claudication

Claudication, literally 'limping' (Latin), is used as a medical term to indicate impairment in walking.^[1]

Intermittent vascular claudication

Intermittent vascular claudication (Latin: claudicatio intermittens) usually refers to cramping pains in the legs (usually the calf muscles, but may be in the thigh muscles) caused by poor circulation of the blood in the arteries to the leg muscles during exercise.^[2][3] True claudication is relieved with rest from exercise.^{[citation needed]}

Prognosis

The prognosis for patients with peripheral vascular disease due to atherosclerosis is poor.^{[citation needed]} Patients with intermittent claudication due to atherosclerosis tend to die from cardiovascular disease (e.g. heart attack), because the same disease that affects the legs is often present in the arteries of the heart.

Spinal claudication/ neurogenic claudication

Spinal claudication/ neurogenic claudication is not due to lack of blood supply, but rather it is caused by nerve root compression and/or stenosis of the spinal canal, usually from a degenerative spine, most often at the "L4-L5" or "L5-S1" level. This may result from many factors, such as bulging disc, herniated disc or fragments from previously herniated discs (post-operative), scar tissue from previous surgeries, osteophytes (bone spurs that jut out from the edge of a vertebra into the foramen, the opening through which the nerve root passes), or other causes. In most cases neurogenic claudiation is bilateral, i.e. on both sides, but can also be present unilaterally. It may be differentiated from arterial claudication based on activity and position. Vascular claudication typically occurs after activities/ambulation for a distance with resultant vascular insufficiency (lack of blood flow) where the muscular demands of oxygen outweighs the supply. Symptoms are lower extremity cramping. However, simple resting from activity even in a standing position may help relieve the symptoms. In Neurogenic claudication, positional changes lead to increased stenosis (narrowing) of the spinal canal and compression of nerve roots and resultant lower extremity symptoms. Standing and extension of the spine narrows the spinal canal diameter. Sitting and flexion of the spine increases spinal canal diameter. A person with neurogenic claudication will have worsening of leg cramping with standing erect or standing and walking. Symptoms may be relieved by sitting down (flexing the spine) or even by walking while leaning over (flexion of the spine) a shopping cart. Another test is the ability to ride a stationary bike for a prolonged period of time which differentiates neurogenic claudication from vascular claudication. Weakness is also a prominent feature of spinal claudication that is not usually present in intermittent claudication. The perceived level of pain from claudication can be mild to extremely severe.

Jaw claudication

Jaw claudication is pain in the jaw or ear while chewing. This is caused by insufficiency of the arteries supplying the jaw muscles. The most common cause is temporal arteritis.

See also

• Peripheral artery occlusive disease
• Intermittent claudication
• Spinal stenosis

References