As we get older, leg pain with walking becomes all too common.  The medical term is claudication.  The knee jerk (so to speak) reaction in medicine is to evaluate the vascular system and to see if blocked arteries are causing the problem.  However, there are two main causes of claudication.

The first is the one we have already mentioned.  Vascular claudication occurs when the patient is living a pro-atherogenic / prediabetic lifestyle.  Over time, plaque builds on the arteries going into the legs and the muscles of the legs do not have the oxygen and nutrients they need to function when the demand for oxygen increases with activity.  Exercise therapy and surgery to put a stent in the artery are two options.  Unfortunately, the outcomes from surgery, quite frankly, suck.

In this particular case, prevention is clearly the best option.

The other type of claudication is called neurogenic claudication.  This is caused when arthritis in the spine begins to shrink the opening for the nerves to come out of, a condition called spinal stenosis.  It is a slow process that creeps up over the years.

The leg pain that comes on with neurogenic claudication has some differing characteristics from the vascular type.  Pain in the legs is less predictable–sometimes it comes on after a minute, sometimes 10, sometimes 8.  The pain with vascular claudication is much more consistent with the time to onset.  Also, in neurogenic claudication, sitting down for just a minute or two can alleviate the pain quickly, while there is a recovery time in vascular claudication.

This particular study brings to light the fact that many patients with vascular claudication may also have neurogenic claudication as well (up to 76’%).  If the physicians looking for vascular claudication are NOT also looking for the spinal component of the leg pain, outcomes may not be as good.  The obvious problem here is the vascular specialist looking at the blood vessels is not all that likely to understand the need for a referral to a chiropractor (preferred) or neurosurgeon.   The patient gets stuck with incomplete treatment.

For neurogenic claudication related to spinal stenosis, a specific chiropractic treatment called Flexion Distraction can work wonders.  This requires a specialized table that applies a gentle traction to the low back, allowing some breathing room to the choked off nerves coming out of the lumbar spine.  In conjunction with chiropractic care, the use of an inversion table at home can add additional benefits to your treatment plan.

The bottom line is, anyone with pain in their legs during activity should who is pursuing help from a vascular specialist should also seek an evaluation from a chiropractor who is familiar with Flexion Distraction to evaluate and treat any neurogenic claudication that might be present as well.

James Bogash

For more than a decade, Dr. Bogash has stayed current with the medical literature as it relates to physiology, disease prevention and disease management. He uses his knowledge to educate patients, the community and cyberspace on the best way to avoid and / or manage chronic diseases using lifestyle and targeted supplementation.


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  1. Thanks for sharing this great information. I can completely relate to this condition and thank you every day for suggesting the inversion table!

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