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Intermittent claudication is a symptom and is by definition diagnosed by a patient reporting a history of leg pain with walking relieved by rest. However, as other conditions such as sciatica can mimic intermittent claudication, testing is often performed to confirm the diagnosis of peripheral artery disease .
Rest pain is a continuous burning pain of the lower leg or feet. It begins, or is aggravated, after reclining or elevating the limb and is relieved by sitting or standing. It is more severe than intermittent claudication, which is also a pain in the legs from arterial insufficiency. [citation needed]
Neurogenic claudication (NC), also known as pseudoclaudication, is the most common symptom of lumbar spinal stenosis (LSS) and describes intermittent leg pain from impingement of the nerves emanating from the spinal cord. [1] [2] Neurogenic means that the problem originates within the nervous system.
In an ischaemic leg, elevation to 15 degrees or 30 degrees for 30 to 60 seconds may cause pallor. (This part of the test checks for elevation pallor.) A vascular angle of less than 20 degrees indicates severe ischaemia. [1] [2] From a sitting position, in normal circulation, the foot will quickly return to a pink colour.
Claudication is a medical term usually referring to impairment in walking, or pain, discomfort, numbness, or tiredness in the legs that occurs during walking or standing and is relieved by rest. [1] The perceived level of pain from claudication can be mild to extremely severe.
Symptoms may also include intermittent claudication or pain at rest. In late stages, paresthesia is replaced by anesthesia (numbness) due to death of nerve cells. [ 11 ] In severe cases, gangrene can occur suddenly and spread rapidly, [ 12 ] and should be treated within six hours of ischaemia.
This results in claudication and chronic leg ischemia. This condition mainly occurs more in young athletes than in the elderlies. [ 2 ] Elderlies, who present with similar symptoms, are more likely to be diagnosed with peripheral artery disease with associated atherosclerosis . [ 2 ]
Of patients with intermittent claudication, only "7% will undergo lower-extremity bypass surgery, 4% major amputations, and 16% worsening claudication", but stroke and heart attack events are elevated, and the "5-year mortality rate is estimated to be 30% (versus 10% in controls)". [84]