Can anything be done for claudication of the legs in GCA sufferers? Is there a test for it?

[Trenny]

This was mentioned in another thread and I wondered... Is there a test for it? I have a lot of mild pain in my calf muscles and find standing or walking for more than a few minutes, particularly up any incline, quite painful and uncomfortable. I have GCA and am down to 11mg Pred, just about to reduce to 10.5mg by the slow method.

[Trenny]

And what is the treatment?

[polkadotcom]

Trenny, I have had this problem from the start and I don't think there is any particular treatment if it is just muscle pain. Artery problems/pain - which is usually what is meant by claudication, when it is the narrowing of an artery - would require some surgical interaction/tests and is much more the serious of the two of course. It is more usually felt in the groin area though.

For the calf pain I have found that stretches generally take care of it. If it persists I use a topical pain relief, but that isn't very often.

[greenlander]

Obviously I don't know if you have claudication but it sounds as though you could have. I would urge you to check it out. As has been pointed out the cause is a restricted blood supply. Despite what was said, the calf is the likeliest site. The pain comes with walking when the muscle is not receiving enough oxygen and should stop after a minute or so rest. You may need some exercise advice and maybe statins and BP checks. There's also a drug that increases oxygen in the blood that helps some people. Most sufferers do not need more than that. But do act on the cautious side.

[raymck]

Hi Trenny, Just to say my surgery nurse did a blood flow test on my legs & found quite severe loss below the calf area, like you describe. Consultant I was referred to didn't recommend angioplasty, however, due to clotting risk. Only when the problem becomes so bad that you can only manage a few 100 yards, he said would he contemplate it. At present my pain occurs about the 1/2 mile stage, so it's grin & bear it! Coming off steroids had no effect on it at all, it's just an old smokers sclerosis of the arteries problem, for which I have only myself to blame.

Ah well, we live and learn. I hope this shows a little light on the problem, but can't offer any hope of relief sadly, the experts all tell you to work through the pain & develop the adjacent viens to take some of the flow! It hasn't happened yet to me after several years of what feels like "muscle cramp" which puts you off walking any distance, unless very slowly indeed.

Hope you get on better, if it's not sclerosis.

Regards,

raymck

[PMRpro Ambassador]

You need to ask your GP to refer you to the vascular clinic. There are tests that can be done to work out where the restriction is on the blood flow and they are done in a vascular lab. Not all hospitals have vascular surgeons, not all have facilities to do the tests. But your GP should know where your local one is. In some cases there are things they can do to help but only the vascular specialists can sort that out. It is possible to improve it by walking "through the pain" - it encourages the body to grow new arteries to bypass the blockage and if that can happen the blood flow to the muscles is improved and the pain is less. As has been said, the calf is the main place for claudication pain - that is specifically pain that comes on when walking and goes away when you stop only to come back when you start walking again. If it is in the groin that is more serious the blockage is much higher up.

Another possibility might be that the achilles tendons and calf muscles are tight - physio to teach you stretches would help there but it needs to be checked first that the achilles tendons are not inflamed.

The vascular clinic is totally different from a vasculitis clinic by the way!

[Trenny]

I think that the test must be the doppler ultrasound test (having googled it). What has been said makes a lot of sense. I'll put it on my list for the next Dr's checkup - or may 'phone her. I have learnt so much from this site and am so grateful for everyone's input.

[Trenny]

As a 'follow-up', I have had a doppler test and it didn't show any problems. I had a 'collapse' the other week when I was out for a very short walk 'around the block' and my knees felt weak and I sank to the ground (luckily a grass verge). Two kind people walked me back to the house and and I felt fine after a rest. The doctor couldn't offer any suggestions when I saw her a week later when I finally got appointment, but I have lost my confidence and now use a National Trust stick which has a collapsible seat attached.

The good news is that I have got down to 10mg Pred now by the slow method.