Cramping leg pain: This type of discomfort is characterized by an aching, crampy, fatigued, and occasionally burning sensation in the legs that appears intermittently. It often arises during walking and subsides with rest, largely due to restricted blood flow in the leg arteries. Medically, this is referred to as intermittent claudication. It can affect one or both legs and may progressively worsen. Some individuals, however, experience only leg weakness or a sense of "fatigue" in the buttocks while walking. In severe cases, pain might be felt even at rest. This is a condition more commonly reported by men.The sporadic nature of the pain stems from the narrowing of arteries that supply blood to the legs, limiting oxygen delivery to the muscles, particularly when their demand for oxygen increases during physical activity. Intermittent claudication can result from temporary artery constriction due to vasospasm, permanent narrowing from atherosclerosis, or complete blockage of a leg artery. It's a fairly prevalent condition, affecting 1-2% of people under 60, 3-4% of those aged 60 to 70, and more than 5% of those over 70, with men being more frequently affected than women.To diagnose this condition, doctors assess pulses in the legs and feet during a clinical examination. Diagnostic methods include blood pressure comparison between arms and legs, Doppler ultrasonography of the legs, duplex Doppler/ultrasound imaging to observe arterial blood flow, and arteriography, which involves injecting dye to visualize the arteries.The prognosis for intermittent claudication is generally positive, as the condition often stabilizes or improves over time. Conservative treatment is recommended. Regular walking can help extend the distance a person can walk without experiencing symptoms. A regimen of brief daily walks, with pauses for pain or cramping, can enhance function by promoting collateral circulation, which is the growth of new small blood vessels bypassing the blocked artery area. Quitting smoking is essential. Avoid applying heat or cold to the legs and wearing tight shoes.Two medications, pentoxifylline (Trental) and cilostazol (Pletal), are available for managing intermittent claudication. They work differently: Trental reduces blood viscosity, improving its flow to the legs, while Pletal dilates arteries by inhibiting phosphodiesterase III and decreases blood clotting. If conservative measures fail, addressing the arterial narrowing may be necessary, depending on its location and severity, as well as the patient's overall health. Potential options include surgical interventions like bypass grafting and procedures such as balloon angioplasty. These may be needed for severe, persistent claudication to alleviate symptoms and pain.The term "claudication" originates from the Latin "claudicare," meaning to limp. The Roman emperor Claudius (A.D. 41-54) was named so due to his limp, likely caused by a birth defect. There is also venous claudication, which occurs due to insufficient venous drainage.
