What disease causes intermittent claudication?

Many people are curious about their intermittent claudication and don’t know which department to go to in the hospital. Intermittent claudication can be diagnosed as a problem with the lumbar spine, so these patients usually experience low back pain and leg weakness. This disease manifests different symptoms when we are resting and walking. If we walk too much, we will experience limping, which will be relieved after resting, thus resulting in symptoms of intermittent claudication. This article introduces the details, let’s take a look.

Causes and common diseases

The main cause of the disease is that on the basis of the existing stenosis of the lumbar spinal canal, the pressure load on the vertebral body and nerve roots increases when standing upright, and the contraction and relaxation of the lower limb muscles during walking further promotes the physiological congestion of the blood vessels of the nerve roots of the corresponding spinal ganglia in the spinal canal, followed by venous congestion and traction of the nerve roots, and obstruction of microcirculation in the corresponding parts, resulting in ischemic radiculitis, resulting in symptoms such as low back and leg pain, numbness and weakness of the lower limbs. When the patient squats, sits down or lies down to rest, the pressure load on the nerve roots is reduced, eliminating the source of stimulation during muscle activity, and the ischemic state of the spinal cord and nerve roots is improved, so the symptoms are alleviated and disappear. When walking again, the above symptoms reappear, and when resting again, the symptoms are relieved again. This repeated and alternating process forms intermittent claudication. This is one of the main clinical features of lumbar spinal stenosis. Lumbar spinal stenosis is a common disease in orthopedics. The causes of the disease are very complex. There are congenital lumbar spinal stenosis and secondary lumbar spinal stenosis. Secondary lumbar spinal stenosis is caused by degeneration of the intervertebral disc and vertebral body, joint degeneration or spondylolisthesis, traumatic fracture and dislocation, and osteitis deformans. The most common of these is degenerative spinal stenosis.

Differential Diagnosis

Lumbar spinal stenosis presents as neurogenic intermittent claudication, which is different from vascular intermittent claudication (such as thromboangiitis obliterans). The main differences are:

1. In neurogenic intermittent claudication, the dorsalis pedis artery pulsation is good, while in vascular intermittent claudication, the dorsalis pedis artery pulsation is weakened or absent.

2. Neurogenic intermittent claudication may cause segmental sensory disturbance in the lower limbs, while vascular intermittent claudication may cause stocking-like sensory disturbance.

3. The walking distance of neurogenic intermittent claudication gradually shortens as the disease progresses, but this is not obvious in vascular intermittent claudication.

4. Arteriography may be performed if necessary. The arteries of neurogenic intermittent claudication are well-developed, while vascular intermittent claudication may show areas of arterial lumen stenosis.