|Condition||Location of pain or discomfort||Character of discomfort||Onset relative to exercise||Effect of rest||Effect of body position||Other features|
|Intermittent claudication||Buttock, thigh, or calf muscles and rarely the foot||Cramping, aching, fatigue, weakness, or pain||After some degree of exercise||Quickly relieved||None||Reproducible|
|Nerve root compression (eg, herniated disc)||Radiates down leg, usually posteriorly||Sharp lancinating pain||Soon after, if not immediately after onset||Not quickly relieved. (Also, often present at rest)||Adjusting back position may relieve pain||History of back problems|
|Spinal stenosis||Hip, thigh, or buttock (within affected dermatome)||Motor weakness more prominent than pain||After walking or standing for some length of time||Relieved by resting only if position changed||Relieved by lumbar spine flexion (sitting or stooping forward)||Frequent history of back problems, provoked by intraabdominal pressure|
|Hip arthritis||Hip, thigh, buttocks||Aching discomfort, usually localized to hip and gluteal region||After variable degree of exercise||Not quickly relieved (and may be present at rest)||More comfortable sitting (ie, weight taken off legs)||Variable, may relate to activity level, weather changes|
|Arthritic, inflammatory processes||Foot, arch||Aching pain||After variable degree of exercise||Not quickly relieved (and may be present at rest)||May be relieved by not bearing weight||Variable, may relate to activity level|
|Venous claudication||Entire leg, but usually worse in thigh and groin||Tight, bursting pain||After walking||Subsides slowly||Relief speeded by elevation of the extremity||History of iliofemoral deep vein thrombosis, signs of venous congestion, edema|
|1. SUPERVISED EXERCISE THERAPY|
A supervised exercise program is recommended as part of the initial treatment
- It should be performed for a minimum of 30 to 45 minutes at least three times per week for a minimum of 12 weeks.
- During each session, an exercise level that is of sufficient intensity to elicit claudication should be achieved.
- The value of an unsupervised exercise program is less well studied, but is generally recommended for patients who cannot participate in supervised exercise programs.
|2. PHARMACOLOGIC THERAPY|