Intermittent Claudication

[I shoot Nikons]

For the last 7 or so years I have been suffering pain when walking which has progressivly become worse and worse until I find myself barely able to go over 100m before the pain forces me to stop. I have seen two GPs and a neurologist about this and each time they said that it sounded like the symptoms of intermittent claudication caused by arteriel disease and each time they have quickly discounted this after taking the pulses in my leg, ankle and foot. The GPs offered no other theory and sent me to the neurologist. I actually got the impression that they didn't believe me at all.

After the neurologist took the pulses and discounted arterial disease he basically said the chances are it's peripheral neuropathy and that the damage is more than likely permanent. He gave me a letter asking my GP to prescribe me Amitriptyline and sent me on my way. Which flies in the face of my diabetes supposedly being a recent thing (despite me telling them I have symptoms going back to when I was 14). A couple of months later I was back at my GP and mentioned that the Amitriptyline wasn't helping with the pain so he took me off them, he didn't prescribe me anything else to try and didn't refer me to see someone who would. This has added to my impression that I'm not being taken at all seriously on this.

Well since this I have been researching what the condition could be, everything from REALLY bad shin splints to a fallen arch to a trapped nerve in my spine and today I came across the following link: http://www.ncbi.nlm.nih.gov/pubmed/21166849

I'm obviously biased but to me it makes remarkably compelling reading. The question is though, if I print this out and take it along for my GP to look at will I be laughed out of his office? I've been effectively housebound for over a year because they won't offer me a walking aid, I was living from savings but they have long since gone. I can't get DLA because the ability to walk 100m is more than enough in their eyes, and I can't get JSA because I can't get to a bus stop or train station to get to a job. I'm just really frustrated, I NEED to get out of this bloody house and get back to trying to get people to invest in my photography again. :thumbdown:

 

[caesarella]

It is worth a try. The worse thing GP can do is disregard your finding. Bring everything and anything you find that might be a possible diagnosis for your condition. You can't continue to be effectively housebound. Also in the meantime maybe ask for something different for the peripheral neuropathy and see if it helps. Maybe Lyrica (pregabalin)- often used for neuropathic pain? I hate to see anyone with so much life being so limited.

 

[I shoot Nikons]

Thanks for your post, caesarella. I will make an appointment this week and broach the subject with him.

 

[Hobs]

Are you by any change taking a daily statin without Co-enzime Q10??

 

[I shoot Nikons]

Hi Hobs,

I'm not on statins, it seems my cholesterol is the only part of me that's fine. :lol:

Have you experienced similar?

 

[daisy1]

I have never taken CoQ10 with my statins. Would that explain the stiffness and aching in my legs ? No-one bothered to tell me that it would be helpful to take it.

 

[I shoot Nikons]

A friend gave me a swimming lesson today, and the pain was as severe in the water as it is out. At one point my mate had to rescue me. It's funny now but let's just say at the time I soiled my good name!! :lol:

So it's pretty apparent that it doesn't matter if the exercise is weight bearing or not. Very frustrating. I can't get an appointment to see the GP for the next 3 weeks. I swear the man has issued a Fatwā warning staff against aiding my occasional badgering.

 

[HOLLYWOOD]

Sorry I'm new to the forum but I'm well educated, self-educated in the world of Diabetes (type1) primarily. My wife is type 1 diabetic and suffers from Diabetic Painful Neuropathy (DPN) which you have described some symptoms of...are you Diabetic? If so then I have have a boat-load of intel I can give to you. If you even have 1 ounce of what my wife suffers from then I am truly sorry and would like to help if I can

 

[robert72]

Hi - I'm new here. 40 years of Type 1

I shoot Nikons, I have intermittent claudication, although I can walk about a quarter mile before the pain starts - usually in calfs and thighs. I have OK pulses in my feet and legs, but I have narrowing of the arteries (heavy smoker for 35 years so I can't complain). The pain is caused by not enough blood reaching the leg muscles during exertion. If you stop walking and rest for a few minutes, you should be able to do the same distance again before the pain starts - and so it goes on (just need to wait for legs to fill up again

My GP sent me to see a vascular consultant. They ordered an ultrasound on my lower arteries which showed 50-70% stenosis of my distal aorta.

