerosis (hardening of the arteries). Peripheral artery disease and atherosclerosis both increase your risk of heart attack and stroke.
Claudication is also a concern because the pain it causes when walking or exercising often keeps people from being active, which only makes the claudication worse.
Neurogenic claudication is typically caused by spinal stenosis, which is sometimes called pseudoclaudication. This is a narrowing of the space around your lower spine, which can put pressure on your spinal cord directly. It can also compress the blood vessels around the spine, depriving it of oxygen-carrying blood. Either of these two possibilities can cause pain that starts in your lower back and continues down your legs, as well as weakness, tingling or numbness in your legs and feet. It can also make it hard for you to regulate your bowel or bladder.
One key difference between vascular and neurogenic claudication is something that people can do to relieve the pain. In neurogenic claudication, people report that they can relieve the pain by leaning forward. This is called the “shopping cart sign” because it resembles the posture of someone pushing a shopping cart, and it’s not seen in people with vascular claudication.
Your risk of developing claudication goes up as you get older. The following factors can increase your risk for developing claudication:
Some people are born with a naturally narrow spinal canal. Others develop this issue because of injuries, degeneration of the spine because of aging, or a combination of all of these factors.
In order to determine if you have claudication — or how severe your case is — your healthcare provider may conduct the following:
Treating claudication is important because it’s usually an indicator of peripheral artery disease or similar circulatory diseases that are life-changing and even deadly. Treatment can take several forms and your doctor may encourage you to do one or more of the following:
If those treatments don’t work, your healthcare provider may recommend treatment options to increase or reroute blood flow, such as surgery or catheterization. Catheter-based approaches are less-invasive and use a medical device inserted into one of your major blood vessels, which can then treat the narrowed or blocked passage. Your doctor can tell you more about the specific options you have when it comes to this kind of procedure.
Nonsurgical treatment of neurogenic claudication includes the use of medication to help manage pain, physical therapy and steroid shots to help reduce inflammation. Your doctor may also recommend stretching, strengthening exercises and other types of activity to help improve your body’s ability to support itself. However, conservative treatment might not be an option for patients whose cases are more severe. If the conservative treatment options don’t work, or for patients whose cases are already more severe, surgery is the next option. Your provider can help explain your options so you can decide together what is best for you.
There are many things you can do to prevent vascular claudication or delay its onset. These include:
Neurogenic claudication is harder to prevent because spinal stenosis is part of the natural aging process. However, while spinal stenosis is more likely to happen as people get older, the majority of people who have it also have no symptoms.
Some recommendations to prevent or delay spinal stenosis include:
Claudication is a symptom that you should always talk about with your healthcare provider because it’s a key symptom in peripheral artery disease. Early diagnosis and treatment can prevent or delay the worsening of claudication symptoms to the point where they impact your life. You should also talk to your provider as soon as possible if this symptom develops or worsens very suddenly.
It’s also important to talk to your provider about claudication even if you don’t have any other health problems because it can also be a sign of a few other diseases and conditions, many of which are more likely to occur in healthy, physically active people. Most of these conditions are serious and some of them are medical emergencies. These include:
Last reviewed by a Cleveland Clinic medical professional on 10/18/2021.
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