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Health Condition

Intermittent Claudication

About This Condition

Intermittent claudication is pain in the legs caused by atherosclerosis (hardening of the arteries) of the lower extremities.

Because atherosclerosis decreases the supply of blood and oxygen to the legs, people with intermittent claudication experience leg pain after walking a certain distance. People with this condition should be monitored by a doctor. The natural treatments for intermittent claudication include many of those used for atherosclerosis; these include controlling high cholesterol, modifying dietary and lifestyle factors that might influence atherosclerosis, and taking various nutritional supplements and herbs.

You should also learn more about atherosclerosis for more information about dietary changes that might favorably influence hardening of the arteries or the risk of heart disease associated with it. What follows is a discussion limited to those aspects of lifestyle and natural medicine that have been studied specifically in relation to intermittent claudication.

Symptoms

Initial symptoms of intermittent claudication are pain, aching, cramping, or fatigue of the muscles in the lower limbs that develop during walking and are quickly relieved by rest. Symptoms typically occur in the calf but may also be located in the foot, thigh, hip, or buttocks. In more advanced stages, the painful symptoms are present even at rest and are worsened by elevating the legs.

Other Therapies

Exercise rehabilitation therapy, weight loss, and smoking cessation are often recommended. Surgical options to restore blood supply, called “revascularization” procedures, are usually reserved for those with progressive or disabling symptoms.

References

1. Schneider B. Ginkgo biloba extract in peripheral arterial disease. Meta-analysis of controlled clinical trials. Arzneimittelforschung 1992;42:428-36 [in German].

2. Peters H, Kieser M, Hölscher U. Demonstration of the efficacy of Ginkgo biloba special extract EGb 761® on intermittent claudication—a placebo-controlled, double-blind multicenter trial. VASA 1998;27:106-10.

3. Bauer U. Six-month double-blind randomised clinical trial of Ginkgo biloba extract versus placebo in two parallel groups in patients suffering from peripheral arterial insufficiency. Arzneimittelforsschung 1984;34:716-20 [in German].

4. Blume J, Kieser M, Hölscher U. Placebo-controlled, double-blind study on the efficacy of Ginkgo biloba special extract EGb 761 in maximum-level trained patients with intermittent claudication. Vasa 1996;25:265-74.

5. Blume J, Kieser M, Hölscher U. Efficacy of Ginkgo biloba special extract EGb 761 in peripheral occlusive disease. Fortschr Med 1998;116:137-43.

6. Schweizer J, Hautmann C. Comparison of two dosages of Ginkgo biloba extract EGb 761 in patients with peripheral arterial occlusive disease Fontaine's stage IIb. Arzneimittelforschung 1999;49:900-4.

7. Wang J, Zhou S, Bronks R, et al. Supervised exercise training combined with ginkgo biloba treatment for patients with peripheral arterial disease. .Clin Rehabil 2007;21:579-86.

8. Kiff RS, Wuick CRG. Does inositol nicotinate (Hexopal) influence intermittent claudication?—a controlled trial. Br J Clin Pract 1988;42:141-5.

9. O'Hara J, Jolly PN, Nicol CG. The therapeutic efficacy of inositol nicotinate (Hexopal) in intermittent claudication: a controlled trial. Br J Clin Pract 1988;42:377-83.

10. Castano G, Mas Ferreiro R, Fernandez L, et al. A long-term study of policosanol in the treatment of intermittent claudication. Angiology 2001;52:115-25.

11. Castano G, Mas R, Roca J, et al. A double-blind, placebo-controlled study of the effects of policosanol in patients with intermittent claudication. Angiology 1999;50:123-30.

12. Carbajal D, Arruzazabala ML, Valdes S, Mas Ferreiro R. Effect of policosanol on platelet aggregation and serum levels of arachidonic acid metabolites in healthy volunteers. Prostaglandins Leukot Essent Fatty Acids 1998;58:61-4.

13. Arruzazabala ML, Valdes S, Mas R, et al. Comparative study of policosanol, aspirin and the combination therapy policosanol-aspirin on platelet aggregation in healthy volunteers.Pharmacol Res1997;36:293-7.

