About Leg Pain

Some people mistakenly think that leg pain is a natural part of getting older. You might be surprised
to learn that leg pain that develops during walking—and then goes away only with rest—can be
caused by intermittent claudication (IC), a potentially disabling yet treatable medical condition.

IC affects roughly 3 million people, most of them over age 55. Unfortunately, an estimated 75
percent of all IC sufferers fail to seek medical help, often because they don’t realize that IC is a
treatable medical condition.

IC is a symptom of peripheral arterial disease (PAD). PAD—also known as “hardening of the
arteries,” or atherosclerosis of the legs—has been estimated to affect approximately 10 percent of
people over age 55. PAD occurs when arteries in the legs become clogged with fatty deposits.

It’s not uncommon for people who have PAD to also have atherosclerosis in other parts of the
body—especially in the heart and brain. Atherosclerosis is a serious health problem that can lead to
heart attack or stroke if left untreated.

The symptoms of IC may be felt in the:

  • Calf
  • Thigh
  • Buttock

And the symptoms may be felt as:

  • Aches
  • Cramps
  • Heaviness
  • Numbness

IC symptoms may be felt in one or both legs and may occur during walking or exercising. The pain
is characterized by aching, cramping, tiredness, or tightness of the affected muscle group. Once you
stop walking or exercising, the symptoms subside within minutes. If you’re experiencing any of
these symptoms, see your podiatric physician. He or she can diagnose your condition and suggest
treatments that may help you walk farther without leg pain.

Controlling Your Risk

You can decrease the risk of developing leg pain due to intermittent claudication (IC) if you take
steps to control its risk factors. Risk factors are conditions that increase your chances of developing

Risk factors and other conditions that may complicate IC include:

  • Smoking
  • High cholesterol
  • High blood pressure
  • Physical inactivity
  • Obesity
  • Diabetes


Smoking is one of the most significant  risk factors for IC. If you smoke, your risk of developing
peripheral arterial disease is two to seven times greater than nonsmokers. Smoking increases the
risk of IC by:

  • Narrowing blood vessels, which decreases blood flow to the legs.
  • Reducing the amount of oxygen in your blood, which can increase leg pain.
  • Irritating the lining of blood vessels, which can speed hardening of the arteries

People with IC who continue to smoke also have a 10-fold greater risk for limb amputation.

Most podiatric physicians include an antismoking component as a routine part of their encounters
with all patients regardless of the diagnosis and no matter what age.

High Cholesterol

High blood cholesterol is another risk factor for IC. Cholesterol is a fat-like substance made by the
liver, and it also enters the bloodstream from the food you eat. When cholesterol builds up in the
walls of the arteries of the legs, blood flow is reduced, causing pain when you walk. Studies
suggest that lowering the amount of fat in the blood, including cholesterol, may slow the
progression of IC and possibly relieve symptoms.

Some steps you can take to control high blood cholesterol include eating a heart-healthy diet,
maintaining a healthy weight, and being physically active. These lifestyle changes are the same as
those recommended for people with IC, giving you even more reason to undertake them. When diet
and exercise aren’t enough, medication may be needed. Your doctor can determine what treatment
is best for you. For more on what you should know about cholesterol, visit the National Cholesterol
Education Program on the Web.

High Blood Pressure

High blood pressure is a major risk factor for IC. It contributes to hardening of the arteries
(atherosclerosis), which is the basis of peripheral arterial disease and IC.

Although clinical studies have not yet been performed to determine if lowering high blood pressure
relieves IC symptoms, it’s wise to take steps to control your blood pressure. For more information
on lowering high blood pressure, visit the National Heart, Lung, and Blood Institute Web site.

Physical Inactivity

Doctors have found a link between IC and an inactive lifestyle, which means that people with IC are
most likely not getting enough exercise. A sedentary lifestyle can result in muscle loss, lower
endurance, and higher blood pressure—all of which complicate IC.

To become more active, people with IC can begin by walking every day for 20 minutes, alternating
walking with periods of rest. Your podiatric physician can ensure your feet will be up to the task of
starting a walking regimen. The goal is to increase continuous walking to 30 to 45 minutes each day
for at least six months. Ask your doctor before you start or significantly increase an exercise program.

Exercise yields many rewards. Research has shown that regular exercise can help control IC risk
factors such as high blood pressure, obesity, and diabetes—as well as almost double your pain-
free walking distance.


Excess weight can make other IC risk factors much harder to control. It raises blood pressure and
blood cholesterol,and increases the risk of developing diabetes. A commitment to losing weight and
maintaining that weight loss can be challenging, but by losing even 10 to 20 pounds, you can help
reduce your risk of developing cardiovascular disease. Your doctor can help you begin a healthy
weight loss plan which may include both diet and exercise.


If you suffer from diabetes (high blood sugar), your risk for developing IC is two to three times
greater. Steps to help control diabetes include quitting smoking, eating a heart-healthy diet, being
physically active, and controlling sugar intake. By controlling diabetes, you may also be able to delay
or prevent its complications, such as IC. For more information on controlling diabetes, visit the
National Diabetes Education Program Web site.

Patients, especially those with diabetes, should pay extra attention to their foot and nail care and
obtain regular foot examinations from their podiatric physician. See your podiatrist at the first sign of
any changes in the foot.

Managing the Condition

Your podiatric physician will undertake a careful examination and diagnosis of the condition. Foot
care is of critical importance to patients with IC, because seemingly minor injuries to the feet may
result in infection, nonhealing wounds, and other complications. Patients, especially those with
diabetes, will receive explicit instructions regarding foot and nail care. Smokers need to stop—
immediately. Exercise programs, particularly walking, can help the condition, and safe, effective drug
therapy may be prescribed by your podiatric physician.
Advanced Foot and Ankle Specialists * Houston: 8200 Wednesbury Lane, Suite 210, Houston, TX  77074 * Sugar Land Location: 17510 West Grand Parkway South, Suite 440, Sugar Land, TX  77479