What are the common causes of leg pain extending from hip to foot. How is sciatica diagnosed and treated. What risk factors contribute to developing leg and foot pain.

Understanding the Diverse Causes of Leg and Foot Pain

Leg and foot pain can vary significantly in type and severity, often influenced by an individual’s lifestyle and underlying medical conditions. While the pain may originate in the leg itself, it can also be caused by issues in the lower back, hip, or pelvic region. The nature of the pain often provides clues about its underlying cause.

What are some common spinal causes of leg pain?

• Herniated or bulging discs
• Spinal stenosis
• Degenerative disc disease
• Spondylolisthesis
• Compression of spinal cord or cauda equina

These spinal conditions can affect nerve roots, leading to pain that radiates into the leg and foot, a condition often referred to as radiculopathy or sciatica.

Vascular Origins of Leg Pain: Understanding Blood Flow Issues

Circulatory problems in the legs can also be a significant source of pain. What vascular conditions commonly cause leg and foot discomfort?

• Peripheral artery disease (PAD): Reduced circulation due to arterial blockages
• Deep vein thrombosis (DVT): Blood clots in deep leg veins
• Superficial thrombophlebitis: Clots in superficial veins leading to varicose or spider veins

In some cases, ruptured blood vessels can cause bleeding within leg tissues, resulting in acute pain and swelling. These vascular issues highlight the importance of maintaining good circulatory health for overall leg comfort and function.

Pelvic and Hip-Related Sources of Leg Pain

The complex anatomy of the pelvis and hip can contribute to leg pain in various ways. What conditions in this region commonly refer pain to the legs?

• Piriformis syndrome: Spasm of the piriformis muscle compressing the sciatic nerve
• Sacroiliac joint dysfunction: Misalignment or abnormal motion of the SI joint
• Hip osteoarthritis: Degenerative wear and tear of the hip joint
• Trochanteric bursitis: Inflammation of the fluid-filled sac on the side of the hip

Trauma, overuse, or degenerative changes in the pelvic bones or hip joint can also lead to leg pain. Understanding the interconnectedness of these structures is crucial for accurate diagnosis and effective treatment.

Neurological Causes: When Nerves Are the Source of Pain

Damage to peripheral nerves in the leg can result in significant pain and discomfort. What medical conditions commonly lead to nerve-related leg pain?

• Diabetes mellitus: Can cause diabetic neuropathy
• Alcoholism: May lead to alcoholic neuropathy
• Infections: Such as shingles (herpes zoster)
• Autoimmune conditions: Rarely, disorders like Guillain-Barré syndrome

These conditions underscore the importance of systemic health in maintaining proper nerve function and preventing leg pain.

Nutritional Factors Contributing to Leg Pain

Surprisingly, nutritional deficiencies can play a role in leg pain, particularly through their effect on peripheral nerves. Which nutrient deficiencies are most commonly associated with leg discomfort?

• Vitamin B12
• Vitamin B6
• Copper

Additionally, excessive alcohol intake or exposure to heavy metals like arsenic, thallium, or mercury can damage peripheral nerves, leading to leg pain. This highlights the importance of a balanced diet and avoiding toxic exposures for overall leg health.

Foot-Specific Pain and Numbness: Identifying Local Issues

While leg pain often extends to the foot, some conditions specifically target foot comfort and function. What are some common causes of foot-specific pain and numbness?

• Tarsal tunnel syndrome: Compression of the tibial nerve
• Peroneal neuropathy: Compression of the peroneal nerve
• Sural nerve entrapment: Compression of the sural nerve
• L5 and/or S1 radiculopathy: Compression of specific spinal nerve roots

In severe cases, foot weakness can lead to foot drop, a condition where lifting the foot becomes difficult. Understanding these localized issues is crucial for targeted treatment and prevention of further complications.

Risk Factors and Prevention of Leg Pain

Identifying risk factors for leg pain can help in prevention and early intervention. What factors increase the likelihood of experiencing leg and foot discomfort?

• Advanced age
• Genetic predisposition
• Poor posture
• Occupational hazards (heavy labor, sports, military service)

While this list is not exhaustive, it covers many common risk factors associated with leg and foot pain. Awareness of these factors can guide preventive measures and lifestyle modifications to reduce the risk of developing chronic leg pain.

Importance of Accurate Diagnosis

Given the wide range of potential causes, why is accurate diagnosis crucial in addressing leg pain?

Many causes of leg pain can produce overlapping symptoms, making precise diagnosis challenging but essential. Accurate identification of the underlying cause is vital for several reasons:

• It enables effective, targeted treatment
• It helps rule out serious conditions such as tumors or infections
• It allows for early intervention to prevent progression of nerve damage
• It guides appropriate lifestyle modifications and preventive measures

Healthcare providers may use a combination of physical examination, patient history, and diagnostic tests to pinpoint the exact cause of leg pain, ensuring the most appropriate and effective treatment approach.

Comprehensive Approach to Treatment

How do healthcare providers typically approach the treatment of leg pain?

Treatment for leg pain often involves a multi-faceted approach, tailored to the specific underlying cause and the individual patient’s needs. Common elements of a comprehensive treatment plan may include:

• Medications to manage pain and inflammation
• Physical therapy to improve strength, flexibility, and function
• Lifestyle modifications, such as weight management and ergonomic adjustments
• Interventional procedures like nerve blocks or epidural injections
• Surgery in severe cases or when conservative treatments fail

The goal of treatment is not only to alleviate pain but also to address the root cause, improve overall function, and prevent recurrence or progression of the condition.

The Role of Self-Care in Managing Leg Pain

What can individuals do to manage and prevent leg pain on their own?

While professional medical care is often necessary, self-care plays a crucial role in managing and preventing leg pain. Some effective self-care strategies include:

• Regular exercise to maintain strength and flexibility
• Proper nutrition to ensure adequate vitamin and mineral intake
• Good posture and ergonomics, especially during work or prolonged sitting
• Stress management techniques to reduce muscle tension
• Use of appropriate footwear and supportive devices when necessary

By incorporating these practices into daily life, individuals can significantly contribute to their leg health and potentially reduce the risk of developing chronic pain conditions.

When to Seek Immediate Medical Attention

Are there signs that indicate a need for urgent medical care for leg pain?

While many causes of leg pain are not immediately life-threatening, certain symptoms warrant immediate medical attention. These include:

• Sudden, severe pain accompanied by swelling or redness
• Leg pain associated with chest pain or difficulty breathing
• Signs of infection, such as fever or warmth in the affected area
• Sudden loss of sensation or paralysis in the leg
• Incontinence or difficulty controlling bladder or bowel function

These symptoms could indicate serious conditions such as deep vein thrombosis, compartment syndrome, or cauda equina syndrome, which require prompt medical intervention to prevent severe complications.

The Future of Leg Pain Management

What advancements are on the horizon for diagnosing and treating leg pain?

