How Do I Know That My Leg Pain Is Due To Poor Blood Flow (Claudication)?

Dr. James Rathmell answers the question: 'Leg Pain Due To Poor Blood Flow?'

ByJames Rathmell, M.d., Director, Pain Center At Massachusetts General Hospital
November 12, 2008, 11:32 AM

— -- Question: How Do I Know That My Leg Pain Is Due To Poor Blood Flow (Claudication)?

Answer: It can be very difficult to differentiate claudication that's coming from not enough blood flow to the lower extremities. The two most common causes of cramping pain in the lower extremities, also called claudication, are neurogenic claudication -- coming from spinal stenosis, and vascular claudication -- coming from peripheral vascular disease that has caused not enough blood flow or narrowing of the arteries to the legs and not enough blood flow. Sorting them out can be very difficult because both come on and present as cramping pain after just minimal walking; very short distances, on comes this cramping pain, usually in both calves; you sit down and it goes away.

Pain coming from lumbar spinal stenosis tends to be better when you lean forward. So someone who can lean forward against a grocery cart and walk without pain, but when they stand up straight, it's painful -- that signals neurogenic claudication, coming from spinal stenosis.

Vascular claudication, on the other hand, it typically occurs in people who have other vascular disease, either heart disease, they've had previous stroke, or they have other problems with blood flow to the lower extremities. And it often comes on with coolness of the extremities, or presents with coolness of the extremities or decreased pulses in the extremities. So those are some of the ways that we can try and figure it out, but it can be very, very difficult to figure out.

Next: What Is Complex Regional Pain Syndrome (Reflex Sympathetic Dystrophy)?

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