Wednesday, October 6, 2010

Doc, Why Do I Have Leg Pain?

(Great article taken from WebMD about frequent causes of leg pain.  I've re-posted it here for all to read.)

Lower Leg Pain: Causes and Treatments

If you're suffering from lower leg pain, you may wonder if it's serious or something you can treat at home. What follows is an overview of several causes and types of treatment for lower leg pain. Be sure to see your doctor if you have any question about your leg pain or if symptoms get worse.

Lower Leg Pain: Bones, Joints, and Muscles

Muscle cramps . This sudden, tight, intense lower leg pain is sometimes called a "charley horse." Often caused by muscle fatigue, heat, or dehydration, muscle cramps are more common among older people, endurance athletes, or athletes who are not well conditioned. In most cases, you can ease muscle cramps by stopping whatever triggered them. If needed, gently stretch or massage your lower leg muscle. Applying heat to tight muscles or cold to tender muscles may ease some symptoms. Proper conditioning and stretching can help prevent problems in the future.
Shin splints . This type of lower leg pain occurs when connective tissues and muscles along the edge of the shin bone become inflamed. This often occurs afterrunning or jumping, especially on hard surfaces. The repetitive force overloads muscles and tendons. Flat feet and too much outward rotation of the foot and leg can also contribute to this problem. Pain usually goes away with rest. It also helps to apply ice, take anti-inflammatories, and avoid anything that causes pain. Once pain lessens, stretch and strengthen your lower leg. To prevent future problems, wear supportive shoes and avoid running on hard surfaces.
Inflamed or torn tendons or muscles. One of the first signs of tendonitis (an inflamed tendon) is pain in the lower calf or back of the heel. Apply ice, take anti-inflammatories, and avoid anything that causes pain. Supportive shoes that lessen tension on tendons may also help. Just as with shin splints, wait until pain lessons to stretch and strengthen your leg. If pain is severe, the Achilles tendon may be ruptured. This can result from intense activity and not warming up well enough. See your doctor.
Broken bone or a sprained knee or ankle. A fracture (broken bone) or sprain (injury to ligaments from overstretching) can also cause leg pain. For mild sprains, try rest, ice, compression, and elevation (RICE). For a more severe sprain or fracture, apply ice and see your doctor right away. You may need a cast or brace. You may also need physical therapy to improve movement and speed recovery. Over time, gradually increase strength to support your weakened leg.

Lower Leg Pain: Veins and Arteries

These are some of the more common sources of lower leg pain caused by problems in blood vessels:
Blood clot. A blood clot that develops in a vein deep in the body is called deep vein thrombosis (DVT). Most deep vein blood clots develop in the lower leg or thigh. They are more likely to occur if you are inactive for long periods, smoke, or take medication that increases risk for clots. If you suspect a blood clot, go to your doctor or emergency room right away. Pieces of blood clots can travel to lungs and other organs. Medications and support stockings are two types of treatment.
Varicose veins. Weak valves and vein walls can cause twisted dark blue or purple veins near the surface of the skin (varicose veins). Varicose veins may cause a dull ache, especially after prolonged standing. Support stockings can be helpful. Throughout the day, alternate between standing and sitting. If your varicose veins are very painful, see your doctor about other types of treatment.
Infection. A skin or soft tissue infection can appear as red, tender, swollen, and warm. Warm soaks can help soothe discomfort. Your doctor may also recommend the use of antibiotics. If symptoms worsen or you develop a fever, call your doctor.
Lower extremity peripheral arterial disease. Just as with the heart, the lining of arteries in your legs may become damaged and hardened (atherosclerosis). Arteries narrow or become blocked, which decreases blood flow circulation. This can cause lower leg pain or cramping when walking, climbing stairs, or other kinds of exercise (called claudication) because muscles aren't getting an adequate blood supply. Resting may bring relief. If arteries become severely narrowed or blocked, pain may persist, even when you're at rest. Also, wounds may not heal well. If not treated, this disease can cause tissue to die (gangrene). People at high risk for PAD include: people with diabetes, high blood pressure, and/or high cholesterol and people who smoke.
Treatment includes lifestyle changes such as:
  • Quitting smoking
  • Reducing intake of foods high in cholesterol or saturated fats
  • Managing weight
  • Exercising, gradually increasing walking distance over time
Other treatment includes medications to control cholesterol, diabetes, and/or hypertension, to help with walking distance, and to help prevent blood clots. Surgery may be needed to improve blood flow to the area.

Lower Leg Pain: Nerves

These are some of the more common sources of lower leg pain brought on by problems in nerves:
Narrowed spinal canal (stenosis) and sciatica. A common cause of a narrowed spinal canal is arthritis of the spine.  Sometimes a herniated disc puts pressure on nearby nerve roots, which can lead to symptoms of sciatica such as:
  • Burning, cramping leg pain when standing or sitting
  • Numbness
  • Tingling
  • Fatigue
  • Weakness
Pain may begin in your back and hip, then later extend down into your leg. Sciatica often doesn't get better with brief periods of rest. Treatment may involve resting for a few days, along with taking anti-inflammatories and pain medications, as needed. Cold and heat can help with some symptoms. Physical therapy and stretching exercises are often useful. Gradually increase movement over time. Your doctor may also recommend other therapies or surgery if pain is not resolved.
Diabetic neuropathy . With diabetes, nerves can be damaged from high blood sugar levels. This is a common complication of diabetes. It can cause pain in both legs along with numbness and less sensation in lower legs. Treatment includes controlling pain with oral medications and managing blood glucose levels.

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