The field of leg pain management is continuously evolving, with promising developments in several areas:

• Advanced imaging techniques for more precise diagnosis
• Regenerative medicine approaches, such as stem cell therapy
• Targeted drug delivery systems for pain management
• Minimally invasive surgical techniques for faster recovery
• Wearable technology for real-time monitoring and pain management

These advancements hold the potential to improve diagnostic accuracy, enhance treatment efficacy, and provide more personalized care for individuals suffering from leg pain. As research progresses, we can expect even more innovative approaches to emerge, offering hope for better outcomes and improved quality of life for those affected by leg and foot pain.

Integrating Complementary Therapies

How can complementary therapies contribute to leg pain management?

In addition to conventional medical treatments, many individuals find relief through complementary therapies. These approaches can often be integrated into a comprehensive treatment plan, offering additional benefits:

• Acupuncture for pain relief and improved circulation
• Massage therapy to reduce muscle tension and promote relaxation
• Yoga or tai chi for improved flexibility and body awareness
• Mindfulness meditation for pain management and stress reduction
• Herbal remedies and supplements (under professional guidance)

While the effectiveness of these therapies can vary among individuals, many people report significant improvements in pain levels and overall well-being when incorporating these approaches into their care regimen. It’s important to discuss any complementary therapies with a healthcare provider to ensure they are safe and appropriate for your specific condition.

The Impact of Lifestyle on Leg Health

How do daily habits and lifestyle choices influence the development and management of leg pain?

Lifestyle factors play a significant role in both the onset and management of leg pain. Understanding and modifying these factors can have a profound impact on leg health:

• Physical activity levels: Regular exercise can improve circulation and muscle strength
• Diet and nutrition: A balanced diet supports overall health and can prevent nutrient deficiencies
• Smoking: Tobacco use can impair circulation and exacerbate leg pain
• Sleep patterns: Adequate rest allows for tissue repair and pain recovery
• Stress management: Chronic stress can contribute to muscle tension and pain

By addressing these lifestyle factors, individuals can create an environment conducive to leg health and potentially reduce the frequency and severity of pain episodes. Healthcare providers often work with patients to develop personalized lifestyle modification plans as part of a comprehensive treatment approach.

The Psychological Aspect of Chronic Leg Pain

How does chronic leg pain affect mental health, and how can this be addressed?

Chronic leg pain can have significant psychological impacts, often leading to:

• Depression and anxiety
• Sleep disturbances
• Reduced quality of life
• Social isolation
• Decreased work productivity

Addressing the psychological aspects of chronic pain is crucial for overall well-being and effective pain management. Strategies may include:

• Cognitive-behavioral therapy to develop coping mechanisms
• Support groups to connect with others experiencing similar challenges
• Mindfulness practices for pain acceptance and stress reduction
• Occupational therapy to maintain work and life roles
• Psychological counseling to address depression and anxiety

By integrating psychological support into the treatment plan, individuals can develop resilience, improve their quality of life, and potentially enhance the effectiveness of physical treatments for leg pain.

Causes of Leg Pain and Foot Pain

Leg pain and foot pain vary in type and severity and typically depend on a person’s lifestyle and associated medical problems.¹ In addition to leg pathology, leg pain may be caused by a condition affecting the lower back, hip, or pelvic region. The type of pain may differ based on the underlying cause.

Sciatica Causes and Symptoms Video

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Some conditions in the lower back can cause pain and other symptoms to radiate into the leg and/or foot, which may be termed as sciatica. Watch Sciatica Causes and Symptoms Video

This article provides a guide to the potential causes, specific diagnostic procedures, and the different types of treatment approaches available for leg and foot pain.

Spinal Causes of Leg Pain

Problems in the lower spine may affect the spinal nerve roots, causing pain to radiate into the leg and/or foot (radiculopathy). Common causes of leg and foot pain that originate in the spine include:

Compression of the spinal cord in the neck and/or cauda equina in the lower back can also cause leg pain.

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Blood Vessel Causes of Leg Pain

The arteries and/or veins in the legs may get inflamed or blocked, causing leg and foot pain. Common causes include:

• Peripheral artery disease: Decreased circulation caused due to blocked arteries.²
• Deep vein thrombosis: Blood clot in the deep vein(s) of the leg causing decreased or altered blood flow.³
• Superficial thrombophlebitis: Blood clots in the superficial veins of the leg causing varicose veins or spider veins to form underneath the skin surface.⁴

Blood vessels may also get ruptured and cause bleeding within the tissue spaces of the leg, causing acute pain and swelling.

In This Article:

Pelvis and Hip Related Causes of Leg Pain

Pain from the joints and/or muscles of the pelvis and hip may be referred into the legs. Common causes include:

• Piriformis syndrome: Spasm of the piriformis muscle in the pelvis impinging the sciatic nerve.

  See What Is Piriformis Syndrome?

• Sacroiliac joint dysfunction: Abnormal motion or malalignment of the sacroiliac joint.

  See Sacroiliac Joint Dysfunction (SI Joint Pain)

• Hip osteoarthritis: Wear-and-tear arthritis of the hip joint.

  Read about Hip Osteoarthritis on Arthritis-health.com

• Trochanteric bursitis: Inflammation of a fluid-filled sac (bursa) on the side of the hip.

  Read about Hip Bursitis on Arthritis-health.com

Pelvic bone fractures or other hip joint problems due to trauma, overuse, or degeneration may also cause leg pain.

Leg Pain due to Nerve Damage

Certain medical conditions may cause damage to the peripheral nerves in the leg. Common causes are:

Rarely, autoimmune conditions such as Guillain-Barré syndrome, where the body’s immune system attacks the peripheral nervous system may cause leg pain.⁵

Nutritional Causes of Leg Pain

Deficiency of certain vitamins and minerals may cause damage to the peripheral nerves (peripheral neuropathy) resulting in leg pain and/or weakness. Typical nutrient deficiencies include⁷:

• Vitamin B12
• Vitamin B6
• Copper

Excessive intake of alcohol and heavy metals, such as arsenic, thallium, or mercury may also cause peripheral nerve damage and pain in the legs.

Causes of Foot Pain and Numbness

Certain conditions may cause pain and/or numbness in the foot with or without leg pain. Foot pain commonly occurs in:

• Tarsal tunnel syndrome: Compression of the tibial nerve due to trauma, swelling, poorly fitting shoes, tendon problems, or enlarged arteries or veins.⁸
• Peroneal neuropathy: Compression of the peroneal nerve due to trauma, tumors, or other systemic conditions.⁹

  See All About Neuropathy And Chronic Back Pain

• Sural nerve entrapment: Compression of the sural nerve due to tumors, scar tissue, or from wearing tight ski boots.¹⁰
• L5 and/or S1 radiculopathy: Compression of the L5 or S1 nerve roots in the lower back.

  See All about L5-S1 (Lumbosacral Joint)

Severe foot weakness can cause foot drop (inability to lift the foot off the ground).

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Risk Factors for Leg Pain

A few risk factors associated with leg and foot pain include:

• Advanced age
• Genetics
• Poor posture
• Occupations, such as heavy labor, sports, or military service

While the listed causes and risk factors are not comprehensive, one or more of these conditions are typically associated with leg and foot pain.

