Intermittent claudication: why your legs hurt when you walk

Intermittent claudication is the crampy, aching pain in your calf, thigh, or butt when you walk that goes away after a short rest. Most often it happens because arteries in the legs are narrowed by atherosclerosis (peripheral artery disease, or PAD). You’re not alone—this is common in people who smoke, have diabetes, high blood pressure, high cholesterol, or are older.

If you're noticing predictable leg pain with walking, pay attention. Not every leg ache is claudication. Claudication has a clear pattern: it starts while walking, grows worse with continued walking, and eases with rest. Symptoms often limit how far you can go without stopping.

How doctors check it

Diagnosis starts with a simple physical exam and a test called the ankle-brachial index (ABI). ABI compares blood pressure in your ankle and arm—low numbers point to PAD. Your provider may also order duplex Doppler ultrasound, CT angiography, or MR angiography if they need more detail. These tests show where blood flow is reduced and help plan treatment.

Practical treatments that work

Treatments aim to reduce symptoms and prevent heart attack or stroke. Here are clear steps you can take now.

1) Start a walking program. A structured walking routine is one of the best ways to improve distance. Try walking until you feel moderate pain, rest until it eases, then walk again. Aim for about 30–60 minutes total, three times a week. Supervised exercise programs run for 12 weeks and often give faster, bigger gains, so ask your clinic whether one is available.

2) Manage risk factors. Quit smoking (ask for a program or meds to help), control blood sugar if you have diabetes, treat high blood pressure, and get your cholesterol down—statins are commonly used. These steps slow artery damage and lower your risk of heart problems.

3) Medicines your doctor may prescribe. Antiplatelet drugs like aspirin or clopidogrel reduce the risk of heart attack and stroke. Cilostazol is a medication that can improve walking distance for many people—tell your provider about any heart failure before taking it. Always review side effects and drug interactions with your clinician.

4) Procedures for severe cases. If lifestyle changes and medicines aren’t enough, procedures can restore blood flow. Options include angioplasty with stenting or bypass surgery. These are usually reserved for people with lifestyle-limiting claudication or critical limb ischemia (rest pain, non-healing wounds).

5) Foot care and everyday tips. Check your feet daily for sores, wear comfortable shoes, and avoid walking barefoot. Keep a simple walking log—seeing progress motivates most people.

See a doctor promptly if pain occurs at rest, you develop ulcers, or your foot becomes cold, pale, or blue. Those are signs of severe blood flow problems. With the right mix of exercise, risk control, meds, and sometimes procedures, many people regain walking ability and lower their overall health risk.