Leg Pain

Leg pain is quite a common health problem that may have been experienced by every individual at some point. It is rarely a serious issue, except for when it is caused by an injury or if it does not subside within a day. Leg pain refers to the discomfort experienced in the area between the groin and ankle. Pain in any part of the leg may have several causes and can be a symptom of an underlying disease.

Depending on the period of onset and the severity of the symptoms, leg pain could be of an acute or chronic type.

Acute leg pain

Acute leg pain is characterised by a sudden onset and shows severe symptoms. The pain is excruciating and may be caused due to muscle spasm, nerve compression, muscle sprain among others. It resolves within a few days.

Chronic leg pain

When leg pain lingers for a long period of time or recurs and is dull or aching, it is of a chronic type. Recurring leg pain could be caused by an underlying health condition such as sciatica, varicose veins, or peripheral arterial disease. If the leg pain persists for over a few days, one must consult the doctor for an immediate diagnosis. 

• People can have different symptoms related to leg pain. Depending upon the cause of leg pain, one may experience a sharp and throbbing pain (as experienced in foot injuries) or may have a dull and spreading ache (as experienced due to tiredness). The pain may increase and get worse when doing any physical activity such as walking or even while sitting.
• People suffering from knee problems experience leg pain while trying to sit down or climbing the stairs.
• Leg pain due to a cramp may feel like a knot that stiffens and produces a radiating pain.
• Leg pain due to circulatory issues may cause inflammation (swelling) and redness of the skin.
• Leg pain in sciatica tends to radiate downward and is accompanied by other symptoms like immobility and burning sensation.
• Individuals suffering from heart diseases or disorders may experience leg pain while exercising or running. This kind of pain will reduce after taking rest. 

Causes

Leg pain can have several causes. Broadly, the categories for the causes of leg pain include:

• Muscle cramp 
  The most common cause of leg pain tends to be a muscle cramp. A muscle cramp in the leg is also known as a Charley horse. Muscle cramps may result due to dehydration or the intake of certain medications like diuretics or statins. Muscular fatigue may also lead to cramps.
• Leg injury
  A leg injury may also lead to leg pain. These injuries include muscle strain, stress fracture, inflammation of the tendons, or micro tears that occur in shin muscles over the legs. Joint dislocations may also lead to leg pain. These leg injuries may occur in different parts of the leg such as the foot, ankle, knee, or the hip area. 
• Vascular problems
  Leg pain may be caused by vascular issues. These causes include varicose veins (where veins of the legs are swollen and visible on the skin), peripheral arterial disease, and varicose eczema (pain along with a discolouration of the skin). In peripheral arterial disease, plaque deposits in the arteries, which carry blood to the organs of the body. Over time, this plaque tends to harden and narrow the arteries. This reduces the flow of oxygen to the organs. Poor circulation of oxygen can lead to pain in the different parts of the leg such as the thighs, calves, and feet. One may also experience cramps while walking and running due to this condition. This disease requires medical treatment because it can be fatal.
• Neurological causes
  These include nerve conditions like nerve damage, sciatica, and the restless leg syndrome in which the legs twitch uncontrollably. Leg pain due to neurological causes may be present even while an individual is resting. For example, in sciatica, the sciatic nerve passes from the spine into the buttocks and then to the back of the thigh and the leg. When pressure is exerted on that nerve due to a slipped disc, blood clots, or other nerve disorders, one may experience symptoms like leg pain, numbness in the leg, and difficulty in moving around. Sciatic nerve pain can be caused by other factors like obesity, smoking, heavy lifting, or sleeping on a very hard surface. Sciatic nerve pain is often treated using medication and physiotherapy. If the pain due to sciatica does not subside, surgery may be required. 
• Blood Clots
  Formation of blood clots can also lead to leg pain. Deep vein thrombosis (DVT) refers to a painful condition in which a blood clot is formed within a deep vein in the body, especially in the legs. It not only causes pain but also leads to swelling. The skin above the affected area often gets warm and turns red due to inflammation. The pain and tenderness due to DVT are usually severe. The blood clot may or may not dissolve on its own, but if an individual experiences shortness of breath or dizziness then immediate medical attention is required.

Some uncommon causes of leg pain are:

• Bone tumours (osteosarcoma)
• Legg – Calve Perthes disease (a disease in which poor blood flow leads to a slow and improper development of the leg)
• Non-cancerous cysts

Risk factors

The following groups of people are at a higher risk of experiencing leg pain:

• Athletes.
• Individuals with obesity.
• People with under-developed bones.
• Elderly people.
• People with joint disorders.
• Pregnant women.
• Individuals with diabetes.
• People with back problems or sciatica.

There are some general preventive measures, which can be taken for preventing leg pain. These include:

• To reduce the chances of a painful leg cramp, one must make sure that they are hydrated and are drinking plenty of fluids, especially while exercising.
• Increasing potassium intake through natural food sources like bananas and oranges can also help in relaxing the muscles.
• Leg cramps are common in individuals who have started working out or physical activities such as weight lifting, running, and skipping. In such cases, the frequency of the leg cramps will decrease as one’s body gets accustomed to the stretching and becomes more flexible. 
• If you have varicose veins or deep vein thrombosis, then avoid remaining seated for too long. Try to walk in every few hours.
• Healthy body weight helps to prevent stress on the bones and the joints. Hence, maintaining a healthy weight can prevent leg pain.
• If one suffers from circulatory problems then it is essential to avoid smoking and manage health factors like blood sugar level, cholesterol, and blood pressure. Moderate exercise also helps to improve circulation and prevent painful symptoms.

