Patient assessment - history
The history that the patient with intermittent claudication may give was outlined in what is claudication.
Typically the patient has been experiencing problems for a few months with a tightness, ache, cramping or pain in the muscles of the leg after a certain distance of walking. The pain is not present at rest and goes after a few minutes of rest once it has started. The pain comes on more quickly after brisk walking or walking uphill. Once the patient has rested and continues walking again, the pain returns after a similar distance.
The muscles affected will depend on where the arteries supplying the leg is diseased. If the artery in the thigh (superficial femoral artery) is narrowed or blocked, the patient will experience calf pains. If the iliac arteries are involved, the pain starts in the calves and works up to the buttocks. In men, if iliac arteries on both sides are involved there may be impotence in addition to the claudication (this is known as Leriche Syndrome).
Claudication does not cause pain at night. Pain in the toes at night relieved by dangling the leg out of bed or getting up indicates progression of the arterial disease to critical ischaemia - where the blood supply to the leg is hampered to such a degree that the skin is at risk of gangrene.
It is important to remember that there are other possible reasons for the leg pain and assessment by your GP or a specialist is needed.
In addition to the history of leg pains, your doctor will want to know about other manifestations of arterial disease such as angina, heart attack or stroke and also about your risk factors including smoking, high blood pressure, high cholesterol, diabetes and family history.