Leg Pain When Walking: Is it Neurogenic or Vascular Claudication? скачать в хорошем качестве

Leg Pain When Walking: Is it Neurogenic or Vascular Claudication?

1. VASCULAR VS NEUROGENIC CLAUDICATION PAIN WHEN WALKING? In this video, I go over the differences between two primary causes to explain pain in both legs when walking. 1. Vascular Claudication Also known as peripheral arterial disease (PAD), occurs when there is reduced blood flow to the legs due to atherosclerosis or other forms of arterial narrowing. The lack of oxygenated blood results in ischemia, which manifests as muscle pain or cramping during physical activity. Symptoms: Pain Location: Typically in the calf muscles but can affect other areas like the thighs or buttocks. Pain Onset: Pain develops during walking or other activities that require exertion. The pain typically occurs after a predictable distance or time of walking (e.g., after 100-200 meters). Relief: The pain subsides with rest and with STANDING, as the muscles receive more blood flow and oxygen. Associated Features: Weak or absent pulses in the affected limbs, cool skin, hair loss, and in severe cases, skin ulcers or gangrene. Mechanism: During physical activity, the muscles demand more oxygen, but the narrowed arteries cannot supply it adequately, leading to ischemic pain. Rest allows for the return of blood flow to the muscles, relieving the pain. 2. Neurogenic Claudication Caused by compression or narrowing of the spinal canal, often due to conditions like severe spinal stenosis. The compression affects the spinal nerves that innervate the legs, leading to pain, numbness, or weakness during movement. Symptoms: Pain Location: Often felt in the lower back, buttocks, and legs, typically in the thighs, calves, or feet. Pain Onset: The pain is induced by prolonged walking, standing, or other activities that require extension of the spine. It typically occurs after a variable distance or time but may be more unpredictable than vascular claudication. Relief: The pain is relieved by bending forward, sitting, or squatting. This position opens the spinal canal and reduces nerve compression. Associated Features: May include tingling, numbness, and weakness in the legs, especially with standing or walking for long periods. The pain is usually bilateral (affecting both legs). Mechanism: The pain arises because the narrowing of the spinal canal compresses the nerve roots, especially when the spine is extended. Flexing the spine (bending forward) opens up the canal and reduces pressure on the nerves, offering pain relief. Key Differences: Diagnostic Approach: Vascular Claudication: Diagnosed through physical examination (e.g., palpating pulses), ankle-brachial index (ABI), and imaging (e.g., Doppler ultrasound, angiography). Neurogenic Claudication: Diagnosed through clinical history and physical exam (e.g., Shopping cart sign), along with imaging studies such as MRI or CT scans to visualize spinal stenosis. Treatment: Vascular Claudication: Management involves lifestyle changes (smoking cessation, exercise), medications (antiplatelets, statins), and surgical options (angioplasty, bypass surgery) to restore blood flow. Neurogenic Claudication: Treatment includes physical therapy, medications (NSAIDs, gabapentin for nerve pain), epidural steroid injections, and surgery (e.g., laminectomy) for decompression of the spinal nerves. This is not medical advice. Please seek the advice of your family health provider if you are having pain in your legs when walking. I do not own the rights to these photos. All rights belong to their respective owners. Educate. Empower. Exercise. Aleks Physio - - - - #legpain #walking #claudication #neurogenicclaudication #vascularclaudication #spinalstenosis