He demonstrates elevation pallor and dependent rubor. He denies any pain presently. Claudication is a specific complaint that is most frequently described as a pain, cramping or tiredness of muscle groups, most commonly the calf or thigh. It is caused by a relative ischemia of these muscles. At rest, the blood flow is sufficient to meet the metabolic demands of the muscles, but as the demand increases with exercise, the proximal arterial obstructive disease does not allow enough flow to meet the increased demands.
Claudication typically occurs one segment below the level of the arterial obstruction.
For example, arterial obstruction in the thigh is associated with symptoms in the calf, while arterial obstruction more proximally in the aortoiliac segments may manifest as cramping in the thigh and calf. Symptoms of claudication occur after a certain distance of walking, which is frequently quantitated as the number of city blocks that one can walk before the symptoms occur. This pain usually causes the patient to stop walking and rest until the pain subsides. Rest Pain is a grave symptom that indicates far advanced arterial insufficiency. It is not pain in a muscle group but rather a severe burning pain usually confined to the foot distal to the metatarsals.