The pathophysiology is similar to that seen in angina pectoris and intermittent claudication. Differential diagnoses include restless legs syndrome, claudication, myositis, and peripheral neuropathy. Severe vasoconstriction may cause symptoms of intermittent claudication. Neurogenic claudication can be treated surgically with spinal decompression. Severe vasoconstriction may result in symptoms of intermittent claudication. This causes leg pain with increased activity, a condition called neurogenic claudication. It is distinct from neurogenic claudication, which is associated with lumbar spinal stenosis. Spinal or neurogenic claudication may be differentiated from arterial claudication based on activity and position. Naftidrofuryl is also licensed for the treatment of intermittent claudication due to peripheral arterial disease. In most cases neurogenic claudication is bilateral, i.e. symmetrical. One of the hallmarks of arterial claudication is that it occurs intermittently. In addition to vascular claudication, pseudo-trochanteric bursitis should be considered in differential diagnosis. In those with intermittent claudication from PAD, stopping smoking and supervised exercise therapy improve outcomes. Intermittent claudication most commonly manifests in men older than 50 years. A study found that moderate consumption of alcohol had a protective effect against intermittent claudication.