Do you know what causes intermittent claudication?

What is intermittent claudication?

When walking, the patients report symptoms of numbness or pain progressively spreading to their legs, preventing them from walking more than a certain distance, but after some rest, they can usually resume walking. This often appears as typical symptoms of spinal stenosis, the walking distance becoming shorter and shorter with time, and in some instances, walking becoming impossible altogether. Another characteristic of this condition is that walking is often made easier if the body can rest on a prop, such as a supermarket cart or a cane.

What are the causes of intermittent claudication?

Obstructive arteriosclerosis, which is caused by the inability of the body to send sufficient blood through the blood vessels due to arteriosclerosis, and lumbar spinal stenosis, which is caused by nerve compression in the spinal canal, are the two main causes for this condition.
In Obstructive arteriosclerosis, blood and oxygen are not sufficiently distributed to the muscles of the legs due to poor blood flow, and one of the characteristics of the disease is the appearance of pain in the legs.
In the case of lumbar spinal stenosis, the symptoms are caused by compression of the nerves in the spine.
The main causes of this condition are the effects of aging, the work environment, and diseases of the spine.

How to treat intermittent claudication?

conservative treatment

Rehabilitation, corsets, nerve block injections, and medications to improve blood flow are some of the options available. Indeed, improving blood flow and reducing pressure on the nerves may relieve the pain. Strengthening the muscles, ligaments, and joints through rehabilitation can also increase the walking distance or prevent the condition from getting worse.
In cases where the gait disorder does not improve with conservative treatment and interferes with daily life, surgery is then considered.

Surgical procedure

When spinal canal stenosis is the cause, spinal fusion is the main surgical procedure to be used. The spine is held in place with a device to prevent it from moving and secured with bolts. Lumbar posterior decompression, in which some of the bone around the nerve is shaved off to remove pressure is also an option, as this can help improve the symptoms.

  • Spinal fusion

  • Posterior lumbar decompression surgery

Risks associated with intermittent claudication surgery

There is some risk that lumbar fusion and posterior lumbar decompression damage nerves and blood vessels.
There is also the risk of infection and suppuration due to bacterial infection that can be contracted through incision. With spinal fusion, a shift in the lumbar vertebra may occur due to a damaged fixation device or loosened screws. Alternatively, there is a risk that the patient's allergic predisposition may be overlooked due to lack of prior communication with the doctor, and an allergic reaction due to metal or artificial materials may occur after surgery.
In addition, attaching a fixation device may induce symptoms such as an odd feeling, a sense of weariness, and pain in the lower back that can last for as long as a year for some people.
Since bending and twisting the back may be difficult after fusing the spine, some movements of daily life may become limited in scope.

How is our clinic’s treatment effective for intermittent claudication?

Lumbar fusion and posterior lumbar decompression may not be an option if surgery poses a high risk to the patient, or for those who already had surgery once but need to be treated again.
At our clinic, we offer DST as a treatment for intermittent claudication. Elder patients who are at high risk during surgery or those who wish to undergo a second surgery may also benefit from the DST procedure. By repairing and regenerating the degenerated intervertebral disc, we can relieve pressure on the nerve and suppress the inflammation, which is the cause of pain. As the nerve is decompressed and pain subsides gradually, the walking function is restored.

  • A cracked intervertebral disc.

  • The needle is inserted into the cracked disc and the drug is injected.
    *There are very few allergic reactions and side effects caused by the drug.

  • Repair and regenerate the intervertebral disc.

  • Contrast radiography makes evident the presence or absence of intervertebral disc damage..

  • The agent is administered to the damaged part of the intervertebral disc.

  • Allergies and side effects caused by the agent are extremely rare.

Treatment flow

  • 01 Consultation with one of our doctors

    An MRI and x-ray will be taken, and the doctor will then make a diagnosis.
    If the diagnosis indicates that DST is suitable, you can start the procedure on the afternoon of the same day.

