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Intermittent Claudication

The term claudication has been derived from the Latin word denoting 'to limp' or weakness of the leg accompanied by circulatory problems. When we say intermittent claudication, it actually refers to vascular claudication and expresses the hurting that builds up in the leg muscles while undertaking any work-out or even just walking. Pain also develops in the calves owing to a blockage of blood circulation in the arteries because of atherosclerosis (a progressive disease of the arteries wherein fatty substances are deposited in the arteries making them narrower). Often the pain originates following after the individual has walked some distance, compelling them to stop recurrently to take rest. In intense or acute cases, blood clots inside the arteries, resulting in the loss of a spot of tissue, gangrene (death of soft tissues owing to the blockade of blood circulation) and even a possible amputation. In case you have a doubt that you are enduring intermittent claudication, talk to your doctor right away.

When one suffers from intermittent claudication, generally the calf muscles are affected most and the patient complain of a spasmodic uneasiness, as typical of the pain. In the early stages of the disease, the patient is able to walk despite the pain, but as the ailment progresses more, walking too seems impossible and the pain of claudication compels the patient to limp and they can get relief from the pain only when they rest. Majority of the patients find that the symptoms of claudication actually deteriorate when they walk in an ascending path. The claudication symptoms may even worsen while walking barefoot or even wearing flat shoes. In fact, the claudication symptoms will deteriorate further when the leg muscles need to work harder. There are some patients who also experience claudication symptoms in the thighs as well as buttocks and the peripheral vascular disease (PVD) is likely to result in impotence in men, a condition known as Leriche syndrome. Precisely speaking development of different symptoms of claudication is largely dependent of the exact arteries that have been affected by this disease. The symptoms are called intermittent as they come to an end when the patient is resting.

It is interesting to note that several other conditions that instigate pain in the legs, such as in the case of neuropathy (nerve problems) and arthritis, might also mimic the symptoms of claudication. In effect, neurogenic claudication is a condition wherein pain develops in the legs owing to firmness of the nerves in the spinal cord and may be extremely problematic to differentiate it from claudication owing to the problems of the arteries.

Supplements and herbs

A number of herbs and supplements are effective in treating intermittent claudication. For instance, several researches have demonstrated that the condition improves considerably when the patient combines walking with supplements - he/ she should take 300 to 400 IU of vitamin E every day as a supplementation.

In effect, intermittent claudication is an indication of an ailment related to the arteries. Keep away from foods that contain high cholesterol, like red meat and dairy products. Simultaneously, enhance your intake of foods that are rich in fiber content, whole grain cereals as well as fresh vegetable and fruits. Also increase ingesting magnesium present in nuts, cooked dehydrated peas and beans, bread prepared with whole grains and cereals, seafood, soybeans, deep green leafy vegetables and milk.

An infusion prepared with hawthorn is an excellent tonic/ stimulant for the circulatory system. To prepare the hawthorn infusion, add two teaspoons of the berries to one cup of steaming water and allow them to infuse for about 20 minutes. For best results, drink the infusion thrice every day.

Scientists have examined a uniform extract of garlic as a new treatment for intermittent claudication. A double-blind study showed that the enhancement in walking distance was considerably more in people who received garlic powder extract - taking 400 mg of the powder twice every day for 12 consecutive weeks, compared to those who were given placebo.

L-arginine (amino acid) is also used to treat recurring leg pain caused by blocked arteries (intermittent claudication). In addition, fish oils, which contain omega-3 fatty acids, too seem to have several useful biochemical and hemodynamic impacts in people suffering from intermittent claudication. Even flavonoids are effective in treating intermittent claudication as they thin the blood and facilitate in augmenting circulation. Flavonoids are present in vegetables and fruits and are also available in the form of supplements.

Scientists have also studied the Chinese herb ginkgo biloba as a remedy for intermittent claudication and suggested a maximum standard dosage of 40 mg of the herb. They undertook a multi-centric, placebo-controlled, randomized double-blind trial on ginkgo biloba special extract, known as EGb 761 (Tebonin forte) in patients who suffered from peripheral occlusive arterial disease, a common manifestation of intermittent claudication. It was concluded from the findings of this study that treating intermittent claudication patients with EGb 761 is not only safe, but also resulted in considerable and therapeutically appropriate prolongation in the walking distance of the patients.

A cholesterol lowering substance called policosanol has associated antiplatelet impacts. This research was carried out with a view to evaluate the consequences of triclopidine and policosanol in people suffering from moderate to acute intermittent claudication. As many as 28 patients were randomized to triclopidine 250 mg tablets or policosanol 10 mg tables taken twice every day. Simultaneous, the walking distances were evaluated on treadmill prior to and following 20 weeks of the treatment. It was found that the group given policosanol as well as that which was given triclopidine were at the same baseline.

Assessed with baseline, it was found that policosanol considerably enhanced the average values of initial (ICD) as well as absolute (ACD) claudication distances from just 162 meters to 273 meters and from 255 meters to 401 meters, in that order. It was also found that triclopidine too significantly increased both ICD and ACD. Evaluations between groups, however, did not demonstrate noteworthy differences. Following 10 weeks, policosanol considerably reduced low-density lipoprotein-cholesterol (LDL-C), total cholesterol (TC) as well as TC/ HDL-C. Simultaneously, it increased the high-density lipoprotein-cholesterol (LDL-C). Policosanol induced reticent, but noteworthy lessening of fibrinogen levels in comparison to baseline and triclopidine. The study concluded that policosanol (10 mg bid) may be equally useful as triclopidine (250 mg bid) for enhancing walking distances of patients suffering from claudication.

