Leg Cramps Caused by Peripheral Vascular Disease (Intermittent Claudication)

What is intermittent claudication?

Intermittent claudication is a group of symptoms caused by a partial blockage of blood flow to the muscles. A blockage in the leg or arm causes pain or weakness when you are walking or physically active. The symptoms usually go away after you rest for a few minutes.

What is the cause?

The discomfort or pain happens when your muscles do not get enough blood because the arteries that carry blood to the muscles have gotten narrower or are blocked. The narrowing is usually caused by hardening of the arteries (atherosclerosis). The arteries get narrowed by a buildup of fats and cholesterol (plaque) in the artery walls. This buildup makes the artery stiff and slows or blocks the flow of blood and oxygen to the body.

When you are not using your muscles, there may be enough blood flow and oxygen for your muscles so they don’t hurt when you are resting. But when you use the muscles, they need more blood. If the muscles don’t get enough blood and oxygen, you may have symptoms.

What are the symptoms?

The main symptoms are usually pain, numbness, aching, or heaviness in the leg muscles when you exercise your legs. Symptoms may include cramping in your legs, buttocks, and feet. The pain may be in one or both legs. You may have pain in the buttocks if the narrowing is in the arteries bringing blood to the thighs. The discomfort may go away when you rest, but it may come back soon after you start walking again. Sometimes you may have symptoms in your arms or hands.

How is it diagnosed?

Your healthcare provider will ask about your symptoms and check your pulse in many parts of your body. If your pulse is weak or cannot be felt in some parts of your body, you probably have blocked blood flow.

Your provider may check blood pressures in your arms and legs. If the blood pressure in your legs is lower than in your arms, it may mean you have blockages in the arteries going to your legs.

You may have one or more of these tests:

• angiogram, which uses X-rays and a special dye so your provider can see problems with the blood vessels
• ultrasound, which uses sound waves to make pictures of your arteries
• Doppler ultrasound, which can measure both the amount of blockage and the speed of blood flow in your arteries
• magnetic resonance imaging (MRI), which uses a powerful magnetic field and radio waves to take pictures from different angles to show thin cross sections of the body
• computed tomography (CT) scan, which is a series of X-rays taken from different angles and arranged by a computer to show thin cross sections of the body

How is it treated?

Your healthcare provider may recommend changes in your lifestyle. Depending on your symptoms, your provider may also prescribe medicine to:

• make it harder for your blood to clot
• relax the blood vessels
• to lower cholesterol

Your healthcare provider may recommend taking a small dose of aspirin every day. Nonsteroidal anti-inflammatory medicines (NSAIDs), such as aspirin, may cause stomach bleeding and other problems. These risks increase with age. Read the label and take as directed. Unless recommended by your provider, do not take aspirin for more than 10 days for any reason.

If your symptoms cannot be controlled or they keep you from doing your normal activities, you may need a procedure to remove or bypass a blockage.

• You may have bypass surgery to remove the blocked area and replace it with a piece of a vein removed from another part of your body.
• You may have a procedure called angioplasty to stretch open a blocked artery. Angioplasty uses a catheter, which is a long, thin, flexible tube that your provider puts into a blood vessel. The catheter has a balloon at the end that can be inflated to open up the artery.

How can I take care of myself?

Follow your healthcare provider’s directions for taking your medicine. Make sure you know how and when to take your medicine. Don’t take more or less than you are supposed to take.

You may need to make some changes in your lifestyle to try to prevent the buildup of plaque in your arteries.

• Be sure to follow your provider’s recommendations for exercise.
• If you smoke, quit. Tell your provider if you need help quitting.
• Avoid secondhand smoke.
• Lose weight if you are overweight.
• Eat a heart-healthy diet. Your provider or a dietician can tell you which foods to avoid.
• Avoid drinking too much alcohol.

Ask your healthcare provider:

• how and when you will hear your test results
• what activities you should avoid
• how to take care of yourself at home and what symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup.

Contact your healthcare provider if you have any questions or your symptoms seem to be getting worse.