Claudication is pain and/or cramping in the lower leg due to inadequate blood flow to the muscles. The pain usually causes the person to limp. The word "claudication" comes from the Latin "claudicare" meaning to limp. Claudication typically is felt while walking and subsides with rest. It is commonly referred to as "intermittent" claudication because it comes and goes with exertion and rest. In severe claudication, the pain is also felt at rest.

Claudication symptoms include:

• Pain when exercising. You may feel Pain or Discomfort in your feet, calves, thighs, hips or buttocks, depending on where you might have artery narrowing or damage. Claudication can also occur in your arms, although this is less common.
• Intermittent pain. Your Pain may come and go as you do less-strenuous activities.
• Pain when at rest. As your condition progresses, you may feel Pain in your legs even when you're sitting or lying down.
• Discolored skin or ulcerations. If blood flow is severely reduced, your toes or fingers may look bluish or feel cold to the touch. You may also develop Sores on your lower legs, feet, toes, arms or fingers.

Other possible symptoms include:

• An aching or Burning feeling
• Weakness of your legs or arms
• Cold feet

When to see a doctor

Talk to your doctor if you have Pain in your legs or arms when you exercise. If left untreated, claudication and peripheral artery disease can reduce the quality of your life and lead to potentially life-threatening complications. Claudication may limit your ability to participate in social and leisure activities, interfere with work, and make exercise intolerable.

Claudication is most often a symptom of peripheral artery disease. In peripheral artery disease, the arteries that supply blood to your limbs are damaged, usually as a result of atherosclerosis. Atherosclerosis can develop in any of your arteries, especially those in your heart. When atherosclerosis affects your arms and legs, it's called peripheral artery disease.

Atherosclerosis narrows the arteries and makes them stiffer and harder. That's because the arteries get clogged with clumps of fat, cholesterol and other material, called atherosclerotic plaques. These plaques can make arteries so narrow that less blood can flow through them. You feel pain because your leg muscles are not getting enough oxygenated blood. Oxygen is the fuel that muscles need to contract.

Atherosclerosis isn't the only possible cause of your symptoms of claudication. Other conditions associated with similar symptoms that need to be considered include spinal stenosis, peripheral neuropathy and certain musculoskeletal conditions.

There are two main ways to treat claudication: medication and a surgical treatment, called revascularization.

Medication therapies are often used initially as they are non-invasive. The two most commonly used medications include:

• Cilostazol (Pletal) reduces the pain of intermittent claudication by widening (dilating) the arteries, thereby improving the flow of blood and oxygen to the legs.
• Pentoxifylline (Trental) decreases the "stickiness" (viscosity) of blood and thereby improves its flow through arteries. This increases the flow of blood and oxygen to muscles.

There are several drugs being investigated to treat claudication. These medications are not yet approved for use in treating this condition. These medications include:

• ACE (angiotensin converting enzyme) inhibitors
• Antichlamydophila therapy –- roxithromycin
• Propionyl-L-carnitine
• Defibrotide
• Prostaglandins

A surgical procedure called a revascularization is used in patients who do not respond to medications. There are two types of revascularization procedures: endovascular (inside the blood vessel) and surgically grafting or bypassing the artery.

• Endovascular procedures include:
• Angioplasty: A balloon is placed in the blocked area and inflated to widen the diameter of the artery and increase blood flow
• Stenting: Wire mesh used to hold a blood vessel open after angioplasty and prevents scar tissue from narrowing the blood vessel
• Surgical grafting or bypassing an artery involves an open surgery with an incision and sewing in a graft using either the patient's vein or a synthetic tube to increase blood flow around the blocked area.
• Compression therapy can also be used as a noninvasive way to treat symptoms of claudication. Intermittent calf compression has been shown in studies to improve symptoms-free walking distance.

The risk factors for claudication are the same as those for developing atherosclerosis, including:

• Smoking
• High cholesterol
• High blood pressure
• Obesity (a body mass index over 30)
• Diabetes
• Age older than 70 years
• Age older than 50 years if you also smoke or have diabetes
• A family history of atherosclerosis, peripheral artery disease or claudication