Intermittent Claudication

Intermittent Claudication

Even in bygone days when doctors were scarce and do-it-yourself medicine was all the rage, some ideas were frankly lame. Take, for instance, this oddball cure for leg pain: “Rub leg with turpentine and sit before the fire until leg begins to tingle.” Fortunately, this dubious remedy was just a flash in the pan that never really caught fire—so to speak.

Nowadays, there are vastly safer natural remedies for intermittent claudication, a type of persistent leg pain that affects 1 in 10 Americans over age 70. The condition is named for Roman emperor Claudius, who, like many people who have this condition, had a noticeable limp. It is caused by hardening of the arteries supplying blood and oxygen to the lower limbs. High blood pressure, diabetes, smoking, high cholesterol—the very same lifestyle factors that promote heart disease—all contribute to this condition, which can cause a burning, cramplike pain in the legs, feet, hips, thighs, or even the buttocks.

The pain typically strikes after a person has walked a short distance, often as little as a block. After you’ve stopped and rested a few minutes, the pain usually disappears. When you have intermittent claudication, the pain recurs once you begin exerting yourself again. As the arteries become more clogged, the distance you can walk before experiencing pain gradually decreases.

“Intermittent claudication definitely interferes with living well. But up to 90 percent of people who have it never report it to their doctors. Most people consider it just a part of getting old. They think, ‘Oh well, I just can’t do what I used to do,’” says Steven Santilli, M.D., vascular surgeon at the Veterans Administration Medical Center and assistant professor of surgery at the University of Minnesota, both in Minneapolis.

That fatalistic attitude is unjustified, Dr. Santilli says. “Lifestyle changes like quitting smoking and getting regular exercise can have a huge impact on this condition. There is really no reason you should have to live with intermittent claudication,” he says. Here are a few effective ways to put the zing back into your step.

Try This First

Walk away from it. Walking—the very activity that usually induces the pain associated with claudication—also is one of the surest ways to stop it, doctors say.

“Some people look at me like I’m crazy when I tell them they need to get out there and walk more, not less. They want pills. But the truth is, we really don’t have a drug that will treat claudication as effectively as walking,” says Jay D. Coffman, M.D., chief of peripheral vascular medicine at Boston University Medical Center.

Walking enhances the ability of your leg muscles to extract oxygen from blood, Dr. Santilli says. So if you walk more, not less, your leg muscles will learn to use oxygen more efficiently, and you’ll be less apt to develop cramps and leg pain.

Set aside about an hour a day five days a week for walking, he suggests. As you walk, avoid stopping when you feel the first twinges of pain. Instead, let the pain intensify a bit, then pick out a nearby goal, like the next telephone pole, and vow to reach it before you rest. Once the pain subsides, get moving again. When you feel the next surge of pain, set your sights on another goal—say, the length between two telephone poles—that’s just a bit more ambitious than the first goal. Keep going on like this for the full hour.

Don’t worry about how many times you have to stop or how fast or far you walk, Dr. Santilli says. In the beginning, some people who try this approach have to stop and rest every two to three minutes. That’s okay. If you sustain this effort for several weeks, your pain should subside and the distance between rest stops should increase, he says. In fact, researchers have found that many people with intermittent claudication who use this technique are able to double their walking distance in just two to three months.

Other Wise Ways

Snag a walking buddy. Ask your spouse, a friend, or a co-worker to join you on your strolls, Dr. Coffman suggests. A companion can encourage you to keep moving and reinforce your determination to beat intermittent claudication.

Walk for cover. Rather than ditching your walk on unseasonably hot or cold days, go to an indoor shopping mall where you can do your routine in temperature-controlled comfort, recommends Dr. Coffman.

Corral the Marlboro man. People who smoke are twice as likely to develop intermittent claudication as nonsmokers, Dr. Santilli says. Smoking constricts blood vessels and makes it harder for your leg muscles to work properly. But even if you’ve lit up for years, quitting now will improve circulation in your legs and help relieve the pain, he says.

Be firm about fat. Eating too much artery-clogging fat will only worsen intermittent claudication, Dr. Santilli explains. That’s because a fatty diet can cause hardening of the arteries, which in turn causes intermittent claudication. For every bite of meat, take four bites of fruits, vegetables, beans, and grains. It will help keep you on track for a low-fat lifestyle. If you must, Dr. Santilli says, you can make fatty foods like gravy, bacon, or fried chicken a once-a-month treat.