After the doctor has inquired about the symptoms, there are different diagnostic tools that can be used to find out the exact cause of leg pain. These include:

• Lab tests
  Blood tests are primarily performed to detect the presence of any infection. A blood test could also be performed in case the doctor suspects that the individual is suffering from gout (a form of arthritis in which there is an inflammation and pain in the joints).
• Imaging tests
  Imaging techniques are very useful to detect any injury which might lead to leg pain, such as:
  • X-rays help greatly in detecting a fractured bone and the growth of any cysts or fluid collections in the joints.
  • Ankle-brachial index (ABI) tries to assess the arterial blood flow to the legs. This can be done by comparing the blood pressure in the arms to the blood pressure in the legs. This test assists in the diagnosis of peripheral arterial disease.
  • A computed tomography (CT scan) could also be performed to get a closer look at the blood vessels to detect any clots. A CT scan helps in evaluating bone injuries and joint problems as well.
  • The magnetic resonance imaging (MRI) scan is widely used for diagnosing sciatica. It also assists in the evaluation of the softer tissues in the legs like the muscles, tendons, and ligaments. MRI scan helps to locate slipped disc or herniated disc in the back, which may be causing leg pain.
  • An ultrasound is also a commonly used imaging test for diagnosing deep vein thrombosis and any swelling in the joints.
• Nerve conduction studies
  To diagnose leg pain caused by neurological issues, nerve conduction studies may be performed. These nerve conduction studies help to evaluate the nerve function in the legs. 

  Treatment of leg pain will depend upon its cause.

• Leg cramps and mild muscular sprains in the feet can be treated at home.
• Leg cramps caused due to excessive and sudden physical activity, which lays stress on the muscles, or due to dehydration can usually be remedied with self-care. The first thing one must do when experiencing a painful leg cramp is to stop engaging in physical activity, which led to the pain.
• Massaging the area gently using gentle pressure can also help to improve the pain.
• Application of a heating pad or an ice pack is also very helpful in reducing the pain. Most people find that heating pads work faster and more effectively than an ice pack to relieve the pain. 
• If the heating pads or ice packs do not work, one can also opt for non-steroidal anti-inflammatory medicines (NSAIDs), which help to reduce leg pain. The doctor may also prescribe anti-spasm medications to provide immediate pain relief.
• In the case of leg injuries, the doctor may prescribe using a leg cast or a walking boot to avoid sudden movement and strain on the damaged area. After the cast has been removed, rehabilitation follows. For example, in the case of ankle sprains, the recovery is expected to be complete in 3 stages:
  • Phase 1 would include taking rest and reducing the swelling in the injured ankle.
  • Phase 2 includes restoring the flexibility and strength of the ankle. 
  • Phase 3 involves returning to normal life activities including playing sports after the ankle has healed completely.
• Leg pain originating from nerve problems like sciatica is treated with pain relief medications along with physiotherapy. Physiotherapy makes use of exercises and massage techniques to reduce pain and inflammation. In some cases, surgery may be needed to get permanent relief from sciatica.
• Treatment for leg pain caused by vascular complications in the leg, such as deep vein thrombosis will include blood thinning medications to dissolve the clot and to prevent it from developing in future. Compression stockings can help in the management of pain.

Lifestyle management

There are several steps that one can take to reduce leg pain. However, the self-care tips will largely depend upon the cause of leg pain.

• For leg pain caused by ankle sprain or any other muscular complication, the first step is to take rest. If the leg is hurting, it is essential not to move around too much and not to place pressure on the damaged part of the leg. If such care is not taken, it could lead to further complications. Use of ice packs and ice compressions help to reduce inflammation and swelling. Pain relief medications can also be administered.
• For leg injuries, taking plenty of rest is necessary. Apart from this, the doctor may recommend physiotherapy that can help to gain mobility and prevent stiffness. If the leg injury does not allow one to walk comfortably, then crutches may be provided for use in the first few days after the injury.
• Pain caused due to stress to the sciatic nerve will require medical treatment. To speed the recovery, one can make use of heating pads to ease the inflammation. Engaging in mild exercise will be helpful since taking prolonged bedrest is not recommended in the case of sciatica. Applying pain relief ointments also help greatly to ease the leg pain. One may opt for NSAIDs like ibuprofen for pain relief. 

Prognosis

Leg pain has a good prognosis and there are several steps one can take in order to manage it. However, chronic leg pain cannot be ignored as it can be indicative of an underlying health condition that may require medical attention. People suffering from chronic leg pain due to health conditions usually get relief by tackling the underlying cause.

Complications

Complications from leg pain are rare. In case they arise, it will be due to delayed diagnosis and treatment of the cause of the leg pain like the peripheral arterial disease, deep vein thrombosis, or sciatica. This can lead to severe consequences, although the complications from each one will be different. As these conditions aggravate, the pain in the legs may increase as well. Complications from leg injuries may include chronic pain, pain in the entire leg, issues with movement, and recurrent swelling.