Claudication is a term used by medical fraternity for pain in the thigh, buttocks, calf which occurs when a person walks and is relieved by rest. The pain can be mild, moderate or extremely severe. Claudication can be a symptom of peripheral artery disease (PAD) in which the blood flow is reduced as a result of narrowing or blockage of the artery supplying blood to buttocks and leg. In the beginning stage, pain in buttocks can develop after walking for a distance. Pain calms down once the patient rests. However, over a period of time, the pain may become severe and patient may not able to walk even for a short distance.Buttock claudication or for that matter claudication in any part such as calf, thigh, arm can indicate an increased risk for heart attack or stroke. Hence, person must consult his doctor as soon as possible when he has this condition.
What is the cause for buttock claudication:
When the pain is in buttock or thigh region, the possibility of claudication is often overlooked and is linked to other conditions. However, buttock claudication is more common than it is realized. One of the major cause of claudication is peripheral artery disease (PAD). It is usually common in people over the age of 50.PAD occurs when the artery or the aorta is narrowed or blocked. This reduces blood flow to the muscles of lower leg that includes calf, thigh and buttock region. This slowdown of blood flow to buttocks or thigh can lead to claudication. PAD normally develops due to atherosclerosis of the artery. It is a type of build of plaque (made up of fat, cholesterol, calcium, and blood substances). This plaque attaches in the interior wall of the artery and narrows the passage of blood. In case of buttock claudication, mostly the internal iliac artery and distal part of aorta becomes narrow or blocked as a result of atherosclerosis.
Aside from vascular claudication, spinal or neurogenic problems can also cause buttock claudication. It is caused due to nerve root compression in the spinal canal. Mainly degenerative disease of spine is the cause. Compression can be due to herniated disk of the spine. Usually in case of neurogenic claudication, the symptoms occur on both sides of buttocks.
Risk factors for buttock claudication are:
- Age over 50
- High cholesterol
- History of claudication in family members
Symptoms of buttock claudication:
Buttock claudication results from narrowing of the artery that supplies blood to the buttock area. It can also develop due to damage to the nerve root that innervates the buttocks. In any case the symptoms are those typically related with claudication.
- Pain, discomfort, numbness and feeling of tiredness in gluteal region and legs while walking for a short distance. Pain is relieved in few minutes by taking rest.
- Coldness in the buttock area due to reduced blood supply. The feet area may also feel cold.
- Pulse in lower limb of the affected side of buttock is diminished or absent.
- Impotence in men
- After certain period of time, pain may occur even during rest in the bed at night.
Often buttock claudication can go undiagnosed, as many people do not take this pain seriously in its beginning stage. They usually consider as consequence of aging. Some people just reduce their level of activity. Most of the test that your doctor use are non invasive and precise. The doctor may check for:
- Pulse of your leg and palm.
- Exercise test: Patient is told to walk at a maximum distance without suffering from pain.
- Blood pressure measurement.
- Doppler study of arteries of abdomen, pelvis and leg.
- MRI study for confirming narrowing of arteries with plaque.
- MRI of spine
Treatment of buttock claudication depends on its severity. However, in any case medications as well as lifestyle changes are two most important treatment measures patient has to follow.
- Stop smoking and drinking alcohol. Both these factors increase the risk of peripheral artery disease.
- Regular exercise.
- Eat foods that are low in fat
- Take medications for accompanying health issues such as hypertension, diabetes, high cholesterol etc. Control of blood sugar in diabetics is very important.
- Take medications as prescribed by the doctor. Certain medicines are prescribed by the doctor to keep the blood thin.
In case if the artery supplying blood to gluteal region is completely blocked procedures such as angioplasty or surgery may be necessary to reinstate the blood flow.
Home remedies such as garlic, fish oil, hawthorn, L-carnitine and ginkgo biloba are useful. Garlic helps to keep the blood thin.