Claudication and blood pressure medication

[Pr0jection]

It's very likely I have claudication. I've always been active and a bit of a walker (about 40 mins each day) but since September my calf muscles have been very painful after about 20 mins. Can I ask how this is managed by people who may also have it?

My second question relates to blood pressure medication and what is the best time to take it, i.e. does it affect the absorption of predinisolone?

I'll be visiting my GP later today but I know she won't have too much time to spend with me, so I thought I'd bounce it off you. Thanks for reading and hope you have a great day......

[PMRpro Ambassador]

The procedure is to request a vascular referral - or at least take BP in arms and ankles to get an AB ratio and check the pulses. But I suspect you will be well down the list if you can walk for 20mins before it stops you. In the UK the criterion used to be inability to walk 100m without pain, There is medication - many patients think it is worse than the problem!

But the simple first approach is to try to walk through the pain, trying to increase the distance you can walk before being stopped. By doing that the body develops what is called collateral circulation - an alternative network of small arteries that replace the blood supplied by the partially blocked artery but that takes time and you have to create the demand. This is what the vascular surgeon will tell patients, aiming to extend the time until more drastic measures are required.

As far as I know there is no interaction between BP meds and pred - mine are separated so I can' speak from personal experience. The problem with calcium is mainly that the calcium supplement coats the pred tablets and mucks up absorption - different thing.

[Pr0jection in reply to PMRpro]

Many thanks for your reply, PMRpro. I saw my GP today and she was very helpful. She recognised the symptoms right away and will refer me to a vascular surgeon. She also took my BP which, since my 5th Covid vaccination has been all over the place, but appears to be on the rise so I have been given 1 month's supply of 5mg Amlopidine to see how I get on. She's being cautious which is a good thing. I'm also having a fasting blood test tomorrow morning so she can see my sugar, cholesterol levels as well as checking my kidney function. I took a urine sample with me so she will see the results of that too. My cholesterol has always been high - my bad and my good are almost equal. She's aware of my disinclination to take statins but says she can give me an alternative which is not a statin but should reduce cholesterol levels (can't remember the name). Thanks again for your input. I had thought to try and walk through the pain but wondered if this was a good idea. I do remember at the first signs of claudication, halfway round our usual walk the pain set in and there was nothing I could do but keep on walking, and the pain finally subsided. Trish x

[sequeluk in reply to Pr0jection]

I have a similar issue with my calf muscles and the pain/aching comes on within a few minutes of starting a walk. I can generally walk ok for 10 or 12 miles and it does ease after a while. Some days it's worse than others. I mentioned this last month when I had a telephone appointment with rheumatology and they referred me to the vascular team and got me booked in very quickly for a Doppler scan the results of which didn't show up anything particularly untoward with good pressure in legs and ankles. They've pretty much echoed what PMRpro said in the reply above about walking through the pain. Interested to read her comment about the body developing collateral circulation. Hope mine does as planning on doing the coast to coast walk next Summer and need to be able to do 15miles/day for 2 weeks. Best wishes with your walking.

[Pr0jection in reply to sequeluk]

Thanks for your reply, much appreciated. It makes sense. I'll try walking through the pain.....

[PMRpro Ambassador in reply to sequeluk]

It was my husband's specialist field - he ran the vascular lab for some years and we were close friends with the surgeon. I learnt all sorts of strange things

[sequeluk in reply to PMRpro]

Thanks, PMRpro. Very useful information. Now I know a bit more about it I'm going to try and get back to daily walks rather than resting because I think my legs are tired. Best wishes.