Causes and Sources of Leg Pain:

Leg pain can be extremely distressing. Being able to walk freely allows us to be mobile, to accomplish our life goals, to socialize with family and friends and to maintain a healthy lifestyle. leg-pain-from-standing

Sadly, many people suffer for days, weeks and even years with leg pain. Limping around and losing time from work is costly. Without the ability to walk freely, our lives become smaller and this can lead to a loss of hope and even depression.

We cannot allow ourselves to lose hope and so it is very important to reach out to gain relief as soon as possible.

Leg pain may result from any of the anatomical structures in the lower leg and spine. These include:

• Leg Pain from Over-use Injuries that strain on the joints and soft tissues:

These may include long hours at work on the feet or repetitive sports injuries.

We tend to take our feet for granted, expecting them to keep up with our long work hours. However, it is very important to give the feet a proper amount of rest during the course of a day’s work. Otherwise, these stresses accumulate within the tissues and lead to inflammation and foot/leg pain.

• Leg Pain from Pressure and Inflammation of the Nerves coming from the Spine:leg-pain-sciatica

Lumbar Radiculopathy is the medical term used for leg pain that is caused by irritation/inflammation of a lumbar nerve root.

Radiculopathy is one of the most common causes of leg pain. This can be confusing, because the pain may often be felt more in the leg than in the back.

Leg pain from lumbar radiculopathy may be excruciating. It may feel like a sharp, shooting pain, searing jolt, pull or ache that radiates down into the leg. Depending on which nerves are being irritated, you may feel pain into the buttocks, hamstring area, side of the thigh, calf, or bottom/side of the foot. You may also feel numbness, tingling, (pins and needles) and/ weakness as well as an altered sensation of hot and cold.

Sciatica describes radicular pain that is felt in the buttocks, hamstring area and into parts of the leg below the knee.  Degenerative changes in the spine from a bulging/ herniated disc and bony spurs can lead to a closing up of the side openings where the nerves exit from the spinal canal to travel to the muscles and organs.

It may be very difficult to get comfortable in a sitting position, to find a comfortable sleeping position at night or to be able to drive for any distance.

• Leg Pain from Leg Length Inequality, Flat Feet, Over-pronation & High Foot Arches:leg-pain-short-leg

These structural/biomechanical problems can lead to conditions such as Plantar Fasciitis, Bunions and Shin Splints. These usually have a genetic component and are made worse by poor choices in shoes and other footwear. The nerves, joints, muscles, and ligaments in the feet, leg, knee, hip and spine become strained and they cannot work efficiently.

• Leg Pain from Hip, Groin and Lumbar Joint Inflammation, Iliotibial Band Strain and Osteoarthritis:

Pain tends to be felt in the thigh and “hip bone”. This stiff, sharp or achy pain may be made worse with a variety of movements and positions including twisting (as in a golf swing), sitting for long periods of time. Lying on the side or after being in bed for a long time can cause pain as well.

• Leg Pain from Lumbar Spinal Stenosis/Neurogenic Claudication (LSS):

In LSS, the central Spinal Canal becomes smaller. Pain may be felt in BOTH legs and it may become more and more difficult to stand up straight, bend backward or walk as far as you used to be able to. People with lumbar spinal stenosis often find relief leaning forward, which is thought to reduce the pressure and venous congestion within the spinal column. This may give immediate relief.

• Leg Pain from Varicose Veins:

Varicose veins affect the more superficial (rather than deep) veins in the legs. The leg pain associated with varicose veins is usually described as an ache/fatigue. Heat may be felt in the calve muscles periodically and ankle swelling, as well and skin discoloration may develop.

Varicose leg pain is made worse when we stand at work for extended periods-especially on hard surfaces or without proper footwear and support and by walking for excessive periods of time without taking the time to elevate the feet and rest. Some women develop varicose veins during pregnancy and pain may worsen as the pregnancy progresses. It is best to avoid tight ribbing in the socks that cut off blood flow.

Some people are born with a predisposition to having varicose veins. There are valves inside our calf veins that play a key role in pumping blood back up to our hearts when we walk. The valves work to prevent blood and other body fluids from getting stuck down in our feet and ankles. These valves can become weak, which leads to sluggish blood flow and swelling in the feet and ankles.

Dr. Horowitz is experienced in fitting patients for medical-grade socks and hosiery. These products are available for order through Toronto Orthotics Clinic.