So yes I have pulses in my feet but I also have IC and it sounds like you do too. You really need to be seen in a vascular clinic for a proper diagnosis.

 

[I shoot Nikons]

That is precisely what I've been lobbying for at my GP surgery, but as I previously said I don't think I'm being taken at all seriously over this. It's a fairly frustrating situation. What treatment have they suggested for you, or is it a case of damage done, nothing we can do about it?

Hollywood, thank you very much for your post, however I'm almost certain that it's not peripheral neuropathy that's the problem.

 

[robert72]

The advice they gave me was to walk for 20-30 minutes a day. This helps widen surrounding arteries. They say you have to walk as far as possible even when it hurts, as that's the point when the surrounding arteries benefit. Eventually, you'll have to stop for a rest, but push on as far as possible.

For meds they say take 75mg aspirin a day and a statin... although bear in mind that the statin could give you muscle pain. Obviously, try and keep BGs as normal as possible. And don't smoke!

They can widen the arteries but it's by far better to try the walking first, as they only get 2 shots at widening and it carries risks. Basically you're stretching a damaged old bit of piping

You may not see instant results but it should hopefully improve by some degree over time.

 

[viviennem]

One other thing you might have a look at is 'lumbar spinal stenosis'. This is an arthritic overgrowth of the facet joints in the lower spine, which can affect the nerves in the legs. There's always the possibility that the problem might be in your lower spine.

I was diagnosed with LSS last year, though the most prevalent symptom with me is lower back pain. However, I do get pain when walking - just like you, 100m was about the limit. When it's really bad, I have constant pain in my right hip and leg, and my lower leg goes numb or tingles. I can't stand upright, it hurts so much. I take Nortriptylene for the pain, a small dose every night. It works for me.

I finally got a diagnosis last year, by making so much fuss my GP referred me to the Spinal Rehab Unit at our local hospital. The senior physiotherapist heard what I had to say, and diagnosed me without even looking! then he sent me for an MRI scan, and there it was. Apparently physiotherapists are much more aware of it than GPs, though give him his due, mine had guessed.

I was advised not to do any load-bearing exercise, but given some physio exercises for my core body muscles (I do them on the bed). I was also told to use the exercise bike at the gym, very gently (ie, no tension and for 15 minutes only) to help get my legs working again and strengthen the muscles.

It has worked for me, and now I have a diagnosis I feel much better about it, though I may end up having spinal surgery. The exercises are helping too, and now I can walk a bit further. It might be worth asking to be referred to your local specialist physio unit. At least it would eliminate things, and they may be able to help. If it's anything like my PCT, only the hospital unit can refer for MRI scans.

I would keep making a fuss with your GP. Take any evidence or suggestions you can, and ask to be referred. If you make enough of a nuisance of yourself, they'll refer you to get rid of you. If you still get no joy, refer the problem to the Patient Liaison Service

It took me 25 years, with the problem developing slowly, to get an answer. I hope you get yours soon!

Viv 8)

PS I too thought I had intermittent claudication at one point, but as soon as I read the description of LSS symptoms I knew they fitted. It was exactly what I'd been complaining about for years! :roll:

 

[I shoot Nikons]

The advice they gave me was to walk for 20-30 minutes a day. This helps widen surrounding arteries. They say you have to walk as far as possible even when it hurts, as that's the point when the surrounding arteries benefit. Eventually, you'll have to stop for a rest, but push on as far as possible.

For meds they say take 75mg aspirin a day and a statin... although bear in mind that the statin could give you muscle pain. Obviously, try and keep BGs as normal as possible. And don't smoke!

They can widen the arteries but it's by far better to try the walking first, as they only get 2 shots at widening and it carries risks. Basically you're stretching a damaged old bit of piping

You may not see instant results but it should hopefully improve by some degree over time.

