Intermittent claudication

You have been diagnosed with a condition called intermittent claudication. Your physiotherapist has given you this leaflet to help you manage your symptoms. This leaflet explains the following:

• What the condition is.

• What you can do to help yourself. Including advice on stopping smoking and exercise programmes.

• What the different treatment options are.

• What alternative treatments there are.

There are other leaflets that explain the procedures and operations listed in this leaflet. Please ask your vascular nurse or consultant for more information.

We hope this leaflet will help to answer some of the questions you may have. If you have any further questions or concerns, please speak to your physiotherapist.

What is intermittent claudication?

Intermittent claudication is a cramp-like pain in the foot, calf, thigh, buttock, or hip. The pain can range from slightly uncomfortable to severe. It is brought on by exercise, and occurs after walking a certain distance.

What causes intermittent claudication?

Intermittent claudication is usually caused by ‘hardening of the arteries’, a narrowing or blockage to the main arteries in your legs. This is due to the gradual build-up of fatty deposits or plaque in the lining of the artery walls (called atherosclerosis). As a result, the blood supply to your leg muscles becomes reduced.

The circulation is sufficient when resting. However, when exercising, the leg muscles cannot get enough blood supply and pain occurs. The pain comes on more rapidly with more vigorous exercise, such as walking quickly or going up hill.

The blockage will never clear itself. However, the symptoms can improve as smaller branches open up to carry blood around the blockage. This is called collateral circulation.

You are more likely to develop intermittent claudication if you:

• smoke

• are diabetic

• have high blood pressure; or

• have high cholesterol levels.

Making changes to your lifestyle will often prevent your symptoms from getting worse.

What can I do to help myself?

In most cases, you will start with a conservative treatment plan. Conservative treatments include lifestyle changes, medications, and exercise. You may have been prescribed a low dose (75mg) of aspirin and a statin, which reduces the chances of developing more issues with your circulation.

1. Smoking

   If you are a smoker, you must stop smoking. Tobacco speeds-up the blockage of your arteries. It also affects the development of collateral circulation, which is trying to increase the blood circulation to your legs. Continuing to smoke also makes other treatments less successful, and makes amputation more likely.

   If you need support to stop smoking, please contact One You Kent on 0300 123 1220, or email.

2. Improve your diet

   Eating well is great for your overall health and can help improve your circulation.

   • Aim to eat 5 portions of fruit and vegetables every day.

   • Base your meals on wholegrain foods, such as brown bread or pasta, and choose leaner protein like fish or chicken.

   • Cut down on foods high in fat, sugar, or salt, such as biscuits, cakes, red meat, and crisps. Eating less fatty food helps keep your cholesterol healthy.

   • Try grilling, baking, or steaming your food instead of frying.

   More information is available on the NHS 5 A Day: what counts? web site.

3. Manage your weight

   Carrying extra weight makes your legs work harder when you move. This can make the claudication pain feel worse, as your muscles need more blood when they work harder. Getting to a healthy weight will help your legs and overall health. Small changes, made slowly and steadily, often work best. Try to make healthy food choices and be a bit more active each day. Remember, losing even a small amount of weight can often help you feel much better.

4. Regular exercise
   Evidence shows that people develop better collateral circulation by exercising regularly. Collateral circulation is the body’s process of building small new blood vessels for your blood. Exercise acts as the signal to tell your body to start this building process. However, it is important to know how you should be exercising, because this will make a difference.

How should I be exercising?

When walking and doing your exercises, work hard enough to bring on your pain symptoms. If you do not push yourself to this point, the exercise will not be effective enough to help your body get better at handling the pain. It is also important to know that working through this pain will not cause any damage. It might be uncomfortable, but the discomfort means you are doing it right.

If you are unsure of how to tell when you have reached this point, follow this advice. On the claudication pain scale below, you should be working at an intensity of 3 out of 4.

Claudication pain scale

It takes a while for your body to adapt to the changes you are making. If you want to see improvements, it is important that you stay consistent with your exercise.

• Start by walking daily into pain. Use the pain scale above to help you.

• Exercise little and often. Try to build-up to 3 times per week for 45 to 60 minutes each session. Continue this for at least 12 weeks. Research suggests that this is the amount of time it takes to see changes.

Staying safe while you exercise

• Take a rest day from exercise if you feel unwell. This includes having a bad cold or flu, a high temperature, or feeling very tired.

