Causes and risk factors
The pain or cramping in the lower extremities is caused due to impaired blood supply and poor circulation to the parts due to blockage of arteries. Blockage is caused as a result of atherosclerosis. Atherosclerosis is a condition in which fatty material deposits along the walls of arteries. This fatty material thickens, hardens and form hard structures called plaques. Eventually, the plaques can make the artery narrow and less flexible, making it harder for blood to flow. Claudication is seen in disorder of the blood vessel known as peripheral artery disease [PAD]. Risk factors for development of claudication due to atherosclerosis include diabetes, obesity, family history of heart disease, high blood pressure, high cholesterol. Being male, tobacco use, smoking, sedentary life are other contributing factors.
Clinical presentation
Main feature of claudication is severe cramping pain on exertion in the muscles of thigh, buttocks, calves, or other organs. The pain is worse on exertion and better by rest. As the condition progresses the pain is experienced even on rest. The pain is intermittent. There can also be bluish discolouration of skin of the affected part. The part may feel cold to touch.
Investigation
Medical history by the patient and Clinical examination by the doctor helps in diagnosis. An angiogram is done. Doppler ultrasound, CT angiography, MRA are advised.
Treatment
Doctor will recommend lifestyle modification measures such as eating heart healthy diet, regular exercise, quit smoking, and keep a check over blood pressure, blood sugar and cholesterol levels which contribute further to the treatment. Blood thinning medicine, medicines to control blood pressure. Endovascular treatment includes Angioplasty, if there is severe blockage or narrowing of the artery which is followed by stent placement to keep the artery open. Laser atherectomy, directional atherectomy are useful. In severe cases bypass graft surgery is performed.
Other Modes of treatment
The other modes of treatment can also be effective in treating claudication. Homoeopathy is a science which deals with individualization considers a person in a holistic way. This science can be helpful in combating the symptoms. Similarly the ayurvedic system of medicine which uses herbal medicines and synthetic derivates are also found to be effective in treating claudication.
