Calcitonin treatment for neurogenic claudication.

Forty-one patients with a possible diagnosis of neurogenic claudication were treated with Calcitonin for four weeks. Eleven responded with considerable improvement in their walking distance. Ten agreed to enter a randomized double-blind cross-over trial, and eight made a correct assessment. It is concluded that Calcitonin is effective in relieving symptoms of neurogenic claudication for some patients. Five patients have received the drug for over one year with no serious side effects, and two have not relapsed after discontinuing the drug. Patients likely to respond will probably have symptoms affecting both legs equally pain extending below the upper calf, limiting walking to under a mile; an abnormal myelogram; and no more than one inappropriate sign. They are more likely to be men in late middle age who have been engaged in manual work. The beneficial effect of Calcitonin is probably the result of an arterial shunt mechanism, whereby a reduction in skeletal blood flow provides for a deprived cauda equina.