  • 02 Before the procedur

    A local anesthetic is administered to the lower back in the operating room and a needle is inserted into the lumbar disc(s) identified during the examination.
    An examination using a contrast agent is performed to pinpoint the location of the damaged disc.

  • 03 The procedure

    Fluoroscope guidance is then used to locate the disc and administer the drug to the damaged area. Once the drug has penetrated the zone, the needle is removed, and the bleeding is controlled.

  • 04 Going home

    The patient can go home upon completion of the treatment, after resting in a private room for about an hour and a final routine examination by the doctor.
    *The time of release depends on the patient's symptoms and condition.

Treatment cost of the DST procedure

Locations Treated 1 disc 2 discs 3 discs 4 discs 5 discs
Cost of Treatment 1,320,000 Japanese Yen (JPY) 1,430,000 Japanese Yen (JPY) 1,540,000 Japanese Yen (JPY) 1,650,000 Japanese Yen (JPY) 1,760,000 Japanese Yen (JPY)
*If the procedure is performed in our hospital, all the costs of consultation, diagnosis, MRI and other tests will be included in the costs listed above.
*If the same treatment is performed again within 3 years of the first treatment, the treatment fees will be reduced by half.
*All taxes included.
*Since this method of treatment is not covered by health insurance, the patient must bear the entire cost of the treatment.
*In case of treatment only (one day treatment), We accept payment by credit card (VISA, MasterCard, China UnionPay).
*If you wish to request rehabilitation (specialized for back pain), bank transfer by credit card is also accepted.
*You can receive a tax refund at the time of filing your tax return for medical expenses.

Questions and answers about intermittent claudication

  • question

    How do you decide when the timing is right to operate?


    Surgery will be considered if the patient cannot walk or is in severe pain.

  • question

    Is there any way to prevent intermittent claudication?


    We recommend stretching and back pain training to make your body less prone to back pain.
    Once intermittent claudication has set in, if the patient is able to walk, it is advised to perform some stretching and walking exercises.

  • question

    Can surgery on spinal stenosis cure intermittent claudication?


    In some cases, the symptoms may be alleviated or completely cured, depending on the person.
    It is also important to put efforts in exercising your muscles and joints on a daily basis.

  • question

    Are there instances when intermittent claudication can heal spontaneously?


    This condition will not heal spontaneously. Treatment methods include conservative treatment and surgery, but there is always a risk of recurrence because spinal canal stenosis can never be completely cured this way. On the other hand, the DST procedure performed at our clinic can thoroughly repair the intervertebral discs.

  • question

    Should I take a rest when I feel pain?


    If the pain is not so severe, we recommend stretching as much as possible.
    If the pain is more severe, we advise you to visit the nearest hospital or clinic for diagnosis.

5 Types of Outpatient Treatment for Low Back Pain

  • The DST Method (Discseel™)

    An intervertebral disc treatment that began in the United States in the 2010s. Can be suitable for a wide range of conditions, including problems in patients after surgery. It is the only (※2)treatment that can repair and regenerate intervertebral discs.
    ※2 According to research by Operation Japan (Ltd.)

    Click here for details.
  • The PIDD Method (Implant)

    An implant intervertebral disc treatment that has been conducted since the 2000s. As with PLDD, results without injury to intervertebral discs can be anticipated. This treatment is suitable for herniated discs only.

    Click here for details.
  • Hybrid Laser Treatment

    A treatment that combines the benefits of PLDD and PODD. This treatment is suitable for herniated discs only.

    Click here for details.
  • The PODD Method (Ozone)

    An ozone intervertebral disc treatment that has been conducted mainly in Europe since the 1990s. It can be suitable for a wide range of conditions.

    Click here for details.
  • The PLDD Method (Laser)

    An outpatient, laser intervertebral disc treatment that has been well known worldwide since the 1980s. This treatment is suitable for herniated discs only.

    Click here for details.