The standard surgical treatment is arterial bypass grafting, such as a femoral popliteal bypass. But there are many popular, successful, non-orthodox alternatives to going under the knife.

Hydrotherapy Exposing the feet to carbonated water (containing CO2, like soda water) has a beneficial effect in various ways on the microcirculation in patients with this problem (Deutsche Med Wochenschr, 1991; 116: 1617-21; Angiology, 1997; 48: 337-43). This form of hydrotherapy in particular has proved to result in an increase in blood flow on the upper surface of the treated foot.

A controlled clinical trial that examined the effects of immersing patients’ legs for 30 minutes five times a week for four weeks into carbonated water showed a significant increase in pain-free walking over long distances (Angiology, 1997; 48: 957-63).

Herbal remedies The herb Ginkgo biloba is especially associated with improvement in circulation. Data from a review of all studies to assess the effectiveness of Ginkgo biloba in the treatment of intermittent claudication showed significant improvement in increasing pain-free walking over distances (Am J Med, 2000; 108: 276-81).

Garlic and massage In one randomised, placebo-controlled trial, a daily dose of 800 mg of extract of Allium sativum (garlic), in powdered form, taken over a 12-week period together with massage twice weekly, was shown to significantly increase pain-free walking over distances in patients with intermittent claudication (Clin Invest, 1993; 71: 383-6).

Tibetan medicine Padma 28 is a mixture of 22 mineral and botanical ingredients used in traditional Tibetan medicine. The product has undergone three rigorous double-blind, placebo-controlled trials. The results in all of these showed that Padma 28 was superior to placebo in increasing pain-free walking (Schweiz Med Wochenschr, 1985; 115: 752-6; Angiology, 1993; 44: 836-67; Forsch Komplementarmed, 1994; 1: 18-26).

Nutritional supplementation Patients with intermittent claudication were reported to be likely to have deficient levels of carnitine (an amino-acid derivative required for oxidation) in the affected muscles (Circulation, 1991; 84: 1490-5).

Several double-blind studies found that supplementation with either l-carnitine or propionyl-l-carnitine (a naturally occurring derivative) was effective in treating intermittent claudication (Am J Cardiol, 1997; 79: 777-80). Indeed, the evidence suggests that those patients with decreased blood carnitine levels derived the most benefit (Circulation, 1996; 93: 1685-9).

Lifestyle changes But perhaps the best remedy for claudication is prevention by stopping smoking and taking regular exercise.

Harald Gaier is a registered homoeopath, naturopath and osteopath.