Intermittent claudication is pain due to poor blood circulation. Although it commonly affects the legs, hips, and buttocks, this condition can also affect the arms.
Patients with intermittent claudication, initially feel pain when doing activities or sports. However, as the disease progresses, pain can be felt after activity, when the body is resting, and even when not doing any activity.
In addition, intermittent claudication can also be characterized by:
- Shiny limbs and skin discoloration.
- Leg hair begins to fall out.
- Legs get cold.
Causes of Intermittent Claudication
Intermittent claudication is basically one of the early and major symptoms of peripheral arterial disease.peripheral artery disease/PAD). Peripheral arterial disease is a condition where the arteries are narrowed, causing blockage of blood flow to the legs.
Over time, the blood vessels around the legs can become blocked due to hardening of the walls of the arteries due to plaque buildup. This plaque consists of a mixture of compounds in the blood, such as fat, calcium, and cholesterol. Plaque that accumulates will constrict blood vessels, and if not treated immediately, can cause clogged arteries, interfere with blood circulation, and reduce the supply of oxygen to the body's cells supplied by these blood vessels.
A number of other causes of intermittent claudication can originate from conditions due to disorders of the nervous system, bones, or muscles of the sufferer, in the form of:
- deep vein thrombosis, This is a blockage in a deep vein.
- lumbar spinal stenosis, This is a narrowing of the spine or lower back.
- Fibromuscular dysplasia, This is the abnormal growth of the cell walls of the arteries.
- herniated lumbar disc, namely disorders that occur in the bearing joints of the lower spine to the tailbone.
- Inflammation of the groin, knee, or ankle.
- Vasculitis, which is a condition that refers to the occurrence of inflammation and death of blood vessels, including conditions such as: giant cell arteritis, Takayasu arteritis, Buerger's disease, polyarteritis nodosa, and Bechet's disease.
- Tight muscles.
- Baker's cyst.
Meanwhile, intermittent claudication has several causes that are classified as rare and generally affect young people. Among others are:
- The formation of a cyst in the main artery at the back of the knee.
- popliteal entrapment, This is the pressure on the arteries at the back of the knee.
- persistent sciatic artery, is a birth defect (congenital), which is characterized by impaired blood circulation in the lower body.
A person's risk of developing intermittent claudication may increase due to the following factors:
- Smoke.
- High blood pressure (hypertension).
- High cholesterol.
- Obesity.
- Diabetes.
- There is a family member who has atherosclerosis, PAD, or diabetes.
- Age above 50 years.
Diagnosis of Intermittent Claudication
Doctors can suspect a patient has intermittent claudication if he has the symptoms, which are confirmed by a review of the medical history and physical examination. To determine the cause, further examination needs to be done. Among others are:
- Check the pulse in the legs and arms.
- Ankle brachial index (ABI), which aims to compare blood pressure in the arms and ankles.
- Doppler ultrasound, to monitor blood circulation around the legs.
- MRI and CT scan, to see any narrowing of the blood vessels due to plaque buildup.
- Physical endurance test. This test can be done using treadmill. The patient will be asked to walk on the device for as long as possible, and stop when he feels pain. It is the time span until the onset of pain that will be measured.
Intermittent Claudication Treatment
Prompt treatment of intermittent claudication can prevent the disease from getting worse and reduce the effects of the symptoms it causes.
Treatment of intermittent claudication generally begins with efforts to change or improve an unhealthy lifestyle to a healthier one. For example with:
- Eat healthy foods to meet nutritional needs, and increase the intake of fruits and vegetables.
- Doing exercise or exercise regularly, which is adapted to the condition of the body.
- Always keep the lower body, especially the legs or feet lower than the heart when sleeping.
- Avoid injury to the legs and feet.
- Do not take drugs that contain pseudoephedrine, because the effect can further constrict blood vessels.
If the condition does not improve after undergoing the above efforts, then some of the treatments that can be done to treat intermittent claudication are:
- Taking medicine. Generally, doctors will give prescription drugs in the form of aspirin to reduce the risk of blockages in blood vessels. In addition to aspirin, doctors can also give other drugs to improve blood circulation, such as: clopidogrel, dipyridamole, or ticlopidine. Use of tablets cilostazol can help improve blood circulation and reduce the symptoms of intermittent claudication. For patients who cannot consume cilostazol, doctor can recommend use pentoxifylline. While the administration of cholesterol-lowering drugs, such as atorvastatin, can be done by doctors to patients who also have atherosclerosis.
- Angiopasti.In the condition of intermittent claudication that is classified as serious, the treatment will be done through angioplasty. This procedure aims to widen the narrowed blood vessels by inserting and inflating a small balloon inside the narrowed blood vessel to improve blood circulation.
- Vascular surgery. In this procedure, the doctor will remove healthy blood vessels from other parts of the body to replace blood vessels that are damaged or causing intermittent claudication. This condition causes the new blood vessels to become an alternative route to replace clogged arteries.
Complications of Intermittent Claudication
Complications of intermittent claudication can be in the form of blood circulation in the legs or arms that becomes very obstructed, so that the pain persists even when you are not doing physical activity. In this condition, the legs or arms also feel cold. In addition, patients with intermittent claudication who have peripheral arterial disease can develop wounds that are difficult to heal. These injuries can lead to gangrene, which is a condition of death of body tissue because it does not get an adequate blood supply, which can lead to amputation.
Intermittent Claudication Prevention
Intermittent claudication can be prevented by reducing the risk factors, including:
- Maintain normal cholesterol and blood pressure values.
- Maintain ideal body weight.
- Exercise regularly.
- Maintain normal blood sugar levels, especially for diabetics.
- Quit smoking.
