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Pain in the legs can happen due to poor circulation, sciatica, excessive physical exertion or neuropathy and, therefore, to identify its cause, it is necessary to observe the exact location and characteristics of the pain, as well as whether both legs are affected or only one and whether the pain worsens or improves with rest.
Usually leg pain that does not improve with rest indicates circulation problems such as peripheral vascular disease, while leg pain upon waking can be a sign of nocturnal cramps or lack of circulation. Pain in the legs and back can be a symptom of spinal problems or compression of the sciatic nerve, for example.
To identify the cause of leg pain, the doctor evaluates the curvatures of the spine and bone ends, and may perform pain provocation tests, in addition to palpation of the abdomen to assess for pain in the abdominal or pelvic region.In addition, blood tests, synovial fluid and imaging tests, such as X-ray or MRI may be indicated. Based on the results, the diagnosis can be reached and the most suitable treatment for each case can be indicated.
Some of the main causes of leg pain are:
1. Muscle or tendon changes
Pain in the legs caused by musculoskeletal causes does not follow the path of the nerves and gets worse when moving the legs. Some changes that can be the cause of pain include myositis, tenosynovitis, thigh abscess, and fibromyalgia.
Muscle pain can occur after sudden physical exertion, such as after intense physical exercise or wearing uncomfortable shoes. In these cases, the pain usually comes at the end of the day and is often felt as "leg fatigue". Another common cause of muscle pain in the legs is cramps that usually occur at night and are very common during pregnancy.
Pain in the calf region can also be caused by compartment syndrome, which causes severe leg pain and swelling that occurs 5-10 minutes after starting physical activity and the region remains painful for long periods. Pain in the anterior region of the leg can also be caused by tibialis anterior tendinitis, which occurs in athletes and people who practice very intense physical activity, such as long-distance runners.
What to do: Take a warm bath and lie down with your legs elevated because it facilitates blood circulation, reducing tiredness. Rest is also important, but there is no need for absolute rest, and it is only indicated to avoid training and great efforts. In case of tendinitis, the use of ice and anti-inflammatory ointments can help faster healing.
2. Joint problems
Especially in the elderly, leg pain can be related to orthopedic problems such as arthritis or osteoarthritis.In these cases, other symptoms must be present, such as joint pain and stiffness in the first 15 minutes of the morning. Pain may not be present every day but tends to get worse with exertion, and reduces with rest.
Deformity of the knees may indicate arthrosis, while a reddened, warm appearance may indicate arthritis. However, knee pain can also be present after a fall, hip disease, or leg length differences.
What to do: apply a warm compress to the affected joint, such as the knee or ankle, for about 15 minutes. In addition, it is recommended to consult the orthopedist as it may be necessary to take anti-inflammatory drugs or undergo physical therapy.
3. Spinal changes
When leg pain worsens with spinal movement, it can be caused by spinal injuries. Spinal canal stenosis can cause moderate or severe pain with a feeling of heaviness or cramping in the lower back, buttocks, thighs, and legs when walking.In this case, the pain only relieves when sitting or leaning the trunk forward, the feeling of numbness may be present.
Spondylolisthesis is also a possible cause of back pain that radiates to the legs, in which case the pain is a feeling of heaviness in the lumbar spine, the person walks with pain but it relieves during rest. A herniated disc also causes back pain that radiates to the legs, the pain is sharp, intense and can radiate to the buttocks, back of the leg, side of the leg and ankle, and sole of the foot.
What to do: Placing a warm compress on the pain site can relieve symptoms, but your doctor may recommend taking anti-inflammatories and recommend physical therapy.
4. Sciatic pain
When leg pain is caused by changes in the sciatic nerve, the person may experience pain in the lower back, buttocks and back of the thigh, and there may also be a tingling sensation or weakness in the legs.The pain can be excruciating, stabbing or shocking that suddenly settles in the lower back and radiates down the legs, affecting the buttocks, back of the thigh, side of the leg, ankle, and foot.
What to do: put a warm compress on the pain site, let it act for 20 minutes, in addition to avoiding efforts, lifting heavy objects and, in some cases, it can be I need to do physical therapy. Check out some exercises you can do at home to fight sciatica.
5. Poor blood circulation
Leg pain caused by poor circulation mainly affects the elderly and can arise at any time of day, but worsens after spending some time sitting or standing in the same position. The feet and ankles may be swollen and have a purplish color, indicating difficulty in returning blood to the heart.
A slightly more serious situation is the appearance of thrombosis, which happens when a small clot manages to interrupt a part of the circulation to the legs.In this case, the pain is most often located in the calf, and there is difficulty moving the feet. This is a situation that can happen after surgery or when using contraceptives without medical advice.
What to do: Lying on your back with your legs elevated for 30 minutes can help, but your doctor may recommend using medication to improve circulation, as well as wearing elastic compression stockings. In case of suspicion of thrombosis, you should go quickly to the hospital.
6. Growing Pains
Leg pain in children or adolescents can be caused by rapid bone growth, which can happen around 3-10 years of age, and is not a serious change. The location of the pain is closer to the knee but it can affect the entire leg, reaching the ankle, and it is common for the child to complain at night before going to sleep or after having performed some type of more intense physical activity.Learn more about growing pains in children.
What to do: Placing ice cubes in a sock and placing it on the painful area and letting it act for 10-15 minutes can help with pain relief. Parents can also massage with moisturizing cream or almond oil and let the child rest. There is no need to stop physical activity, just decrease its intensity or weekly frequency.
7. Leg pain in pregnancy
Leg pain in pregnancy is a very common and normal symptom, especially in early pregnancy, as there is a large increase in estrogen and progesterone production, which cause leg veins to dilate, increasing blood volume on the woman's legs. The growth of the baby in the uterus, as well as the weight gain of the pregnant woman, lead to compression of the sciatic nerve and inferior vena cava leading to swelling and pain in the legs.
What to do: To relieve this discomfort, the woman can lie on her back, with her knees bent, doing a spine stretching exercise and resting with her legs high.
When to go to the doctor
It is advisable to go to the doctor when the pain in the legs is very intense or when there are other signs and symptoms, such as:
- When leg pain is localized and very intense;
- When there is calf stiffness;
- In case of fever;
- When the feet and ankles are very swollen;
- In case of suspected fracture;
- When work is not allowed;
- When walking is difficult.
During the consultation, the intensity of the pain should be mentioned, when it appeared and what was done to try to alleviate it. The doctor may order tests to indicate the appropriate treatment, which sometimes may include the use of medication or physical therapy.