• Rest if you have hurt a muscle or joint, or if you have bad pain from arthritis. Only start exercising again when you feel better.

• If you have any existing medical conditions, please tell your physiotherapist before exercising.

• Stop exercising straight away if you feel pain in your chest, get dizzy, or become very short of breath. If you stop for any of these reasons, please tell your GP or nurse before you exercise again. They will tell you if or when you can exercise again.

  Important: Call 999 for an ambulance right away, if the chest pain or being very short of breath does not stop when you rest.

What options are available for me to exercise?

Following an assessment by your physiotherapist, they will offer you the following options.

• Attending a supervised intermittent claudication exercise class. Supervised exercise classes produce the greatest benefits. Please ask your physiotherapist for more information.

• Completing a home exercise programme. Complete this program 3 times per week, and go for a walk every day. See below for information on how you can structure your program.

Warm-up exercises

The warm-up part of your exercise program should last for about 10 minutes. Gently walk outside or in your home along a corridor.

Exercises

This part of the exercise program should take up most of your time. Aim for a total time of 30 minutes each day.

• Select 5 to 6 exercises from the examples below.

• Do each exercise for 2 minutes, or until you reach 3 on the claudication pain scale.

• Rest for about 1 minute between each exercise. It is okay to take more time if you need to.

• Try to repeat your chosen 5 to 6 exercises twice, like a circuit. This will help you reach the recommended exercise time.

Walking

Just like your warm-up, you can walk outside or along a corridor.

Cool down exercises

Now you need to help your body relax and recover. This part is important and should last about 10 minutes.

Gentle walk

Begin the cooldown by walking slowly for a few minutes. No need to rush.

Stretching

Finish the cool down with some stretches. This will help your muscles feel better later. Remember to listen to your body, stretching should feel like a gentle pull, not pain.

What happens if I don't make any changes to my lifestyle?

If you choose not to make changes to your lifestyle, your symptoms may not improve or they could get worse. If this happens, your vascular doctor will review and discuss possible treatment options with you.

How successful are lifestyle changes as a treatment option?

Lifestyle changes provide a long-term solution for most people, and it is a safe option. Exercise helps to:

• reduce pain

• reduce the need for vascular procedures

• improves heart and vascular health; and

• improves overall health and well-being

The following are quotes from patients who have used exercise as a treatment option for intermittent claudication.

• "Being booked into a class helps you commit to actually doing the exercise."

• "Can now walk more than 50 yards without stopping, and feel better in myself."

• "Both intermittent claudication symptoms and overall health and wellbeing have improved, although I still experience claudication pain - but not so quickly after starting to walk."

• "It helped me."

Where can I get more information?

If you have any questions or concerns, please contact one of the following.

• Physiotherapy Department
  Telephone: 01227 783065

• Vascular Nurse Practitioners
  Telephone: 01227 864137
  Email

• Vascular Secretaries general line                                           
  Telephone: 01227 868602

References

• Ross, M. (2022). Exercise Intervention for the Treatment of Patients with Intermittent Claudication (Update of SPARG review guideline published in 2012). Scottish Physiotherapy Amputee Research Group (SPARG).

• Tew, G., Harwood, A., Ingle, L., Chetter, I., & Doherty, P. (2018). The BASES Expert Statement on Exercise Training for People with Intermittent Claudication due to Peripheral Arterial Disease.  

• NICE (National Institute for Health and Care Excellence) (2020). Peripheral arterial disease: diagnosis and management.

• NICE. Scenario: intermittent claudication (2025).

• NHS. Eating a balanced diet.

• NHS. Tips to help you lose weight.

• East Kent Hospitals University NHS Foundation Trust. Intermittent claudication patient leaflet, September 2016.

• Intermittent claudication rehabilitation program, Home exercise program, 2008

• Harwood AE, Pymer S, Ingle L, et al. Exercise training for intermittent claudication: a narrative review and summary of guidelines for practitioners. BMJ Open Sport Exerc Med. 2020;6(1):e000897.

• Royal Free London NHS Foundation Trust. Exercises to perform at home for those with intermittent claudication.

• Patient testimonials collected via short survey of patients who attended the intermittent claudication group exercise class at KCH between 28/4/25 - 9/5/25.

• Office for Health Improvements and Disparities. The Eatwell Guide, 2024. 

• Kent County Council. Quit smoking.

[Web sites last accessed 10th October 2025]

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