Blockage of leg arteries

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Alternative names
Intermittent claudication; Vaso-occlusive disease of the legs; Arterial insufficiency of the legs; Recurrent leg pain; Recurrent leg cramping; Calf pain with exercise

Definition
Blockage of leg arteries results from poor circulation of blood in the leg arteries. This produces an aching, tired, and sometimes burning pain in the legs that is brought on by exercise, and relieved by rest. Claudication refers to the limping that occurs from leg cramps.

Considerations
Intermittent claudication may occur in both legs, and it often continues to worsen over time. However, some people complain only of weakness in the legs when walking, or a feeling of “tiredness” in the buttocks. Impotence is an occasional complaint in men. Pain at rest is uncommon.

Common Causes

This condition is due to narrowing or blockage of the arteries (atherosclerosis or arteriosclerosis obliterans - peripheral vascular disease). Blockage of arteries can occur anywhere in the body. If they occur in the heart, a person may experience angina or even a heart attack. If they occur in the neck or the brain, a person may have a stroke.

Intermittent claudication is when the blockage occurs in the legs, most commonly in the calf or the foot. It occurs only at certain times, such as after a period of walking and is relieved by rest.

Atherosclerosis, or blockage of arteries, can occur for many reasons such as smoking, diabetes, and High cholesterol.

Home Care

Talk to your doctor about the cause of your leg cramping and about what to do at home to relieve it. A healthy diet is important to decrease progression of Atherosclerosis.

A program of daily walking for short periods, and stopping for pain or cramping, may help improve function. It is essential to stop smoking.

Avoid applications of hot or cold items on legs. Avoid tight shoes.

Call your health care provider if

There are many other causes of leg pain such as arthritis or low blood potassium. However, some causes of leg pain may be life threatening such a blood clot in the legs. Seek medical attention if you have:

• Leg pain that does not go away.
  
• Legs that may be red, hot or swollen.
  
• Any chest pain or shortness of breath accompanying leg pain.
  
• Diabetes.
  
• If you are pregnant.

What to expect at your health care provider’s office
The medical history will be obtained and a physical examination performed.

Medical history questions documenting claudication in detail may include:

• Time pattern
  o Do you have leg cramps at night (nocturnal cramps)?
  o How often does leg pain with cramping occur?
  o Is it getting worse?
  
• Quality
  o Is the pain sharp?
  o Is there an aching pain with the cramps?
  
• Aggravating factors
  o Is it worse after you exercise?
  o Is it worse after you are standing?
  o Do you smoke? How much?
  o Do you drink alcohol? How much?
  o Are you diabetic? How well is your blood sugar controlled?
  
• Other
  o What other symptoms are also present?
  o Has there been impotence (men)?
  o Is there pain in the back?
  o Is there a darkening of the skin of the legs, feet, or toes?
  o Is there weakness or paralysis of the legs?

The physical examination may include evaluation of the femoral pulse (in the groin) and the other areas where the pulse can be felt in the legs.

Diagnostic tests that may be performed include:

• Blood pressure measured in arms and legs for comparison
  
• Doppler ultrasonography on the legs and the heart
  
• Duplex Doppler/ultrasound exam of extremity to visualize arterial blood flow
  
• ECG- to evaluate the activity of your heart
  
• Aortography- to visualize blockages in your arteries

Intervention:
Surgical or angioplastic treatment may be recommended if claudication interferes with the patient’s essential activities or work, and if the diseased arteries appear likely to improve after corrective treatment.

After seeing your health care provider:
If a diagnosis was made by your health care provider related to cramping leg pain, you may want to note that diagnosis in your personal medical record.

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