Occasional leg pain after being on your feet all day or a good workout at the gym is normal. However, chronic or ongoing leg pain that prevents you from participating in regular daily activities is not. Sometimes your symptoms are trying to send you a message. If your leg pain causes you to avoid routine activities, hobbies, or exercise, or you just feel slowed down in general, it is likely a sign of an underlying medical condition. You shouldn’t accept it as part of getting older.
Pinpointing the Cause of Leg Pain
Here are some observations I can share with you that may give you some insight into your condition. This will point you in the right direction so that, with a little more research on your own, it will help you have an informed conversation when you see your provider. I will also let you know what are the most common problems which cause leg pain.
There are several basic questions which help sort out the cause, and the answers can point you in the right direction.
- Does the pain occur when you are standing and walking? If so, this points to a joint condition.
- Does the pain get better after you walk around? This suggests arthritis.
- Does the pain occur when you are walking? This can be due to back, joint or artery conditions.
- Does the pain come on with specific positions like bending over or twisting? This suggests a back origin to the leg pain.
- Is the pain worse at the end of the day even when you are resting? This can be due to a vein condition or from overused joints
- Does the pain start in the back or hip and go down the leg? This can be a back or hip condition or sciatica.
- Does the pain in your legs occur when you are sleeping in certain positions? This can be due to a back condition or pressure on a sore joint.
When Leg Pain Isn’t Normal
Here are the most common causes of abnormal leg pain that I see in the office:
1. Arterial disease
Arterial disease interferes with blood flow due to blocked arteries. Peripheral arterial disease (PAD) is a common outcome of this condition. The pain from arterial disease consistently comes on after walking the same distance each time. You may notice that climbing stairs or walking up a hill worsens the pain. Arterial disease pain typically produces aching or burning that goes away about 10 minutes after sitting down to rest. You may also develop pain in your buttocks, calves, or thighs depending on location of the blockage. Other symptoms associated with arterial disease can include:- Impotence in men
- Loss of skin hair on the foot or calf
- Purple discoloration of foot
- Tingling of feet
Arterial disease is common but not life-threatening when controlled. If you have this condition, it puts you at higher risk of a heart attack from arterial blockage. You also have a higher risk of foot or toe amputation. If you have these symptoms, you are at high risk of heart disease, which you should discuss with your healthcare provider. If your provider orders an arterial ultrasound, make sure they order an exercise ultrasound, which will reveal any blockages.
2. Hip or knee disease
Hip or knee disease causes leg pain immediately when standing on the leg, and after sitting down, it gets better within a few minutes. If you have been on the leg all day, it may continue to ache some after you sit down but sitting will definitely help it feel better. People often report a sensation of creaking, clicking and crunching in the joint. One oddity of the body is that the nerve connections between the hip and knee are shared, so sometimes people have knee pain but the problem is actually their hip and vice versa. This is best sorted out with a visit to an orthopedist who will likely order x-rays or scans.
3. Lumbosacral disc disease
Lumbrosacral disc disease involves a pinched nerve in the back, usually due to a slipped disc. There is always pain in the back and when a leg nerve is pinched, the pain seems to track down the outside of the leg, calf and foot - also called sciatica. The pain comes on when the nerve is pinched so certain positions will produce the pain such as bending, picking up things, your sleep position or walking. The real risk to this is that as it progresses it can result in loss of muscle function and numbness of the leg which can be permanent. Evaluation by a specialist who treats this condition such as an orthopedist or neurosurgeon is the next step, and they will order scans.
4. Venous disease
Venous disease causes your legs to ache when standing or walking, and usually improves when you elevate your legs or wear compression stockings. Other invisible signs of a vein condition include fatigue and poor sleep as well as aching, painful and restless legs. It’s important to note that this condition is highly treatable with prompt relief of symptoms and an increase in energy. Only vein treatments get to the underlying condition that causes this condition. Most patients experience some form of relief soon after starting treatments.
You Don't Have to Live With It
Bottom line, don’t live with ongoing leg pain when you don’t have to. The first step is to understand the cause so that you can find the right solution. If chronic leg pain is limiting your life, or the life of someone you know, I want you to understand more than anything - that it’s not normal and you don’t have to learn to live with it. There is a solution, and by arming yourself with information, you and your healthcare provider can partner together on finding relief.