• Intermittent (Vascular) Claudication:

Intermittent Claudication is a symptom of Artery disease, due to diminished blood flow in the lower limb arteries because of plaque buildup. This type of leg pain is usually experienced during exercise or walking, and the legs feel achy, weak and/cold which gets more intense as the activity gets more intense. As the disease progresses, discoloration may develop in the legs and the pain can be felt even at rest. Unlike the pain of Lumbar Spinal Stenosis, relief is not found by bending forwards.

Claudication occurs more in smokers, diabetics, people with higher cholesterol and high blood pressure as well as in people over 50. Obesity is a risk factor as well.

• Leg Pain from Psoriasis, Crohn’s and Colitis, Rheumatoid arthritis and seronegative spondylopathies:

Some of these conditions affect joints as well as the soft tissue attachments such as tendons and ligaments of the feet. They may result in episodes of heel pain, Achilles tendonitis and heel spurs as well as Plantar Fasciitis.

• Leg Pain from Peripheral Neuropathy related to Diabetes or Alcoholism:

Diabetic Neuropathy occurs when high sugar levels injure nerves, most commonly in the legs and feet. This leg pain is usually worse at night, can be sharp, numbness or burning. As the nerve injury progresses, muscle weakness, altered foot reflexes, reduced ability to sense pain, as well as temperature and pressure differences,  develop.

People with Diabetic peripheral neuropathy develop loss of coordination and balance with an increased frequency of falls and injuries.  Ulcers and foot infections can develop if regular foot hygiene is not practiced.

Alcoholic Neuropathy can develop following the long-term use of alcohol. Drinking too much alcohol leads to malnutrition and failure to absorb the nutrients needed for the nerves to work properly. Leg pain in people who abuse themselves with alcohol varies from pins and needles to numbness, loss of sensation, muscle weakness, muscle wasting, cramps, and muscle spasms.

• Lymphedema:

If a person must undergo surgery related to cancer and one or more of their lymph nodes/vessels are removed, then lymphatic fluid (which is part of the immune system) can build up in the legs.  Over months, the swelling gets worse. More rarely it occurs as a genetic condition.

The leg pain of lymphedema feels heavy, achy and or tight and the person is not able to move the foot, ankle or knee joints very well. If you suffer from this condition,  see a therapist who specializes in treating lymphedema.

• Deep Vein Thrombosis:

A clot develops inside a deep leg vein in the calf or thigh, usually after prolonged travel, bedrest, after surgery or an accident.

A person can develop a clot without any pain, but when pain is present, there is usually swelling in the area with cramping or a sore feeling. The skin becomes red and the area feels warm. Since a clot can break off and travel to the lungs, this is a serious type of leg pain that can cause difficulty breathing, which is a medical emergency.

It is important for people who have had an episode of deep vein thrombosis to wear medical-grade compression socks or hosiery, especially when they travel long distances or on a plane.

An Accurately Diagnosis is Key:

Since all parts of the leg receive their nerve supply from the spine, the first step to take for anyone with foot or leg pain should be to have a thorough examination of the joints of the lower back and nervous system. To only examine the area of pain may lead to a missed diagnosis, wasted time and money.

An accurate diagnosis is important, and this can only be obtained by a doctor skilled in taking an accurate history and conducting a thorough examination.

By consulting with Dr. Horowitz, you receive the advantage of obtaining the opinion of a knowledgeable doctor with years of experience, who treats not only the feet but also spinal conditions.

When to Seek Immediate Help for Leg Pain:

You should seek immediate help if you experience:

a) weakness in one or both legs that is persistent, or that comes on suddenly or unpredictably, often described as the leg “giving out”

b) inability to lift your foot when taking the next step (Drop Foot) or to swing the leg for the next step as quickly or that you are tripping more often.

c) a significant difference in size and shape of your right and left muscles in the legs.

d) so much pain that you are missing work, social events and that you are finding it difficult to take care of yourself properly.

e) cuts or ulcers in your feet or legs that do not heal well

f) sudden shortness of breath, feeling dizzy or faint and chest pain when you take a deep breath in (seek emergency help in this instance)

Toronto Orthotics is located in North Toronto

Relief from Plantar Fasciitis, Foot, Leg and Lower Back Pain

For help with your Leg Pain, call Dr. Horowitz at Toronto Orthotics Foot, Leg and Back Pain Clinic at (647) 349-4909. You may also submit the form on this page to ask Dr. Horowitz a question.