Differential diagnosis

This includes:

• spinal claudication:
  • typically the pain is relieved by standing with the spine flexed
  • often, a history of low back pain
  • legs may be weak
  • diagnosis can be confirmed by myelogram
    
    
• venous claudication:
  • calf pain relieved by elevating the legs to assist venous drainage
  • signs of chronic venous insufficiency e.g. swelling, lipodermatosclerosis, ulceration
  • diagnosis confirmed by venogram
    
    
• rheological claudication:
  • due to gross hyperviscosity of blood
  • pain usually affects the whole leg, and is relieved by standing still
    
    
• sciatica:
  • pain is usually accentuated by bending or twisting
  • ankle arterial pressures are unchanged or increased after exercise

Reference:

1. Lower limb peripheral arterial disease. NICE Clinical Guideline (August 2012, updated December 2020)