Patients with intermittent claudication (In the Netherlands popularly called ‘shop window legs’) have pain when walking due to arterial calcification in the legs. It is a common condition. An estimated three percent of people aged 55 or older suffer from it. As the age increases, this number increases to 1 in 7 patients aged 70 or older. After walking a certain distance, ‘claudicants’ must stop walking, because they get pain in the legs due to lack of oxygen in the muscles. By waiting for some time (minutes) the pain gets less and the patient can continue walking, after which complaints start to occur again. Because it is said that people hide the complaints by pretending to be looking at shop windows, intermittent claudication is popularly called ‘shop window legs’ or ‘the shop window disease’.
‘Shop window legs’ are caused by artery calcification or atherosclerosis. This occurs in all people as they start ageing. A number of factors accelerate this process. Smoking and an unhealthy lifestyle are the biggest culprits. Addressing factors causing it lies primarily with the patient, although various caregivers can help with this. The first-line treatment by the general practitioner and possibly the practice assistant (POH) consists initially of treating the risk factors present. This is aimed at preventing the increase in arterial calcification and complications such as a heart attack or stroke. The most important risk factor is smoking. But apart from stopping smoking, all patients with ‘shop window legs’ also need a regular small dose of aspirin (‘a child’s aspirin’), medicine to control lipid profile, the latter independent of the measured cholesterol values. The GP (and POH) also pays attention to blood pressure and the possible presence of diabetes. The symptomatic treatment (that is, to reduce the symptoms) consists of walking therapy.
Walking therapy has been underrated for a long time. Patients came to the GP or vascular surgeon with pain when walking and were sent home with the advice to walk more. This went (and goes) against the logic of most patients, so that patient compliance to this was low. Too often, angioplasty or a bypass operation was then carried out. Treatments such as this can be associated with complications, death and, in any case, considerable costs. A cheaper and safer alternative is walking therapy under the supervision of a certified physiotherapist or supervised walking therapy. Research has shown that supervised walking therapy is a good and effective treatment for ‘shop window’ legs.
You can read what you can do yourself in the 5-Step plan.