14. Arruzazabala ML, Valdes S, Mas R, et al . Effect of policosanol successive dose increases on platelet aggregation in healthy volunteers. Pharmacol Res 1996;34:181-5.

15. Haeger K. Long-time treatment of intermittent claudication with vitamin E. Am J Clin Nutr 1974;27:1179-81.

16. Williams HT, Fenna D, Macbeth RA. Alpha tocopherol in the treatment of intermittent claudication. Surg Gynecol Obstet 1971;Apr:662-6.

17. Donnan PT, Thomson M, Fowkes GR, et al. Diet as a risk factor for peripheral arterial disease in the general population: the Edinburgh Artery Study. Am J Clin Nutr 1993;57:917-21.

18. Livingstone PD, Jones C. Treatment of intermittent claudication with vitamin E. Lancet 1958;ii:602-4 [review].

19. Piesse JW. Vitamin E and peripheral vascular disease. Int Clin Nutr Rev 1984;4:178-82 [review].

20. Carrero JJ, Lopez-Huertas E, Salmeron LM, et al. Daily supplementation with (n-3) PUFAs, oleic acid, folic acid, and vitamins B-6 and E increases pain-free walking distance and improves risk factors in men with peripheral vascular disease. J Nutr2005;135:1393-9.

21. Kiesewetter H, Jung F, Jung EM, et al. Effects of garlic coated tablets in peripheral arterial occlusive disease. Clin Investig 1993;71:383-6.

22. Brevetti G, Chiariello M, Ferulano G, et al. Increases in walking distance in patients with peripheral vascular disease treated with L-carnitine: a double-blind, cross-over study. Circulation 1988;77:767-73.

23. Brevetti G, Perna S, Sabba C, et al. Effect of propionyl-L-carnitine on quality of life in intermittent claudication. Am J Cardiol 1997;79:777-80.

24. Brevetti G, Diehm C, Lambert D. European multicenter study on propionyl-L-carnitine in intermittent claudication. J Am Coll Cardiol 1999;34:1618-24.

25. Smulski HS, Wojcicki J. Placebo-controlled, double-blind trial to determine the efficacy of the Tibetan plant preparation Padma 28 for intermittent claudication. Altern Ther 1995;1(3):44-9.

26. Drabaek H, Mehlsen J, Himmelstrup H, Winther K. A botanical compound, Padma 28, increases walking distance in stable intermittent claudication. Angiology 1993;44:863-7.

27. Törnwall ME, Virtamo J, Haukka JK, et al. The effect of alpha-tocopherol and beta-carotene supplementation on symptoms and progression of intermittent claudication in a controlled trial. Atherosclerosis 1999;147:193-7.

28. Neglen P, Overfordt P, Eklof B. Peroral magnesium hydroxide therapy and intermittent claudication. Vasa 1985;14:285-8.

29. Christie SB, Conway N, Pearson HE. Observations on the performance of a standard exercise test by claudicants taking gamma-linolenic acid. J Atheroscler Res 1968;8:83-90.

30. Cahan MA, Montgomery P, Otis RB, et al. The effect of cigarette smoking status on six-minute walk distance in patients with intermittent claudication. Angiology 1999;50:537-46.

31. Gardner AW, Womack CJ, Montgomery PS, et al. Cigarette smoking shortens the duration of daily leisure time physical activity in patients with intermittent claudication. J Cardiopulm Rehabil 1999;19:43-51.

32. Walker RD, Nawaz S, Wilkinson CH, et al. <strong>I</strong>nfluence of upper- and lower-limb exercise training on cardiovascular function and walking distances in patients with intermittent claudication. J Vasc Surg 2000;31:662-9.

33. Gardner AW, Katzel LI, Sorkin JD, et al. Improved functional outcomes following exercise rehabilitation in patients with intermittent claudication. J Gerontol A Biol Sci Med Sci 2000;55:M570-7.

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The information presented by Healthnotes is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. Self-treatment is not recommended for life-threatening conditions that require medical treatment under a doctor's care. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires December 2018.

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