Read more: Leg Pain and Numbness: What Might These Symptoms Mean?

Several causes of leg pain can produce overlapping signs and symptoms. It is important to accurately diagnose the underlying cause of leg pain in order to effectively treat the condition as well as rule out serious problems, such as tumors, infections, or nerve damage.

References

• 1.Brewer RB, Gregory AJ. Chronic lower leg pain in athletes: a guide for the differential diagnosis, evaluation, and treatment.  Sports Health. 2012;4(2):121–127. doi:10.1177/1941738111426115
• 2.Zemaitis MR, Bah F, Dreyer MA. Peripheral Arterial Disease. [Updated 2019 May 25]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK430745/
• 3.Stone J, Hangge P, Albadawi H, et al. Deep vein thrombosis: pathogenesis, diagnosis, and medical management. Cardiovasc Diagn Ther. 2017;7(Suppl 3):S276–S284. doi:10.21037/cdt.2017.09.01
• 4.Di Nisio M, Wichers IM, Middeldorp S. Treatment for superficial thrombophlebitis of the leg. Cochrane Database Syst Rev. 2018;2(2):CD004982. Published 2018 Feb 25. doi:10.1002/14651858.CD004982.pub6
• 5.Grimm BD, Blessinger BJ, Darden BV, Brigham CD, Kneisl JS, Laxer EB. Mimickers of Lumbar Radiculopathy. Journal of the American Academy of Orthopaedic Surgeons. 2015;23(1):7-17. doi:10.5435/jaaos-23-01-7
• 6.Hanewinckel R, Ikram MA, Van Doorn PA. Peripheral neuropathies. In: Neuroepidemiology. Elsevier; 2016:263-282. doi:10.1016/b978-0-12-802973-2.00015-x
• 7.Staff NP, Windebank AJ. Peripheral neuropathy due to vitamin deficiency, toxins, and medications. Continuum (Minneap Minn). 2014;20(5 Peripheral Nervous System Disorders):1293–1306. doi:10.1212/01.CON.0000455880.06675.5a
• 8.Kiel J, Kaiser K. Tarsal Tunnel Syndrome. [Updated 2019 Feb 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-.Available from: https://www.ncbi.nlm.nih.gov/books/NBK513273/
• 9.Poage C, Roth C, Scott B. Peroneal Nerve Palsy. Journal of the American Academy of Orthopaedic Surgeons. 2016;24(1):1-10. doi:10.5435/jaaos-d-14-00420
• 10.Brewer RB, Gregory AJ. Chronic lower leg pain in athletes: a guide for the differential diagnosis, evaluation, and treatment. Sports Health. 2012;4(2):121–127. doi:10.1177/1941738111426115

Causes, Symptoms, Treatment, Prevention & Pain Relief

Overview

True sciatica is an injury or irritation to the sciatic nerve, which starts in your buttock/gluteal area.

What is sciatica?

Sciatica is nerve pain from an injury or irritation to the sciatic nerve, which originates in your buttock/gluteal area. The sciatic nerve is the longest and thickest (almost finger-width) nerve in the body. It’s actually made up of five nerve roots: two from the lower back region called the lumbar spine and three from the final section of the spine called the sacrum. The five nerve roots come together to form a right and left sciatic nerve. On each side of your body, one sciatic nerve runs through your hips, buttocks and down a leg, ending just below the knee. The sciatic nerve then branches into other nerves, which continue down your leg and into your foot and toes.

True injury to the sciatic nerve “sciatica” is actually rare, but the term “sciatica” is commonly used to describe any pain that originates in the lower back and radiates down the leg. What this pain shares in common is an injury to a nerve — an irritation, inflammation, pinching or compression of a nerve in your lower back.

If you have “sciatica,” you experience mild to severe pain anywhere along the path of the sciatic nerve – that is, anywhere from the lower back, through the hips, buttocks and/or down your legs. It can also cause muscle weakness in your leg and foot, numbness in your leg, and an unpleasant tingling pins-and-needles sensation in your leg, foot and toes.

What does sciatica pain feel like?

People describe sciatica pain in different ways, depending on its cause. Some people describe the pain as sharp, shooting, or jolts of pain. Others describe this pain as “burning,” “electric” or “stabbing.”

The pain may be constant or may come and go. Also, the pain is usually more severe in your leg compared to your lower back. The pain may feel worse if you sit or stand for long periods of time, when you stand up and when your twist your upper body. A forced and sudden body movement, like a cough or sneeze, can also make the pain worse.

Can sciatica occur down both legs?

Sciatica usually affects only one leg at a time. However, it’s possible for sciatica to occur in both legs. It’s simply a matter of where the nerve is being pinched along the spinal column.

Does sciatica occur suddenly or does it take time to develop?

Sciatica can come on suddenly or gradually. It depends on the cause. A disk herniation can cause sudden pain. Arthritis in the spine develops slowly over time.

How common is sciatica?

Sciatica is a very common complaint. About 40% of people in the U.S. experience sciatica sometime during their life. Back pain is the third most common reason people visit their healthcare provider.

What are the risk factors for sciatica?

You are at greater risk of sciatica if you:

• Have an injury/previous injury: An injury to your lower back or spine puts you at greater risk for sciatica.
• Live life: With normal aging comes a natural wearing down of bone tissue and disks in your spine. Normal aging can put your nerves at risk of being injured or pinched by the changes and shifts in bone, disks and ligaments.
• Are overweight: Your spine is like a vertical crane. Your muscles are the counterweights. The weight you carry in the front of your body is what your spine (crane) has to lift. The more weight you have, the more your back muscles (counterweights) have to work. This can lead to back strains, pains and other back issues.
• Lack a strong core: Your “core” are the muscles of your back and abdomen. The stronger your core, the more support you’ll have for your lower back. Unlike your chest area, where your rib cage provides support, the only support for your lower back is your muscles.
• Have an active, physical job: Jobs that require heavy lifting may increase your risk of low back problems and use of your back, or jobs with prolonged sitting may increase your risk of low back problems.
• Lack proper posture in the weight room: Even if you are physically fit and active, you can still be prone to sciatica if you don’t follow proper body form during weight lifting or other strength training exercises.
• Have diabetes: Diabetes increases your chance of nerve damage, which increases your chance of sciatica.
• Have osteoarthritis: Osteoarthritis can cause damage to your spine and put nerves at risk of injury.
• Lead an inactive lifestyle: Sitting for long period of time and not exercising and keeping your muscles moving, flexible and toned can increase your risk of sciatica.
• Smoke: The nicotine in tobacco can damage spinal tissue, weaken bones, and speed the wearing down of vertebral disks.

Is the weight of pregnancy the reason why so many pregnant women get sciatica?

