Leg Pain: Musculoskeletal, Vascular and Neurological
Leg pain is generally described as a pain occurring between the groin and the ankle. Hip and foot pain most often own their own pain classifications and are treated as separate entities.
The causes of leg pain are as varied as are the treatments available to eliminate the pain. Some causes are readily apparent and some are intermittent and vague. Medical knowledge of not only the variety of causes, but also the availability of the most modern diagnostic protocols is necessary for proper curative treatment.
The groupings below represent just a very small portion of the causes of leg pain. It must be remembered that the leg is normally the longest appendage, and that a combination of any or all of the systemic causes listed below can result in leg pain. Again, a professional diagnosis is critical to providing proper and timely treatment.
Some Musculoskeletal Causes of Leg Pain
Acute Blunt Force Trauma:
This is the most obvious cause of leg pain, and is associated with a sports injury or other traumatic event such as an auto accident. Bone fracture and/or muscle, tendon or ligament tears can all instantly happen in an acute traumatic event. Whatever the cause, immediate specialized care is required for this type of leg injury.
Chronic Overuse:
Less obvious are chronic pains caused by repetitive use. For example, mild to severe shin splints can be caused by over-exercising. Pain from shin splints can loosely be defined as occurring from an overload of the muscles and tendons along the shin bone.
Or, if distance running is your thing, then there is the risk of musculoskeletal or vascular damage that results in leg pain. Rest, ice, compression and elevation of the injured leg should be done to provide immediate palliative care. Proper diagnosis for further treatment and/or therapy should be undertaken as quickly as possible.
Stress Fractures:
Again, chronic overuse through repetitive exercise is the culprit here. These small bone fractures can be caused by an abrupt increase in the intensity of exercise. The pain becomes apparent as you continue with your new receptive exercise. If the leg pain onset is coming earlier and earlier in your exercise routine, chances are that you have a stress fracture. Rest to allow bone healing is necessary accompanied by radiographs to assure proper diagnosis.
Arthritis:
Found primarily in the elderly, Osteoarthritis is caused when cartilage loses it elasticity and the ability to absorb impacts or shocks within the joints. Because of the loss of elasticity, the cartilage wears…causing damaged tendons and stretched ligaments and pain occurs. Continued cartilage deterioration may lead to a painful “bone on bone” condition that may require surgical intervention. As you may have guessed, osteoarthritis becomes more common as we age.
Strained Hamstring:
Most everyone has felt the pain of a Hamstring strain. This large muscle running the length of the back of the thigh is prone to strain through overuse that is usually associated with running. Failure to properly stretch the muscle to aid its flexability prior to exercise can lead to strains or tears of varying severity. Dehydration during stressful use can also contribute to a hamstring strain.
Leg Cramps:
If you’re over 60 years of age, you may be part of the thirty plus per cent of the population that suffers from leg cramps. These cramps, most often occurring in the calf, occur when the muscle goes into spasm and lasts for several minutes. Relief occurs from stretching and/or massaging the affected area.
Some Vascular (blood supply) Causes of Leg Pain
Claudation:
Atherosclerosis (a narrowing of the blood vessels due to plaque formation and/or hardening) is the cause of this form of leg muscle cramping. This painful condition occurs when the blood supply to the muscle is partially blocked, and is known by several other names such as “peripheral vascular disease”.
In textbook cases, the cramping leg pain occurs during exercise (most often at the same point in the exercise), and usually in the calf. The pain is relieved by taking a 10 minute rest. However, cases of non-classic Claudation may be asymptomatic or be painful in an atypical area such as the thigh.
Deep Vein Thrombosis (DVT):
When diagnosed as such, DVT is a life-threatening medical emergency. It is caused by a blood clot in a deep vein in the leg. The danger is that a piece of the clot can separate and flow the lung resulting in a pulmonary embolism (partial blockage of the blood supply to the lung causing the affected tissue to die).
DVT can be asymptomatic. More commonly though, there are external symptoms consisting of swelling, redness, tenderness, warmth and pain over the area of blockage.
Under normal circumstances, DVT occurs in 1 of 1000 adults in America. Additionally, it can be a consequence of hip or knee surgery with a 1% risk of post-surgical onset. Knee arthroscopic surgery presents a 0.5% risk of post-surgical onset to the patient.
Some Neurological (nerve) Causes of Leg Pain
Sciatica:
A narrowing of the spinal nerve canal due to injury or arthritis can put pressure on the a nerve that may result in leg pain. Often beginning in the hip or lower back, the sciatic pain radiates down the leg and is constant. Rest may or may not help, but stretching and anti-inflammatory medications often provide relief. Because of the complexity of the possible causes, many diagnostic procedures may be indicated. Treatment runs the gamut from rest, stretching, supervised exercise and medications to spinal surgery.
Diabetic Neuropathy:
High blood sugar levels found with diabetes may cause nerve damage in one or both legs resulting in pain or numbness particularly in the lower leg. Treatment involves strict blood sugar level management with proper and exact diagnostics blood work.
These are but a few of the conditions that may cause leg pain. As with any pain, proper diagnosis as soon as possible from a trained professional is necessary to provide immediate pain relief and termination of the cause long term.
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