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Intermittent claudication

MagazineDecember 2002 (Vol. 13 Issue 9)Intermittent claudication

Intermittent claudication is cramp-like pain, mostly in the calves when walking, due to poor circulation of blood in the leg muscles

Intermittent claudication is cramp-like pain, mostly in the calves when walking, due to poor circulation of blood in the leg muscles. It also causes attacks of lameness and leg pain.

The standard surgical treatment is arterial bypass grafting, such as a femoral popliteal bypass. But there are many popular, successful, non-orthodox alternatives to going under the knife.

Exposing the feet to carbonated water (containing CO2, like soda water) has a beneficial effect in various ways on the microcirculation in patients with this problem (Deutsche Med Wochenschr, 1991; 116: 1617-21; Angiology, 1997; 48: 337-43). This form of hydrotherapy in particular has proved to result in an increase in blood flow on the upper surface of the treated foot.

A controlled clinical trial that examined the effects of immersing patients' legs for 30 minutes five times a week for four weeks into carbonated water showed a significant increase in pain-free walking over long distances (Angiology, 1997; 48: 957-63).

Herbal remedies
The herb Ginkgo biloba is especially associated with improvement in circulation. Data from a review of all studies to assess the effectiveness of Ginkgo biloba in the treatment of intermittent claudication showed significant improvement in increasing pain-free walking over distances (Am J Med, 2000; 108: 276-81).

Garlic and massage
In one randomised, placebo-controlled trial, a daily dose of 800 mg of extract of Allium sativum (garlic), in powdered form, taken over a 12-week period together with massage twice weekly, was shown to significantly increase pain-free walking over distances in patients with intermittent claudication (Clin Invest, 1993; 71: 383-6).

Tibetan medicine
Padma 28 is a mixture of 22 mineral and botanical ingredients used in traditional Tibetan medicine. The product has undergone three rigorous double-blind, placebo-controlled trials. The results in all of these showed that Padma 28 was superior to placebo in increasing pain-free walking (Schweiz Med Wochenschr, 1985; 115: 752-6; Angiology, 1993; 44: 836-67; Forsch Komplementarmed, 1994; 1: 18-26).

Nutritional supplementation
Patients with intermittent claudication were reported to be likely to have deficient levels of carnitine (an amino-acid derivative required for oxidation) in the affected muscles (Circulation, 1991; 84: 1490-5).

Several double-blind studies found that supplementation with either l-carnitine or propionyl-l-carnitine (a naturally occurring derivative) was effective in treating intermittent claudication (Am J Cardiol, 1997; 79: 777-80). Indeed, the evidence suggests that those patients with decreased blood carnitine levels derived the most benefit (Circulation, 1996; 93: 1685-9).

Lifestyle changes
But perhaps the best remedy for claudication is prevention by stopping smoking and taking regular exercise.

Harald Gaier is a registered homoeopath, naturopath and osteopath.

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