Ischaemia and intermittent claudication – what is the difference, and how does it feel?

Many people experience leg pain or cramping and wonder if it is due to poor blood circulation caused by ischaemia or intermittent claudication. While these two terms are closely related, they have distinct meanings. In this article, we explain what ischaemia and intermittent claudication are, how they are connected, and what you can do to get the right treatment.

What is ischaemia?

Ischaemia refers to reduced or restricted blood supply to a tissue or part of the body. This often occurs when blood vessels become narrowed or blocked, resulting in a lack of oxygen and nutrients reaching the affected area.

In the legs, ischaemia can cause pain, fatigue, or more serious complications such as ulcers or tissue death if blood flow is not restored. Ischaemia is typically caused by atherosclerosis, where fatty deposits and calcium build up inside the arteries.

What is intermittent claudication?

Intermittent claudication is a specific form of ischaemia affecting the legs. It occurs when the blood supply to the leg muscles is insufficient during physical activity, such as walking. The muscles lack the oxygen and energy they need, leading to pain and cramping.

Symptoms of intermittent claudication:

• Pain when walking: Most commonly in the calf muscles, but it can also affect the thighs or hips.
• Relief with rest: The pain usually subsides after a short pause.
• Recurring discomfort: Symptoms are intermittent and depend on activity levels.

How are ischaemia and intermittent claudication connected?

Ischaemia and intermittent claudication are closely linked but describe different aspects of circulatory problems. Ischaemia is a broad term that refers to insufficient blood supply to tissues, depriving them of oxygen and nutrients. This condition can affect many parts of the body, including the heart, brain, and legs.

In the legs, ischaemia is often caused by atherosclerosis, which narrows the arteries and reduces blood flow. Intermittent claudication is a specific manifestation of ischaemia that occurs during physical activity. When muscles work harder, they require more oxygen, but restricted blood flow prevents this need from being met. This leads to symptoms such as pain, cramping, or heaviness in the legs, which typically disappear after a short rest.

Research analysing the treatment of intermittent claudication highlights that supervised walking programmes are among the most effective methods to improve symptoms. Systematic reviews show that such programmes not only enhance blood flow but also help patients walk longer distances without pain. Read more about the research here.

It is important to note that not all cases of ischaemia lead to intermittent claudication. If blood flow is severely restricted, the condition can progress to critical ischaemia, which is much more serious. Critical ischaemia causes symptoms such as pain at rest, ulcers, or even tissue death because blood supply is inadequate even during inactivity.

A study published in a leading medical journal emphasised the importance of supervised exercise therapy for patients with intermittent claudication. Experts recommend integrating such programmes into clinical practice to improve patients' quality of life and reduce the need for invasive treatments. Read more about this research here.

Treatment options for ischaemia and intermittent claudication

Treatment depends on the severity of symptoms and the underlying cause of reduced blood flow. The main goals are to improve circulation and alleviate symptoms.

Lifestyle changes:

• Walking programmes: Regular physical activity, particularly walking, can stimulate blood circulation and promote the development of new blood vessels (collateral circulation).
• Quit smoking: Smoking worsens blood vessel health and should be avoided.

Medical treatment:

• Medications to improve blood flow, lower cholesterol levels, or reduce the risk of blood clots.

Surgical procedures:

• Angioplasty: A minimally invasive procedure to open narrowed arteries.
• Bypass surgery: A surgical technique to create a new pathway for blood flow around the blocked artery.

When should you seek medical advice?

If you experience leg pain or cramping that limits your daily activities or worsens over time, you should consult a specialist. Early treatment can improve your quality of life and reduce the risk of serious complications such as critical ischaemia.

At UK Vein Care, we offer expert assessments and treatment options for circulatory problems. Our experienced specialists can help you receive an accurate diagnosis and tailored care plan to restore your mobility and comfort.

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