Intermittent Claudication

Medically Reviewed By William C. Lloyd III, MD, FACS
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What is intermittent claudication?

Intermittent claudication is the medical term for pain, numbness, achiness, burning, heaviness or cramping in the legs that occurs during activities such as walking or climbing stairs. You may feel these symptoms in any of your lower limb muscles, including those in the feet, calves, thighs, or buttocks. Intermittent claudication may be localized or diffuse, affecting one or both legs. Symptoms usually decrease after the activity is stopped and the muscles rest.

Intermittent claudication is primarily caused by reduced blood flow due to peripheral artery disease, also called peripheral vascular disease. In this condition, your muscles cannot get enough oxygen because blood circulation has been blocked or restricted in the arteries. Atherosclerosis (hardening of the arteries) causes peripheral artery disease.

Atherosclerosis is a common cardiovascular disease in the United States. The disease is a leading cause of illness and death in the United States. Most commonly, people develop atherosclerosis as a result of diabetes, genetic risk factors, high blood pressure, a high-fat diet, obesity, high blood cholesterol levels, and smoking.

Although life-threatening complications of intermittent claudication are rare, individuals with intermittent claudication due to peripheral artery disease may be at risk for heart attack and stroke. Seek immediate medical care (call 911) if you experience shortness of breath, pain or pressure in the chest area, severe or sudden headache, or difficulty walking, or if you think you may be having a heart attack or stroke.

Seek prompt medical care if your intermittent claudication is persistent, recurrent, or causes you concern.

What other symptoms might occur with intermittent claudication?

Intermittent claudication may accompany other symptoms, which vary depending on the underlying disease, disorder or condition.

Symptoms of peripheral artery disease that may occur along with intermittent claudication

Intermittent claudication may accompany other symptoms of peripheral artery disease including:

  • Burning or tingling sensation (paresthesia)
  • Cold feet or legs
  • Decreased or absent pulse in the lower limb
  • Erectile dysfunction
  • Pale or bluish skin
  • Poor hair growth on the legs
  • Poor toenail growth
  • Sores or wounds on the lower limb that heal slowly, poorly, or not at all

Serious symptoms that might indicate a life-threatening condition

In some cases, peripheral artery disease may cause a serious loss of blood flow to the extremities or to the kidneys. Seek immediate medical care (call 911) if you, or someone you are with, have serious symptoms including:

  • Absent pulses in the legs or feet
  • Decreased urine output
  • Gangrene
  • Profound decrease in the temperature of one leg or foot
  • Swelling or fluid buildup in the body

What causes intermittent claudication?

Peripheral artery disease is the primary cause of intermittent claudication. In this condition, plaque, consisting mainly of fat and cholesterol, adheres to the walls of arteries that deliver blood to the muscles of the lower limbs. The plaque blocks or restricts the flow of blood through the arteries to the muscles.

During activity, the muscles require more oxygen and, therefore, more blood to function properly and painlessly. If arteries are restricted or blocked by plaque, the muscles do not receive enough blood, and the reduction in oxygen can cause the pain, numbness and cramping associated with intermittent claudication.

Questions for diagnosing the cause of intermittent claudication

To diagnose your condition, your doctor or licensed health care practitioner will ask you several questions related to your intermittent claudication including:

  • Which of the following symptoms do you feel: pain, numbness, achiness, burning, heaviness or cramping?

  • Where in your lower limb do the symptoms occur?

  • Do symptoms occur in both legs?

  • How long have you had your symptoms?

  • Do symptoms occur during activity? If so, which activities cause symptoms?

  • Are symptoms better when you are resting?

  • Do you have any other symptoms?

What are the potential complications of intermittent claudication?

In rare cases, untreated intermittent claudication can lead to serious complications. Getting prompt treatment of intermittent claudication can help you avoid serious complications and permanent damage. Intermittent claudication that is a result of peripheral artery disease can also lead to serious or potentially life-threatening complications.

Once the underlying cause of intermittent claudication is diagnosed, it is important for you to follow the treatment plan that you and your health care professional design specifically for you to reduce the risk of potential complications including:

  • Adverse effects of treatment

  • Amputation

  • Blood clots or emboli that block off small arteries

  • Consequences of athersclerosis (heart attack, transient ischemic attack, stroke)

  • Coronary artery disease (reduced blood flow in the arteries that supply blood to the heart)

  • Open sores on the lower legs (ischemic ulcers)

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2020 Dec 19
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
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  2. What is peripheral arterial disease? National Heart, Lung, and Blood Institute Diseases and Conditions Index. http://www.nhlbi.nih.gov/health/dci/Diseases/pad/pad_what.html
  3. Collins RD. Differential Diagnosis in Primary Care, 5th ed. Philadelphia: Lippincott, Williams & Williams, 2012.
  4. Kahan S, Miller R, Smith EG (Eds.). In A Page Signs & Symptoms, 2d ed. Philadelphia: Lippincott, Williams & Williams, 2009.