What is claudication?
Claudication is caused by atherosclerosis or “hardening of the arteries”. It’s a cramp like pain, usually occurring in the back of the calf during walking. It can sometimes occur in the thigh muscles or buttocks. The pain is due to the muscles having insufficient blood to supply to meet their oxygen needs during exercise, a condition called ischaemia .Blood cannot get to the muscle because of narrowings in the artery which slow down the flow. It is rather like road works on a motorway, traffic eventually gets to its destination, just slowly. The pain occurs after a variable distance of walking, in some patients after just a few steps and in others after a mile or more. At the shorter distances the pain is usually too severe to allow continued walking but in milder forms it is uncomfortable and a nuisance, making the individual slow down rather than stop. Sometimes the leg feels "dead" and the foot feels numb. All these symptoms almost always disappear within ten minutes of stopping walking.

What’s the cause?
Almost always smoking. High cholesterol and raised blood pressure are also significant. The arteries are repeatedly damaged by substances in tobacco and essentially the inner lining of the artery is scarred and narrowed.

Is it treatable?
Yes, It is now possible to place small balloons inside arteries and to squeeze open the narrowing (stenosis) in the arteries. This is normally done under local anaesthetic and should, apart from some mild discomfort, be painless.

Why are you not offered this easily on the NHS?
Mainly because some doctors feel that claudication is not immediately life-threatening and don’t want to risk giving you a complication for a condition that although troublesome is not regarded as dangerous.

Should I not have a choice in this decision?
Absolutely! We feel that you should be told in simple language the risks and benefits of any intervention and it is you who should decide.

Why do we think differently?
We feel that moderate to severe claudication seriously reduces your quality of life. Your self confidence and independence are affected. We find many people who give up social activities such as golf or bowls because they are embarrassed to be in situations where they can’t keep up with their friends.

What are the risks?
The risk of something unwanted happening during an angioplasty is about 1%.

Of this small group the vast majority will need only a minor operation or intervention and leave hospital within a day or so well. About one person in a thousand will end up with a serious complication that would have a serious impact on their lives and may take months to recover from.

How does this compare to other operations?
It is significantly less than complications related to hip or knee surgery, which most people wouldn’t think twice about having if it is reducing their independence or producing pain.

A very small proportion of people with claudication get worse and need surgical treatment to help. This will usually only be necessary if the circulation deteriorates to the point of suffering pain at rest in the feet and particularly at night. There is more information about this kind of surgery on the page about major vascular operations.