SYMPTOMS

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Peripheral arterial disease and and claudication

Treatment of underlying causes of PAD

Although your physician will treat your claudication, he or she will also treat the underlying causes of your PAD, such as high cholesterol or high blood pressure. Treatment for these conditions includes lifestyle changes, such as smoking cessation, exercise and weight loss, medication, and, if necessary, endovascular intervention or surgery.

Exercise therapy

Exercise therapy is the initial treatment for claudication. Your physician will develop an exercise plan specifically for you. The plan may include what type of exercise to do, how hard you should exercise, how long, and how many times per week you should exercise. Therapeutic exercise recommendations for claudication generally consist of walking for periods of 1 hour or more, 3 or more times per week, for at least 3 to 6 months, ideally under medical supervision. The aim is to increase the amount of time that you can walk without reproducing severe pain in your legs. You will gradually accomplish this by walking for longer and longer periods.

At first, you should walk until you experience claudication pain, usually between 3 and 5 minutes after you begin walking. You should then continue walking until the pain becomes moderate (on a scale of 1 to 5, the pain is 3), which is usually at around 8 to 10 minutes of walking. Then you should stop walking and rest until the pain goes away, at which point you should begin walking again. Repeat this cycle of exercise and rest for approximately 35 minutes at the beginning and gradually increase the time until you can walk up to a total of 50 minutes. A sign that you are making progress in your walking program is that you will be able to walk for longer periods without pain.

Medications

Your physician may also prescribe medications, such as cilostazol (Pletal), which sometimes can help improve the distance you are able to walk without discomfort or pain. This medication may not be helpful, however, if you have certain heart conditions. Your physician will help you decide what is best for your particular situation.

If appropriate, your physician may suggest medications, such as statins, to help control your blood lipid (fat) levels, medication to control high blood pressure, and/or medication for diabetes.

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