Peripheral artery disease (PAD) is a common circulatory problem in which narrowed arteries reduce blood flow to the limbs, usually the legs. This reduced blood flow often causes pain when walking, a condition known as “claudication.” Unfortunately, claudication can sometimes be mistaken for nerve or joint pain, leading to misdiagnosis and delayed treatment.

Understanding Claudication

Claudication refers to muscle pain, cramping, or fatigue that occurs during physical activity due to insufficient blood flow. It typically affects the calves, thighs, or buttocks and is relieved by rest. The pain results from the muscles not getting enough oxygen-rich blood during exercise, a consequence of the narrowed or blocked arteries.

Symptoms of Claudication

• Pain during exercise: Claudication typically occurs during walking or other forms of exercise and subsides with rest.
• Location of pain: The pain is often felt in the calves, thighs, or buttocks, depending on where the artery is narrowed.
• Cramping or weakness: Muscles may feel weak or cramp during activity.
• Numbness or aching: Some individuals report a numb or aching sensation rather than sharp pain.

Misdiagnosis: Nerve or Joint Pain?

Claudication can easily be mistaken for other conditions like nerve pain (neuropathy) or joint pain (osteoarthritis). This misdiagnosis happens because the symptoms can overlap, especially in older adults who may have multiple health issues.

Nerve Pain (Neuropathy): This pain is often described as burning, tingling, or shooting, and may not be directly related to activity. However, in conditions like sciatica, pain can occur in the legs and be mistaken for claudication.

Joint Pain (Osteoarthritis): Osteoarthritis pain is generally related to the joint itself, with stiffness, swelling, and pain that worsens with movement and improves with rest. Like claudication, osteoarthritis pain can also affect the lower limbs, particularly the knees and hips.

Differentiating Claudication from Other Pain

To correctly identify claudication, healthcare providers may use several diagnostic tools:

• Ankle-Brachial Index (ABI): This test compares the blood pressure in the ankle with the blood pressure in the arm to detect reduced blood flow.
• Doppler Ultrasound: This imaging test visualizes blood flow through the arteries.
• Exercise Testing: Pain that is consistently triggered by a certain level of physical activity, particularly walking, and is relieved by rest, is a key indicator of claudication.

Why Misdiagnosis Matters

Misdiagnosing claudication as nerve or joint pain can lead to inappropriate treatments, such as physical therapy for supposed arthritis or medications for nerve pain, which may not address the underlying vascular issue. Delayed diagnosis can result in worsening symptoms, increased risk of heart attack or stroke, and reduced mobility.

Treatment and Management

Once correctly diagnosed, PAD and claudication can be managed with lifestyle changes, medications, and sometimes procedures to restore blood flow. Key treatments include:

• Exercise Therapy: Supervised exercise programs can help improve walking distance and reduce symptoms.
• Medications: Drugs that lower cholesterol, manage blood pressure, and improve blood flow may be prescribed.
• Surgical Interventions: In severe cases, angioplasty or bypass surgery may be necessary to restore blood flow.

Conclusion

Recognizing the symptoms of claudication and differentiating them from nerve or joint pain is crucial for effective treatment. Individuals experiencing pain when walking should seek medical evaluation, especially if the pain subsides with rest, to rule out PAD and avoid the consequences of misdiagnosis. Early detection and treatment can significantly improve quality of life and reduce the risk of severe cardiovascular events.

Experiencing Leg Pain? Schedule a Consultation.

Central Coast Vein & Vascular is the Central Coast’s premier clinic for outpatient vascular and other minimally-invasive surgeries. Led by Dr. Ken Spearman, a Harvard-trained vascular interventionalist, our practice provides full-service consultation, diagnostics and state-of-the-art arterial and venous treatments all in a convenient comfortable office setting. Schedule a consultation today.