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Leg Cramps Are Not Just Something To Walk Off

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b2ap3_thumbnail_leg-cramp.jpgMost people experience leg muscle cramps one time or another in their lifetime. Frequently cited causes of leg cramps include muscle fatigue caused by overuse, dehydration or potassium deficiency. While leg cramps are usually not very serious, sometimes they are an indication of a more serious health threat, such as like poor circulation.


The cramping of muscles caused by poor circulation to the legs is called claudication. In the majority of claudication sufferers, these cramps usually occur intermittently while walking or other physical activity, and stop during periods of rest. Patients with severe claudication can also experience cramps during periods of rest, as well.


Patients with claudication have low blood flow to the lower extremities, often as a side effect of peripheral artery disease, or PAD. Peripheral artery disease is a vascular condition affecting 12 to 20 percent of Americans, according to Harvard Health. The condition is caused by atherosclerosis, or the hardening of the arteries due to a build of up of cholesterol plaque inside the blood vessel. Plaque buildup in PAD patients is often significant, and reduces blood flow to the legs and feet. 

"When blood flow, which carries oxygen vital for survival, doesn’t reach tissues that need blood to survive, tissues begin to die," said Dr. Michael Budler, M.D., a Grand Island, Nebraska interventional radiologist who sees patients with peripheral artery disease. "Claudication happens when patients are walking or moving because walking or moving requires oxygen, and their oxygenated blood flow is restricted."

As a result of restricted blood flow, muscles contract causing feeling of pain, burning, tiredness or aching. Usually, claudication cramps occur in the lower leg, around the calf area. The reason for this is that arterial plaque buildup begins in the arteries that are the furthest away from the heart. 

"Patients who experience pain in other parts of their leg likely have a blockage or severe build up localized to that area," Budler said. 

Some PAD patients experience pain in the groin or buttocks, too.

Budler test patients for peripheral artery disease and arterial plaque build up through a test known as the ankle-brachial screening. This noninvasive test checks the blood pressure of the patient's legs against the blood pressure of the patient’s arms. 

"When a patient has a reduction in blood flow in the legs, they typically have peripheral artery disease," Budler said.

Once diagnosed with PAD, patients will likely be placed on medications to thin the blood and reduce cholesterol production. Many patients also will have to switch to a healthy, low-cholesterol diet and should begin an exercise regimen under the advisement of their physicians. PAD patients should quit smoking and using nicotine products, which are known to constrict the blood vessels.

If arterial plaque buildup is serious, it will warrant a more serious intervention such as balloon angioplasty or vascular stenting. Budler performs both of these procedures at his clinic, Advanced Radiology.

During balloon angioplasty, a small, thin catheter tube is inserted into the affected artery. Once in the proper position, a small balloon is inflated inside the vessel. This balloon pushes the arterial plaque back against the walls of the artery, allowing blood flow to increase.

During the vascular stenting procedure, a wire mesh tube is inserted into the artery via catheter to push arterial plaque buildup back against the wall and hold it there while simultaneously holding the blood vessel open. This also allows the flow of blood to increase, giving the patient improved circulation.

Other signs of peripheral artery disease include numbness or tingling in the lower legs and feet, slow healing wounds or ulcers, the loss of hair or toenails and a shiny appearance to the skin. If a patient has these symptoms, along with leg cramping, they should consult their physician immediately, advises Budler.

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