Claudication of Calf Muscles: Causes, Symptoms, Treatment

Claudication is a painful condition normally caused as a result of too little blood flow most commonly while exercising but at times during rest as well. This pain is felt in almost all of the cases in the lower extremities but sometimes it may occur in the upper extremities as well.

When symptoms of claudication are felt in the muscles of the calf then it is termed as claudication of the calf muscles. When the symptoms of claudication occur only when exercising, then it is termed as intermittent claudication.

The blood vessels in the calf region are the most affected in cases of claudication of the calf muscles. In the initial phase the pain is only felt when during any strenuous activities or while exercising but as the condition progresses the affected individual might feel pain at rest as well.

Claudication in itself is not a medical condition but is rather a sign of an underlying medical condition and in majority of cases is a symptom of peripheral artery disease. This is a circulation problem which is potentially serious but perfectly treatable condition.

It is caused by narrowing of the blood vessels which supply blood to the calf muscles and other areas of the lower extremities resulting in decreased flow of blood to these areas causing the classic symptom of claudication. However with timely diagnosis and adequate treatment, an individual in almost all the cases is able to get rid of claudication of the calf muscles.

As stated, claudication is in almost all the cases a symptom of a medical condition called peripheral artery disease in which the arteries supplying blood to the calf muscles get narrowed resulting in reduced supply of blood to the calf area causing pain with any attempts at movement or while performing any strenuous activity.

The narrowing of the artery is normally caused by deposition of fatty material within the arteries. This is also termed as atherosclerosis. This usually occurs in the arteries of the heart but tends to also occur in the arteries supplying blood to the extremities as well. The significant decrease of oxygenated blood supplied to the calf muscles results in pain due to Claudication of Calf Muscles.

Apart from atherosclerosis, there are certain other medical conditions like spinal stenosis, peripheral neuropathy, DVT, and certain musculoskeletal disorders that can also result in Claudication of Calf Muscles.

Some of the classic presenting features of Claudication of Calf Muscles are:

Pain experienced in the calf with any attempts at exercising. This pain may radiate down to the feet or up high into the buttocks and hips depending on where the actual narrowing of the artery is. This pain at the beginning may be intermittent but may become constant if left untreated and may even be present at rest.

There may also be ulceration of the skin or bluish skin discoloration in and around the calf region. There may also be cool sensation in and around the calf region downwards as a result of Claudication of Calf Muscles.

Some of the other symptoms of Claudication of Calf Muscles are:

• Aching or burning feeling in the calves
• Weakness of the lower extremities especially around the calf region

Claudication of Calf Muscles in many cases remains undiagnosed for a long period of time as most people think the pain to be as a result of aging and try and decrease their activity level for control of pain.

The suspicion arises when the pain does not get relieved and in fact worsens and is present even at rest. This is when the physician orders a battery of tests in order to identify the cause for the pain. Some of the tests done to diagnose Claudication of Calf Muscles are:

• The physician may check the pulses of the feet
• An ankle-brachial indices which is a comparison of the blood pressure in the ankle and the arms
• A Doppler ultrasound is quite a useful tool in the diagnosis of Claudication of Calf Muscles it will show the areas where there is reduced supply of blood which in this case will be in the calf area.
• Once an area of reduced blood supply is visualized then for further inspection advanced imaging studies in the form of MRI scans may be done to pinpoint exactly the location of the narrowing of the arteries.

All the above tests will confirm the diagnosis of Claudication of Calf Muscles. In cases where the symptoms are caused by other conditions like spinal stenosis or other musculoskeletal disorders then a detailed history of the patient will be taken and studies done to confirm the diagnosis of the condition causing Claudication of Calf Muscles.

Once Claudication of Calf Muscles has been identified then prompt treatment of it does wonders in eliminating the symptoms of pain and allowing the individual to get back into his or her normal activities.

There are certain lifestyle changes that are recommended in order to prevent the symptoms from getting worse especially in cases where peripheral neuropathy is proved to be the cause of Claudication of Calf Muscles.

These changes may include abstaining from nicotine and alcoholic substances and following diligently a regular exercise routine. If the symptoms do not resolve with these activity modifications then the physician may adopt a stronger approach towards treating Claudication of Calf Muscles.

Medications in the form of aspirin may be prescribed to prevent the chances of any blood clots. Additionally medications like Plavix or Persantine may be given to prevent blood clots. Pletal may be prescribed to improve blood flow to the calf region to treat the symptoms of Claudication of Calf Muscles.

The physician may also prescribe a cholesterol lowering agent to decrease the cholesterol level in the body and prevent worsening of Claudication of Calf Muscles.

In cases where peripheral artery disease is a cause of Claudication of Calf Muscles then more aggressive treatments in the form of an angioplasty may be performed.

In this procedure the affected artery is widened so as to improve blood flow to the calf region. Once the artery is widened then a stent may be placed to keep the artery wide and the blood flow is not affected.

Vascular surgery is yet another option for treatment of claudication of calf muscles. In this procedure, the vessel or artery that has the blockage is replaced by a healthy vessel or artery taken from elsewhere in the body.

This restores free flow of blood and resolves the issue of Claudication of Calf Muscles. In some cases, a combination of medications and angioplasty may be adopted as a mode of treatment for Claudication of Calf Muscles.