Thank you very much for that. I'll give it a bash.

 

[I shoot Nikons]

One other thing you might have a look at is 'lumbar spinal stenosis'. This is an arthritic overgrowth of the facet joints in the lower spine, which can affect the nerves in the legs. There's always the possibility that the problem might be in your lower spine.

I was diagnosed with LSS last year, though the most prevalent symptom with me is lower back pain. However, I do get pain when walking - just like you, 100m was about the limit. When it's really bad, I have constant pain in my right hip and leg, and my lower leg goes numb or tingles. I can't stand upright, it hurts so much. I take Nortriptylene for the pain, a small dose every night. It works for me.

I finally got a diagnosis last year, by making so much fuss my GP referred me to the Spinal Rehab Unit at our local hospital. The senior physiotherapist heard what I had to say, and diagnosed me without even looking! then he sent me for an MRI scan, and there it was. Apparently physiotherapists are much more aware of it than GPs, though give him his due, mine had guessed.

I was advised not to do any load-bearing exercise, but given some physio exercises for my core body muscles (I do them on the bed). I was also told to use the exercise bike at the gym, very gently (ie, no tension and for 15 minutes only) to help get my legs working again and strengthen the muscles.

It has worked for me, and now I have a diagnosis I feel much better about it, though I may end up having spinal surgery. The exercises are helping too, and now I can walk a bit further. It might be worth asking to be referred to your local specialist physio unit. At least it would eliminate things, and they may be able to help. If it's anything like my PCT, only the hospital unit can refer for MRI scans.

I would keep making a fuss with your GP. Take any evidence or suggestions you can, and ask to be referred. If you make enough of a nuisance of yourself, they'll refer you to get rid of you. If you still get no joy, refer the problem to the Patient Liaison Service

It took me 25 years, with the problem developing slowly, to get an answer. I hope you get yours soon!

Viv 8)

PS I too thought I had intermittent claudication at one point, but as soon as I read the description of LSS symptoms I knew they fitted. It was exactly what I'd been complaining about for years! :roll:

Hi Viv,

I had an MRI of my lower spine last year, and they said there was a bit of wear and tear but it was nothing to worry about. This is the thing, the symptoms could be any one of 100 things. I guess I'll have to take your advice and keep badgering my GP.

 

[hanadr]

I would take it along to the GP and try to tighten up on the Bg getting as near to 5s as possible.
Have you tried swimming?
It's often the only way of exercising some conditions safely.
Hana

 

[I shoot Nikons]

Hi Hana,

I have tried swimming, cycling, elliptical etc. but no matter how low impact the exercise the pain still raises it's ugly head, this is what stole my attention when I saw this study. Hopefully we can get it cleared up soon!

 

[robert72]

One thing I forgot to mention - if you have lost most of the hair on your lower legs and feet, it's a good indicator for intermittent claudication.

 

[I shoot Nikons]

Hi mate, lower legs have been almost entirely bald for years now. That was chalked up to the diabetes by the doc. Everything with these people seems to be blamed on the diabetes. :roll:

 

[Paul1976]

One thing I forgot to mention - if you have lost most of the hair on your lower legs and feet, it's a good indicator for intermittent claudication.

OMG!!!
That's what's happened with my legs and I don't know if it's relevant but the hair went to be replaced by a rash that has now gone brown like lots of golden brown freckles and patches that cover my ankles and lower legs and also when I stand for more than 20 minutes the aching in my calf muscles is quite nasty. :thumbdown:

 

[robert72]

Bald legs might not mean that you have it, but it's one of the indications if you have the other symptoms as well.I don't have any skin condition like the one you're describing bigfatpaulie, but with a poor blood supply it wouldn't be surprising I guess. The main symptom is calf pain on walking that disappears on rest. Walking up an incline will be more painful than on a level.

There's a quick overview on this link: http://en.wikipedia.org/wiki/Intermittent_claudication