
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
- 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 balloon angioplasty or bypass surgery.
- A balloon angioplasty opens the blood vessel and improves blood flow. A metal mesh device called a stent is usually left in the artery to help keep the blood vessel open.
- Bypass surgery uses arteries or veins from other parts of the body to make a new path around a blocked area.
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. Walking and other forms of exercise can help you have less discomfort with activity and help you walk for longer distances without pain. Studies have shown that walking can be as good as medicine or surgery for many people.
- 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.
Leg Cramps Caused by Peripheral Vascular Disease (Intermittent Claudication): References
Aboyans, V, Criqui, MH, Denenberg, JO,et al. Risk factors for progression of peripheral arterial disease in large and small vessels. Circulation 2006; 113:2623.
Criqui, MH, Fronek, A, Barrett-Connor, E, et al. The prevalence of peripheral arterial disease in a defined population. Circulation 1985; 71:510.
Hirsch, AT, Haskal, ZJ, Hertzer, NR, et al. ACC/AHA 2005 Practice Guidelines for the management of patients with peripheral arterial disease (lower extremity, renal, mesenteric, and abdominal aortic): a collaborative report from the American Association for Vascular Surgery/Society for Vascular Surgery, Society for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, Society of Interventional Radiology, and the ACC/AHA Task Force on Practice Guidelines (Writing Committee to Develop Guidelines for the Management of Patients With Peripheral Arterial Disease): endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation; National Heart, Lung, and Blood Institute; Society for Vascular Nursing; TransAtlantic Inter-Society Consensus; and Vascular Disease Foundation. Circulation 2006; 113:e463.
McDaniel, MD, Cronenwett, JL. Basic data related to the natural history of intermittent claudication. Ann Vasc Surg 1989; 3:273.
McDermott, MM, Greenland, P, Liu, K, et al. Leg symptoms in peripheral arterial disease: associated clinical characteristics and functional impairment. JAMA 2001; 286:1599.
Murabito, JM, Evans, JC, Nieto, K, et al. Prevalence and clinical correlates of peripheral arterial disease in the Framingham Offspring Study. Am Heart J 2002; 143:961.
Pasternak, RC, Criqui, MH, Benjamin, EJ, et al. Atherosclerotic vascular disease conference: Writing Group I: epidemiology. Circulation 2004; 109:2605.
Selvin, E, Erlinger, TP. Prevalence of and risk factors for peripheral arterial disease in the United States: results from the National Health and Nutrition Examination Survey, 1999-2000. Circulation 2004; 110:738.