Homeopathy

Intermittent claudication may also be cured using homeopathic remedies. The two homeopathic remedies that are effective in treating this condition are Baryta muriatica 6c and Proteus 30c. To treat intermittent claudication, take Baryta muriatica 6c thrice every day for three consecutive weeks. If you opt for Proteus 30c, you should take this medication during the severe claudication attacks.

Additional things you may do

In addition to using allopathic medications, herbs, supplements and homeopathic remedies, you may do many other things that will help you to prevent as well as cure intermittent claudication. Among the most imperative things that you may do comprise quitting smoking, losing weight, undertaking work-outs on a regular basis, as well as treat any vascular risk factors you might have. Undertaking these activities will not only help you to enhance your walking and lower the low risk of losing limb even more, but they can also facilitate in reducing problems arising out of widespread atherosclerosis. In effect, vascular risk factors are issues that put a patient at augmented risk of stiffening of the arteries.

In case you smoke cigarettes, it is essential for you to make a strong-minded endeavour to quit it totally. Remember, tobacco is harmful owing to two main reasons - first, it accelerates the stiffening of the arteries, which is the primary reason for trouble, and, second, the smoke of cigarette tighten up on the small collateral blood vessels, thereby reducing the amount of blood and oxygen supplied to the muscles. The best way to quit smoking is to select a day when you would be stopping smoking totally instead of attempting to cut back little by little. In case you have problems in quitting smoking, you may consult your doctor who is able to give you counselling regarding nicotine gum as well as patches or get you in touch with any support group. In the event of requiring an angioplasty or surgery, it is likely that the results would be much inferior if you continue with your smoking habit. In addition, being excessively overweight may add to the disease. Therefore, it is advisable that you initiate measures to maintain your regular weight.

There is sufficient proof that people suffering from intermittent claudication and undertaking exercise on a regular basis are able to enhance their walking distance - the same distance they were able to work earlier, but had to stop time and again to take rest owing to pain. In order to increase the walking distance, it is vital to reserve some of your time for work-outs. It is advisable that you should walk at a normal pace till you experience pain and subsequently make an attempt to proceed a little more. As the pain increases and reaches to a point which is close to maximum, stop walking and take rest until the pain subsides. Start walking again when you have been relieved of the pain. Always bear in mind the distance you walked on the first day and walk an equal distance on the following day. Continue with this practice - walking the same distance for about one week, and increase the distance a little in the second week of your exercise. The augmented distance is subsequently continued for the second week and in the following week increase the walking distance a little more. Remember, it is important that you only increase the walking distance every week, and not abruptly, by a little more distance or else it might turn out to be very easier said than done.

It is essential to work out no less than three to four times every week and very steadily over a period of several weeks to add to the walking distance. In the initial phases, you may feel uncomfortable, but you ought to start feeling the actual advantages at about six to eight weeks. Moreover, it is also imperative that you should not try and augment your walking distance very quickly since this may turn out to be excruciating as well as wearisome.

You would be happy to know that a number of centers offer organized/ monitored exercise programs. In effect, such programs have demonstrated maximum gains when the exercise/ work-out session continued for over 30 minutes and when such sessions occurred no less than thrice a week. In addition, these programs have proved to be beneficial when the patients have walked a distance till they experienced a condition in the vicinity of the utmost pain and when it continued for a minimum of six months at a stretch. You ought to always bear in mind that exercising has the aptitude to enhance the ability to walk in patients suffering from intermittent claudication by as much as 150 per cent!

Enhancements in walking from a work-out program seem to be better compared to any medicine, counting cilostazol, and may perhaps be comparable in the long term to walking from enduring angioplasty. In effect, angioplasty has the aptitude to get more rapid improvements in the ability to walk. However, this might not be long lasting. In addition, angioplasty also has several inherent risks.

In case the weather conditions do not allow you to walk, you may use the stationary indoor bicycle as an alternative. However, it is advisable that you talk to your doctor prior to commencing any type of exercise routine.

If you have intermittent claudication, it is extremely vital not to gain weight, as more weight in the leg muscles means that they need to have more supplies of oxygenated blood that they will require for proper functioning. If you contact your doctor or dietician, they will give you proper advice regarding diets that will help you to reduce your weight. In case you have a high blood cholesterol level, you will be required to intake a diet very low in fat content and also need to take drugs that help to lower the cholesterol levels.

In addition, it is important that your blood pressure is checked regularly and in case your blood pressure is constantly high, you ought to contact your doctor for immediate treatment. Increased blood pressure has the aptitude to result in further worsening in the stiffening of the arteries in case it is not cured timely. In the event of you suffering from diabetes, it is pertinent that your sugar levels are regulated on a regular basis and this will help you to avoid problems in the times to come.

It has been found that the symptoms of a number of patients suffering from intermittent claudication deteriorate when they wear flat shoes. A shoe with a raised heel will raise the heel of the foot and is able to absorb some heaviness off the calf muscles. This will help you to enhance your walking distance. There are occasions when precise treatment for thrombophilias may perhaps be useful.

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