It’s true that sciatica is common in pregnancy but increased weight is not the main reason why pregnant women get sciatica. A better explanation is that certain hormones of pregnancy cause a loosening of their ligaments. Ligaments hold the vertebrae together, protect the disks and keep the spine stable. Loosened ligaments can cause the spine to become unstable and might cause disks to slip, which leads to nerves being pinched and the development of sciatica. The baby’s weight and position can also add pressure to the nerve.

The good news is there are ways to ease sciatic pain during pregnancy, and the pain goes away after birth. Physical therapy and massage therapy, warm showers, heat, medications and other measures can help. If you are pregnant, be sure to follow good posture techniques during pregnancy to also ease your pain.

Symptoms and Causes

What causes sciatica?

Sciatica can be caused by several different medical conditions including:

• A herniated or slipped disk that causes pressure on a nerve root. This is the most common cause of sciatica. About 1% to 5% of all people in the U.S. will have a slipped disk at one point in their lives. Disks are the cushioning pads between each vertebrae of the spine. Pressure from vertebrae can cause the gel-like center of a disk to bulge (herniate) through a weakness in its outer wall. When a herniated disk happens to a vertebrae in your lower back, it can press on the sciatic nerve.

• Degenerative disk disease is the natural wear down of the disks between vertebrae of the spine. The wearing down of the disks shortens their height and leads to the nerve passageways becoming narrower (spinal stenosis). Spinal stenosis can pinch the sciatic nerve roots as they leave the spine.
• Spinal stenosis is the abnormal narrowing of the spinal canal. This narrowing reduces the available space for the spinal cord and nerves.

• Spondylolisthesis is a slippage of one vertebra so that it is out of line with the one above it, narrowing the opening through which the nerve exits. The extended spinal bone can pinch the sciatic nerve.
• Osteoarthritis. Bone spurs (jagged edges of bone) can form in aging spines and compress lower back nerves.
• Trauma injury to the lumbar spine or sciatic nerve.
• Tumors in the lumbar spinal canal that compress the sciatic nerve.
• Piriformis syndrome is a condition that develops when the piriformis muscle, a small muscle that lies deep in the buttocks, becomes tight or spasms. This can put pressure on and irritate the sciatic nerve. Piriformis syndrome is an uncommon neuromuscular disorder.
• Cauda equina syndrome is a rare but serious condition that affects the bundle of nerves at the end of the spinal cord called the cauda equina. This syndrome causes pain down the leg, numbness around the anus and loss of bowel and bladder control.

What are the symptoms of sciatica?

The symptoms of sciatica include:

• Moderate to severe pain in lower back, buttock and down your leg.
• Numbness or weakness in your lower back, buttock, leg or feet.
• Pain that worsens with movement; loss of movement.
• “Pins and needles” feeling in your legs, toes or feet.
• Loss of bowel and bladder control (due to cauda equina).

Diagnosis and Tests

Straight leg raise test helps spot your point of pain. This test helps identify a disk problem.

How is sciatica diagnosed?

First, your healthcare provider will review your medical history. Next, they’ll ask about your symptoms.

During your physical exam, you will be asked to walk so your healthcare provider can see how your spine carries your weight. You may be asked to walk on your toes and heels to check the strength of your calf muscles. Your provider may also do a straight leg raise test. For this test, you’ll lie on your back with your legs straight. Your provider will slowly raise each leg and note the point at which your pain begins. This test helps pinpoint the affected nerves and determines if there is a problem with one of your disks. You will also be asked to do other stretches and motions to pinpoint pain and check muscle flexibility and strength.

Depending on what your healthcare provider discovers during your physical exam, imaging and other tests might be done. These may include:

• Spinal X-rays to look for spinal fractures, disk problems, infections, tumors and bone spurs.
• Magnetic resonance imaging (MRI) or computed tomography (CT) scans to see detailed images of bone and soft tissues of the back. An MRI can show pressure on a nerve, disk herniation and any arthritic condition that might be pressing on a nerve. MRIs are usually ordered to confirm the diagnosis of sciatica.
• Nerve conduction velocity studies/electromyography to examine how well electrical impulses travel through the sciatic nerve and the response of muscles.
• Myelogram to determine if a vertebrae or disk is causing the pain.

Management and Treatment

How is sciatica treated?

The goal of treatment is to decrease your pain and increase your mobility. Depending on the cause, many cases of sciatica go away over time with some simple self-care treatments.

Self-care treatments include:

• Appling ice and/or hot packs: First, use ice packs to reduce pain and swelling. Apply ice packs or bag of frozen vegetables wrapped in a towel to the affected area. Apply for 20 minutes, several times a day. Switch to a hot pack or a heating pad after the first several days. Apply for 20 minutes at a time. If you’re still in pain, switch between hot and cold packs – whichever best relieves your discomfort.
• Taking over-the-counter medicines: Take medicines to reduce pain, inflammation and swelling. The many common over-the-counter medicines in this category, called non-steroidal anti-inflammatory drugs (NSAIDs), include aspirin, ibuprofen (Advil®, Motrin®) and naproxen (Naprosyn®, Aleve®). Be watchful if you choose to take aspirin. Aspirin can cause ulcers and bleeding in some people. If you’re unable to take NSAIDS, acetaminophen (Tylenol®) may be taken instead.
• Performing gentle stretches: Learn proper stretches from an instructor with experience with low back pain. Work up to other general strengthening, core muscle strengthening and aerobic exercises.

How long should I try self-care treatments for my sciatica before seeing my healthcare professional?

Every person with sciatic pain is different. The type of pain can be different, the intensity of pain is different and the cause of the pain can be different. In some patients, a more aggressive treatment may be tried first. However, generally speaking, if a six-week trial of conservative, self-care treatments – like ice, heat, stretching, over-the-counter medicines – has not provided relief, it’s time to return to a healthcare professional and try other treatment options.

Other treatment options include:

• Prescription medications: Your healthcare provider may prescribe muscle relaxants, such as cyclobenzaprine (Amrix®, Flexeril®), to relieve the discomfort associated with muscle spasms. Other medications with pain-relieving action that may be tried include tricyclic antidepressants and anti-seizure medications. Depending on your level of pain, prescription pain medicines might be used early in your treatment plan.
• Physical therapy: The goal of physical therapy is to find exercise movements that decrease sciatica by reducing pressure on the nerve. An exercise program should include stretching exercises to improve muscle flexibility and aerobic exercises (such as walking, swimming, water aerobics). Your healthcare provider can refer you to a physical therapist who’ll work with you to customize your own stretching and aerobic exercise program and recommend other exercises to strengthen the muscles of your back, abdomen and legs.
• Spinal injections: An injection of a corticosteroid, an anti-inflammatory medicine, into the lower back might help reduce the pain and swelling around the affected nerve roots. Injections provide short-time (typically up to three months) pain relief and is given under local anesthesia as an outpatient treatment. You may feel some pressure and burning or stinging sensation as the injection is being given. Ask your healthcare provider about how many injections you might be able to receive and the risks of injections.
• Alternative therapies: Alternative therapies are increasingly popular and are used to treat and manage all kinds of pain. Alternative methods to improve sciatic pain include spine manipulation by a licensed chiropractor, yoga or acupuncture. Massage might help muscle spasms that often occur along with sciatica. Biofeedback is an option to help manage pain and relieve stress.

