EDP column by Professor Ketan Dhatariya
“I get cramp in my calves when I walk up the stairs or walk a short way. It goes away quickly if I stop. Why is this?”
It sounds as though you may have a condition called ‘intermittent claudication’. This is where the blood doesn’t supply enough oxygen to the muscles when they are active.
Do you remember when you were a child running around in the playground? Every now and again you might get cramp in your calves. You may remember being told that cramp occurs in those situations because the muscles are working so hard, they are using up all the oxygen in the blood. As a result, the muscles change the way they use the glucose in the cells and they start to work ‘anaerobically» – that is, without oxygen. This change in the metabolism of glucose leads to a build up of lactic acid. Too much lactic acid in the muscles causes cramp.
As people get older – and especially if they are smokers, have poorly controlled diabetes or high levels of cholesterol, they may get something called atherosclerosis. This can be translated into ‘hardening of the arteries’. This means the blood vessels carrying the oxygen to the muscles have a layer of fatty material coating them. This results in the blood vessels not being able to get bigger and increase the blood flow when the muscles start to work. The muscles then run out of oxygen quickly and the same process which happened as a child running in the playground, now happens as one gets older.
The pain goes away again when you stop walking because the muscles are not working as hard and need less oxygen. Don’t forget this ‘hardening of the arteries’ doesn’t just happen in the legs, but in other blood vessels as well such as the heart and brain.
The best treatment for this condition is to stop smoking. Other factors can help, such as good diabetes control and a good blood pressure. Simply walking through the pain for a few more minutes to help build up the blood supply will help your symptoms. Your GP may prescribe medication to help prevent your symptoms getting worse. However, if you get pain in your feet and legs even when you are at rest, you should see your doctor who may refer you to a specialist.
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