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Question:

I’ve been told based on an angiogram that I have pseudoclaudication. It has worsened to the point where I cannot walk more than one block without severe lower leg pain. Can you provide information on causes, treatment and prognosis?

Answer:

The term claudication (claw-dih-KAY-shun) refers to a group of symptoms that include pain in an affected limb (usually the leg) that occurs during walking and is relieved with rest. It occurs in people with obstruction of arterial blood supply to the muscles. Pseudoclaudication (false claudication) leads to similar symptoms in the absence of circulatory problems. It is commonly due to the compression of nerves that radiate out from the lower part of the spinal cord and is caused by spinal stenosis.

Spinal stenosis is a narrowing of the lower part of the canal in the spine, through which nerves run that transmit sensations, including pain. Compression of these nerves leads to discomfort in the buttocks, thighs or calves. The discomfort increases when you stand or walk and is relieved if you sit or bend forward at the waist. In some cases, bladder and bowel control may be impaired as well. The most common cause of spinal stenosis is osteoarthritis of the spine, which causes bony outgrowths called spurs to project into the spinal canal. The diagnosis of pseudoclaudication is based on evidence from a scan or myelogram of a narrowing of the spinal canal, and exclusion of other possible causes, including:

Decreased circulation

A protruded disc

A tumor in the spine

Treatment is determined by the severity of the symptoms. It may include:

Analgesics

Anti-inflammatory drugs (NSAIDs)

Physical therapy

A back support

Surgery

Surgical treatment may involve removal of bones and soft tissues that protrude into the spinal canal (laminectomy) and possibly a spinal fusion.