When is surgery considered?

Spinal surgery is usually not recommended unless you have not improved with other treatment methods such as stretching and medication, your pain is worsening, you have severe weakness in the muscles in your lower extremities or you have lost bladder or bowel control.

How soon surgery would be considered depends on the cause of your sciatica. Surgery is typically considered within a year of ongoing symptoms. Pain that is severe and unrelenting and is preventing you from standing or working and you’ve been admitted to a hospital would require more aggressive treatment and a shorter timeline to surgery. Loss of bladder or bowel control could require emergency surgery if determined to be cauda equine syndrome.

The goal of spinal surgery for sciatic pain is to remove the pressure on the nerves that are being pinched and to make sure the spine is stable.

Surgical options to relieve sciatica include:

Microdiscectomy: This is a minimally invasive procedure used to remove fragments of a herniated disk that are pressing on a nerve.

• Laminectomy: In this procedure, the lamina (part of the vertebral bone; the roof of the spinal canal) that is causing pressure on the sciatic nerve is removed.

How long does it take to perform spine surgery and what’s the typical recovery time?

Discectomy and laminectomy generally take one to two hours to perform. Recovery time depends on your situation; your surgeon will tell you when you can get back to full activities. Generally the time needed to recover is six weeks to three months.

What are the risks of spinal surgery?

Though these procedures are considered very safe and effective, all surgeries have risks. Spinal surgery risks include:

What complications are associated with sciatica?

Most people recover fully from sciatica. However, chronic (ongoing and lasting) pain can be a complication of sciatica. If the pinched nerve is seriously injured, chronic muscle weakness, such as a “drop foot,” might occur, when numbness in the foot makes normal walking impossible. Sciatica can potentially cause permanent nerve damage, resulting in a loss of feeling in the affected legs. Call your provider right away if you lose feeling in your legs or feet, or have any concerns during your recovery time.

Prevention

Can sciatica be prevented?

Some sources of sciatica may not be preventable, such as degenerative disk disease, sciatica due to pregnancy or accidental falls. Although it might not be possible to prevent all cases of sciatica, taking the following steps can help protect your back and reduce your risk:

• Maintain good posture: Following good posture techniques while you’re sitting, standing, lifting objects and sleeping helps relieve pressure on your lower back. Pain can be an early warning sign that you are not properly aligned. If you start to feel sore or stiff, adjust your posture.
• Don’t smoke: Nicotine reduces the blood supply to bones. It weakens the spine and the vertebral disks, which puts more stress on the spine and disks and causes back and spine problems.
• Maintain a healthy weight: Extra weight and a poor diet are associated with inflammation and pain throughout your body. To lose weight or learn healthier eating habits, look into the Mediterranean diet. The closer you are to your ideal body weight the less strain you put on your spine.
• Exercise regularly: Exercise includes stretching to keep your joints flexible and exercises to strengthen your core – the muscles of your lower back and abdomen. These muscles work to support your spine. Also, do not sit for long periods of time.
• Choose physical activities least likely to hurt your back: Consider low-impact activities such as swimming, walking, yoga or tai chi.
• Keep yourself safe from falls: Wear shoes that fit and keep stairs and walkways free of clutter to reduce your chance of a fall. Make sure rooms are well-lighted and there are grab bars in bathrooms and rails on stairways.

Outlook / Prognosis

What can I expect if I have been diagnosed with sciatica?

The good news about sciatic pain is that it usually goes away on its own with time and some self-care treatments. Most people (80% to 90%) with sciatica get better without surgery, and about half of these recover from an episode fully within six weeks.

Be sure to contact your healthcare provider if your sciatica pain is not improving and you have concerns that you aren’t recovering as quickly as hoped.

Living With

When should I contact my healthcare provider?

Get immediate medical attention if you experience:

• Severe leg pain lasting more than a few hours that is unbearable.
• Numbness or muscle weakness in the same leg.
• Bowel or bladder control loss. This could be due to a condition called cauda equina syndrome, which affects bundles of nerves at the end of the spinal cord.
• Sudden and severe pain from a traffic accident or some other trauma.

Even if your visit doesn’t turn out to be an emergency situation, it’s best to get it checked out.

Is the sciatic nerve the only source of “sciatica” pain?

No, the sciatic nerve is not the only source of what is generally called “sciatica” or sciatica pain. Sometimes the source of pain is higher up in the lumbar spine and causes pain in front of the thigh or in the hip area. This pain is still called sciatica.

How can I tell if pain in my hip is a hip issue or sciatica?

Hip problems, such as arthritis in the hip, usually cause groin pain, pain when you put weight on your leg, or when the leg is moved around.

If your pain starts in the back and moves or radiates towards the hip or down the leg and you have numbness, tingling or weakness in the leg, sciatica is the most likely cause.

Is radiculopathy the same as sciatica?

Radiculopathy is a broader term that describes the symptoms caused by a pinched nerve in the spinal column. Sciatica is a specific type, and the most common type, of radiculopathy.

Should I rest if I have sciatica?

Some rest and change in your activities and activity level may be needed. However, too much rest, bed rest, and physical inactivity can make your pain worse and slow the healing process. It’s important to maintain as much activity as possible to keep muscles flexible and strong.

Before beginning your own exercise program, see your healthcare provider or spine specialist first to get a proper diagnosis. This healthcare professional will refer you to the proper physical therapist or other trained exercise or body mechanics specialist to devise an exercise and muscle strengthening program that’s best for you.

Can sciatica cause my leg and/or ankle to swell?

Sciatica that is caused by a herniated disk, spinal stenosis, or bone spur that compresses the sciatic nerve can cause inflammation – or swelling – in the affected leg. Complications of piriformis syndrome can also cause swelling in the leg.

Are restless leg syndrome, multiple sclerosis, carpal tunnel syndrome, plantar fasciitis, shingles or bursitis related to sciatica?

While all these conditions affect either the spinal cord, nerves, muscles, ligaments or joints and all can cause pain, none are directly related to sciatica. The main causes of these conditions are different. Sciatica only involves the sciatic nerve. That being said, the most similar condition would be carpal tunnel syndrome, which also involves a compression of a nerve.

A final word about sciatica. . . .

Most cases of sciatica do not require surgery. Time and self-care treatment are usually all that’s needed. However, if simple self-care treatments do not relieve your pain, see your healthcare provider. Your healthcare provider can confirm the cause of your pain, suggest other treatment options and/or refer you to other spine health specialists if needed.

Sacroiliac Joint Dysfunction | Cedars-Sinai

Overview

Dysfunction in the sacroiliac joint is thought to cause low back pain and/or leg pain. The leg pain can be particularly difficult and may feel similar to sciatica or pain caused by a lumbar disc herniation. The sacroiliac joint lies next to the bottom of the spine, below the lumbar spine and above the tailbone (coccyx). It connects the sacrum (the triangular bone at the bottom of the spine) with the pelvis (iliac crest).

