Vascular claudication is angina in the legs: pain that starts when plaque narrows an artery enough that it cannot meet a working muscle’s demand for blood. One of the first English-language descriptions, from 1904, is still apt [1]:
“The patient while walking experiences paresthesia and pains in the feet; tension, pain or stiffness in the calves or even above... finally an increasing difficulty of locomotion that in increasingly shortening intervals causes the sufferer to stop completely and rest. After a short rest all of the symptoms disappear, and the subject is able to walk on as usual.”
Just as angina is a symptom of coronary artery disease, vascular claudication is a symptom of peripheral artery disease, or PAD. This symptom is not always present: PAD, like coronary artery disease, is often asymptomatic. But when claudication does appear, MSK clinicians are often the first to hear about it and the first to get a chance to raise the alarm. Vascular claudication points to PAD, which in turn points to systemic atherosclerotic disease. The claudication is ‘a warning sign to you and your patient’, as one professional group puts it. Within five years, 10 to 15% of people with PAD will die of plaque-related disease [2].
Where patients feel the pain depends on where the narrowing sits.
