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Intermittent Claudication

Signs and symptoms
Intermittent claudication is a disorder that causes calf pain. It can be confused with muscular pain in the calf but has several important differences. Muscular pain will involve stiffness first thing in the morning, pain stepping down stairs and, when painful, stopping to rest will not stop the pain upon starting to walk again. Claudication pain won t have an impact on the first steps of the day. Walking downstairs won t be painful but walking upstairs may be. When walking and your calves hurt, you will usually sit to rest for a couple of minutes. You will then be able to start off without pain and go the same distance again before they hurt. This is the claudication distance . It might be 80 metres or 6 minutes but is reasonably constant over the same sort of terrain. It will happen sooner if the  work is harder e.g. carrying heavy bags or going uphill.

What is it?
This problem has a lot in common with angina. Both the heart and the calf are muscles that use a lot of oxygen to perform. To get the oxygen, they rely on the blood flowing to them via arteries. If the arteries are narrowing, the amount of blood available may not be enough to supply the oxygen that is needed to perform heavier tasks. As you can imagine, your heart can t just stop to have a rest if there isn t enough oxygen. There is a way that muscles can continue to work without it, but it produces a chemical that causes pain. Your body wants you to stop working hard for a while so that muscles demand less and the blood and oxygen can come in and clear up this oxygen debt . In the leg, if you stop to rest, everything gets back to normal and you can start to walk again. Fortunately, while angina can be a precursor to heart attacks, this doesn t happen in the leg. Some care needs to be taken with the foot though. The foot s blood supply will almost always be worse than the leg s but painful symptoms don t usually occur within these smaller muscles. It is important to have the blood flow to the foot assessed.

What can you do?
See your GP to manage the condition. You need good control of your weight, blood sugar, blood fats / cholesterol and blood pressure. Take care to avoid injury that may be difficult to heal due to limited blood supply. Keep walking up to the point of pain as often as possible. This will help to maintain blood flow and stop the problem from worsening. See a podiatrist to have your foot blood flow assessed using a Doppler ultrasound.

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