The joint typically has the following characteristics:

• Small and very strong, reinforced by strong ligaments that surround it
• Does not have much motion
• Transmits all the forces of the upper body to the pelvis (hips) and legs
• Acts as a shock-absorbing structure

Symptoms

The most common symptoms for patients are lower back pain and the following sensations in the lower extremity: pain, numbness, tingling, weakness, pelvis/buttock pain, hip/groin pain, feeling of leg instability (buckling, giving way), disturbed sleep patterns, disturbed sitting patterns (unable to sit for long periods, sitting on one side), pain going from sitting to standing.

Causes and Risk Factors

While it is not clear how the pain is caused, it is thought that an alteration in the normal joint motion may be the culprit that causes sacroiliac pain. This source of pain can be caused by either:

Too much movement (hypermobility or instability): The pain is typically felt in the lower back and/or hip and may radiate into the groin area.

Too little movement (hypomobility or fixation): The pain is typically felt on one side of the lower back or buttocks and can radiate down the leg. The pain usually remains above the knee, but at times pain can extend to the ankle or foot. The pain is similar to sciatica — or pain that radiates down the sciatic nerve — and is caused by a radiculopathy.

Diagnosis

Accurately diagnosing sacroiliac joint dysfunction can be difficult because the symptoms mimic other common conditions, including other mechanical back pain conditions like facet syndrome and lumbar spine conditions including disc herniation and radiculopathy (pain along the sciatic nerve that radiates down the leg). A diagnosis is usually arrived at through physical examination (eliminating other causes) and/or an injection (utilized to block the pain).

Treatment

Treatments for sacroiliac joint dysfunction are usually conservative (meaning nonsurgical) and focus on trying to restore normal motion in the joint:

• Ice, heat and rest.
• Medications: acetaminophen, as well as anti-inflammatory medications (such as ibuprofen or naproxen) to reduce the swelling that is usually contributing to the patient’s pain.
• Manual manipulation provided by a chiropractor, osteopathic doctor or other qualified health practitioner may help. This can be highly effective when the sacroiliac joint is fixated or “stuck.” It may be irritating if the sacroiliac joint is hypermobile. The manipulation is accomplished through a number of methods, including (but not limited to): side-posture manipulation, drop technique, blocking techniques and instrument-guided methods.
• Supports or braces for when the sacroiliac joint is “hypermobile,” or too loose.
• Controlled, gradual physical therapy may be helpful to strengthen the muscles around the sacroiliac joint and appropriately increase range of motion. In addition, any type of gentle, low-impact aerobic exercise will help increase the flow of blood to the area, which in turn stimulates a healing response. For severe pain, water therapy may be an option, as the water provides buoyancy for the body and reduces stress on the painful joint.
• Sacroiliac joint injections.

When these treatments fail, surgery may be offered. In surgery, one or both of the sacroiliac joints may be fused with the goal of eliminating any abnormal motion.

© 2000-2021 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional’s instructions.

Piriformis Syndrome | Cedars-Sinai

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Overview

Piriformis syndrome is a condition in which the piriformis muscle, located in the buttock region, spasms and causes buttock pain. The piriformis muscle also can irritate the nearby sciatic nerve and cause pain, numbness and tingling along the back of the leg and into the foot (similar to sciatic pain).

The piriformis muscle:

• Starts at the lower spine and connects to the upper surface of each femur (thighbone)
• Functions to assist in rotating the hip and turning the leg and foot outward
• Runs diagonally, with the sciatic nerve running vertically directly beneath it (although in some people the nerve can run through the muscle)

Symptoms

Most patients describe symptoms of acute tenderness in the buttock and sciatica-like pain down the back of the thigh, calf and foot. Typical piriformis syndrome symptoms may include:

• A dull ache in the buttock
• Pain down the back of the thigh, calf and foot (sciatica)
• Pain when walking up stairs or inclines
• Increased pain after prolonged sitting
• Reduced range of motion of the hip joint

These symptoms often become worse after prolonged sitting, walking or running, and may feel better after lying down on the back.

Causes and Risk Factors

The exact causes of piriformis syndrome are unknown. Suspected causes include:

• Muscle spasm in the piriformis muscle, either because of irritation in the muscle itself or irritation of a nearby structure such as the sacroiliac joint or hip
• Tightening of the muscle, in response to injury or spasm
• Swelling of the piriformis muscle, due to injury or spasm
• Bleeding in the area of the piriformis muscle

Any of the above problems, or a combination of them, can affect the muscle, causing buttock pain, and may affect the adjacent sciatic nerve (causing pain, tingling or numbness in the back of the thigh, calf or foot).

Diagnosis

Diagnosis of piriformis syndrome is based on a review of the patient’s medical history, a physical examination and possibly diagnostic tests (such as X-rays, MRI or nerve conduction tests).

Piriformis syndrome is often diagnosed through a process of ruling out other possible conditions that may be causing the patient’s symptoms, such as a lumbar disc herniation or sacroiliac joint dysfunction.

Treatment

Almost every treatment for piriformis syndrome will include a focus on carefully and progressively stretching the muscle.

Other treatment modalities include:

• Physical therapy: Range-of-motion exercises and deep massage
• Ice packs and ice massage
• Heat therapy
• Medications: anti-inflammatory medications (such as ibuprofen or naproxen) to reduce the swelling that is usually contributing to the patient’s pain
• Injections: corticosteroid plus a local anesthetic; Botox
• TENS unit

© 2000-2021 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional’s instructions.

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Lower Extremity Pain – Hip, Knee, Ankle, Foot

Hip Pain and Causes

Hip pain is very common among all ages and can cause mild to severe discomfort when performing daily activities such as standing, walking, squatting, bending, and climbing stairs. Hip pain can be described as dull, achy, sharp, shooting, or tingling.  Muscle strains, tendinitis, or bursitis can occur outside the hip joint and femoral acetabular impingement (FAI), labral tears or osteoarthritis can occur inside the hip joint. The hip joint, also referred to as the femoral acetabular joint, is extremely important because it helps connect the upper body to the lower extremities. It is responsible for dissipating loads from the upper body to the lower body, while providing stability, trunk control, and balance. While the hips are designed to support our bodyweight, every hip is different in terms of alignment and orientation. As movement experts, a physical therapist not only treats conditions such as strains, tendinitis, bursitis, and osteoarthritis, but also assesses each patient’s biomechanics to treat underlying impairments that can cause hip pain.  

Common causes of hip pain include: 

• Muscle Strains and tendinitis: A strain occurs when a muscle supporting the hip is stretched beyond its limits. This results in pain, tenderness, and tightness around the hip. Muscle strains can occur in the front of the hip, in the back of the hip, or on the side of the hip. Strains usually occur when the muscle is in its most lengthened position (think of a runner pulling his hamstring when the leg is completely straight). Overuse of the muscles in these areas can also lead to tendinitis and tendinopathy.  
• Bursitis: A bursa is a fluid filled sac located where muscles and tendons move over bones in order to reduce friction. With trauma or overuse, the bursa can become inflamed or swollen, causing pain and limiting range of motion. The most common is greater trochanter bursitis, which causes pain on the outer most aspect of the hip. Usually, bursitis is a secondary result of tendinopathy of a muscle.  
• Snapping hip syndrome (often referred to as dancer’s hip): Snapping or popping while walking or with leg movement can occur along the front of the hip (snapping of the iliopsoas), or along the outside of the hip (snapping of the IT Band/glute complex).  
• Femoral Acetabular Impingement (FAI): Impingement of the hip is very common and can be described as abnormal contact between the femur (the long thigh bone) and the acetabulum (the socket of the hip bone where the femur inserts). This results in increased friction with hip movement overtime that can to labral tears. Hip impingement causes pain and stiffness throughout the joint and results in progressive loss of motion if not treated. Popping and clicking occur with hip flexion and rotation. 
• Acetabular labral tears: Tears to the labrum be degenerative due to FAI or caused by a trauma to the hip. They are characterized by clicking and popping along the groin area. With labral tears, lying on your back and raising a straight leg will cause pain. 
• Osteoarthritis: Hip OA is one of the leading sources of pain for elderly individuals. Pain is usually worse in the morning and decreases throughout the day with movement. However, there is much more to it than the joint simply being bone-on-bone! Abnormal changes such as cartilage degradation and bone spurs can alter normal joint function, resulting in pain, limited range of motion, and compensation through areas of the body. 
• Pinched nerves: Numbness, tingling, and radiating pain into leg can be caused by impingement of a nerve in the hip (it is not always stemming from the back!). We’ve all heard of the dreaded sciatica that can shoot pain down the back of your leg. Other nerves can also be impinged causing pain to radiate down the front, middle, and outer aspect of the leg as well.  

How can Physical Therapy help? 

A PT will perform a thorough evaluation to determine the structure that is injured or painful, but more importantly why it is injured or painful. Your past medical history will be reviewed to determine any possible underlying causes of pain. The problem is often coming from another non-painful part of the body. If you keep putting air in a tire without fixing the gash, then you will continue to have a problem. For example, progressive hip impingement (FAI) can be the result of stiffness and/or weakness in the core, low back, hip, knee, or ankle. Your PT will design a treatment program to correct any of these underlying mobility or strength deficits, so your problem doesn’t return once the painful structure is healed. For more information on different treatments we offer click here. –   The goal of physical therapy is to get patients moving pain free, so that they can perform activities they enjoy and live life the fullest! 

Knee Pain and Causes 

The knee is arguably the most injured joint in the body. It is a complex joint that takes the brunt of compressive forces during standing, walking, and running. Even in people not experiencing pain, the knee can make sounds like Rice Krispies Cereal: Snap, crackle, and pop. Knee injuries can occur at any age and are the result of sudden trauma, overuse, lack of use, or underlying conditions such as arthritis. Pain can be felt around the kneecap, behind the knee, or inside the joint. Common injuries include muscle strains, ligament sprains, patella femoral pain syndrome, patellar tendinitis, IT band syndrome, bursitis, meniscal injuries, and osteoarthritis. Each can have a negative effect on everyday activities such as standing, walking, squatting, climbing stairs, and even getting in and out of a car. Luckily, most knee injuries respond very well to physical therapy and conservative management.  

Common knee injuries include: 

• Muscle strains: A strain occurs when a muscle supporting the knee is stretched beyond its limits. This results in pain, tenderness, and tightness around the knee, behind the thigh, or in front of the thigh. Strains usually occur when the muscle is in its most lengthened position (think of a runner pulling his hamstring when the leg is completely straight). Overuse of the muscles in these areas can also lead to tendinitis and tendinopathy.  
• Ligament sprains: There are numerous ligaments that stabilize the knee, but the four most important are the anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), medial collateral ligament (MCL), and lateral collateral ligament (LCL). Like muscles, a ligament can be sprained when it is stressed beyond its limits. When this occurs, it will leave the knee feeling unstable, often causing it to buckle with weightbearing movements.  
• Patella femoral pain syndrome (PFPS): Pain is usually felt around or underneath the kneecap. PFPS is more common in young, active populations during activities such as running and jumping, but pain can also occur during prolonged sitting. The culprit causing the pain is weakened quadriceps and weak areas of the hip that cause the kneecap to move abnormally.  
• Patellar tendinitis: Pain is felt below the knee, along the patellar tendon, close to the tibial tubercle (the bony area below the knee). It is a common injury in activities requiring sprinting and jumping when the patellar tendon is loaded or stressed excessively.  It can also make going up and down stairs very difficult. In adolescents, you may see similar injuries referred to as Osgood- Schlatters or Sinding-Larsen-Johansson disease.  
• Iliotibial Band Friction Syndrome (IT band syndrome): The most common running injury is known as IT Band syndrome and pain is usually felt along the outside of the thigh and knee. The IT Band moves over the outside of the knee when the knee is flexed and extended. So, activities that slowly and repeatedly bend and straighten the knee such as speed walking and jogging can cause a great deal of friction and tension along the IT Band. However, even though pain is felt in the knee, IT Band syndrome arises from strength deficits at the hip.  
• Bursitis: A bursa is a fluid filled sac located where muscles and tendons move over bones in order to reduce friction. The knee has five bursae, but the pre patella bursa on the front of the knee is the most commonly irritated with kneeling or a direct blow to the kneecap. It becomes inflamed or swollen, which causes pain and limited range of motion. 
• Meniscal injuries: The two menisci play a very important role in making the femur (the long bone in the thigh) and tibia (lower leg) fit together perfectly (the knee would be incongruent without the menisci). They also absorb up to 70% of compressive forces placed on the knee. Injuries to the menisci can be acute from sudden twisting or degenerative in nature due to long periods of poor biomechanics and muscle imbalances. Symptoms include pain around the knee joint, as well as popping and clicking with movement.  
• Osteoarthritis (OA): Knee OA can be debilitating and can get progressively worse if not treated. Pain is usually worse in the morning and decreases throughout the day with movement. However, there is much more to it than the joint simply being bone-on-bone! Abnormal changes such as cartilage degradation and bone spurs can alter normal joint function, resulting in pain, limited range of motion, and compensation through areas of the body. However, surgery does not have to be the answer and should never be the first line of defense.  

How can Physical Therapy help? 

A PT will perform a thorough evaluation to determine the structure that is injured or painful, but more importantly why it is injured or painful. The problem is often coming from another non-painful part of the body. Remember, a great deal of compressive and shear force is placed on the knee with everyday activity. If other structures in the leg are not functioning optimally, these forces will increase, leading to injury. For example, patellar femoral pain can be the result of stiffness in the hip or ankle and/or weakness in the gluteal muscles. IT Band Syndrome stems for hip stiffness and/or weakness in either the gluteals or the tensor fascia late (TFL). Your PT will design a treatment program to correct any of these underlying mobility or strength deficits, so your problem doesn’t return once the painful structure is healed. For more information on different treatments we offer click here. –   The goal of physical therapy is to get patients moving pain free, so that they can perform activities they enjoy and live life the fullest! 

Foot/Ankle Pain and Causes

From elite athletes to a person walking on the street, ankle and foot injuries can happen to anyone, at any time.  The ankle/foot complex consists of 26 bones and over 30 joints, all of which are vital in helping people get around. The ankle and foot have three major functions: 1) An adaptor that conforms to terrain and provides balances strategies. 2) A rigid lever to allow individuals to propel themselves from point A to point B. 3) A shock absorber to transmit forces when the ground is contacted. Examples of injuries to the ankle and foot include ankle sprains, calf strains, Achilles tendinitis, shin splints, plantar fasciitis, calcaneal bursitis, and bunions over the big toe. Overuse injuries can cause pain upon waking up or after prolonged activities. Sudden, acute injuries, such as ankle sprains, can occur out of nowhere, like stepping awkwardly on a curb. Physical therapy will treat the injured structure, as well as address any underlying impairments that may have led to the injury.

• Ankle Sprains: Ligament sprains to the outside of the ankle are considered the most common ankle injury. They occur when the foot twists or rolls inward, causing the ligaments along the outside of the ankle to be overstretched. A less common sprain can occur to the inside of the ankle when the foot rolls or rotates outward. This disrupts the syndesmosis between the tibia and fibula (the joint between the two lower leg bones) and is often referred to as a high ankle sprain. A physical therapist can determine the severity of the sprain by examining range of motion, swelling, bruising, and tenderness.
• Calf strains: The calf runs along the back of the lower leg and can be strained when it is stretched beyond its limits. This occurs when the foot is flexed upward while the knee if fully extended. The result is pain and tightness along the back of the lower leg.
• Achilles tendinitis: The Achilles is the largest tendon in the body. It spans from the calf muscle to the heel. It is commonly injured when the tendon is placed under excessive load during activities such as running, jumping, and climbing. The abrupt action of pushing off and lifting your foot can cause pain just above the heel. Instances where a popping noise occurs could be due to a tear of the Achilles tendon.
• Shin splints (Medial tibial stress syndrome): Aching pain to the lower half of the leg during activity has often been referred to as shin splints (although the more accurate term is medial tibial stress syndrome). The pain usually occurs at the beginning and after running activities due to repeated microtrauma to the lower leg. Also, the aching symptoms are reported along most of the front of the leg. Conversely, stress fractures are characterized by a pinpoint pain location. Muscle imbalances in the lower leg, weakness in foot musculature, and decreased ankle range of motion can cause medial tibial stress syndrome.
• Plantar Fasciitis: Excess pressure to the bottom of the heel can cause irritation to the tissue that runs along the bottom of the foot. Pain is felt on the heel, usually within the first few steps of the day or after prolonged activity. Risk factors for plantar fasciitis include decreased ankle range of motion, decreased big toe extension, an increased body mass index, and even hamstring tightness.
• Calcaneal Bursitis: A bursa is a fluid filled sac located where muscles and tendons move over bones in order to reduce friction. The calcaneal bursa is located between the Achilles tendon and the calcaneus (heel bone). The bursa can get inflamed or swollen with overuse and pain is experienced at the end of the day or after prolonged activity.
• Bunions at the 1^st Ray: When there is decreased ankle/foot range of motion and poor biomechanics with walking, a bony bump (bunion) can form at the base of the big toe. The base of the big toe begins to stick out and the tip is pulled towards the other toes. Poor mechanics with walking can also be caused by impairments higher up the lower extremity chain in the low back, hip, and knee.

How can Physical Therapy help?

A PT will perform a thorough evaluation to determine the structure that is injured or painful, but more importantly why it is injured or painful. The problem is often coming from another non-painful part of the body. If other structures in the leg are not functioning optimally, the ankle and foot will be forced to compensate, leading to injury. For example, a bunion at the first ray can be the result of weakness in the gluteal muscles and/or deep muscles that rotate the hip. This leads to overpronation when walking (the arch of the foot collapses) and excessive stress at the base of the big toe. Your PT will design a treatment program to correct any of these underlying mobility or strength deficits, so your problem doesn’t return once the painful structure is healed. For more information on different treatments we offer click here. –   The goal of physical therapy is to get patients moving pain free, so that they can perform activities they enjoy and live life the fullest!

HIP, LEG PAIN and KNEE PAIN

Certain diseases also lead to hip injuries or problems that may be treated by your doctor and/or Orthopedic Surgeon. Patient may also experience hip pain due to pathology originating from low back spine including disk herniation, sacroiliac disease, facet joint arthritis or spinal stenosis.

Sciatica is a pain that runs along the sciatic nerve, a large nerve extending from the lower back and down the back of each leg. Sciatica is a common kind of back pain. Although sciatica can be very painful, it is rare for the disorder to cause permanent nerve damage.

• Pain in the rear or leg that is worse when sitting
• Burning or tingling down the leg
• Weakness, numbness, or difficulty moving the leg or foot
• A constant pain on one side of the rear
• A shooting pain that makes it difficult to stand up

Sciatica usually affects only one side of the lower body. Often, the pain extends from the lower back all the way through the back of the thigh and down the leg. Depending on where the sciatic nerve is affected, the pain might also extend to the foot or toes. For some people, the pain from sciatica can be severe and debilitating. For others, the pain from sciatica might be infrequent and irritating, but has the potential to get worse.

Any condition that causes irritation to the sciatic nerve can cause the pain associated with sciatica. In many cases, sciatica is caused by pressure on the sciatic nerve from a herniated disc (also called a slipped disc or ruptured disc). Additional common causes of sciatica include:

• Lumbar spinal stenosis (narrowing of spinal canal in the lower back
• Degenerative disc disease (breakdown of discs, which act as cushions between the vertebrae)
• Weakness, numbness, or difficulty moving the leg or foot
• Spondylolisthesis (a condition in which one vertebra slips forward over another one)
• Pregnancy

In diagnosing sciatica, a doctor will take your medical history and perform an examination of the back, hips, and legs in order to test for strength, flexibility, sensation, and reflexes.

Other tests might include:

• X rays
• MRI scans
• CT scans

Nerve conduction studies are when an electrical current is passed through a nerve to determine the health or disease of that nerve and these are sometimes used.

Treatment for sciatica focuses on relieving pressure and inflammation. Typical sciatica treatments include:

• Medical treatments, such as non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, oral steroids.
• Epidural steroid injections where steroids, with their strong anti-inflammatory effects, are delivered at the origin of the inflamed sciatic nerve roots.
• Physical therapy usually starts after adequate pain control, and has an essential role both for the acute episode as well as long-term avoidance of further episodes.
• Surgery for sciatica might be warranted if the sciatic nerve pain is severe and your surgeon feels surgery is necessary. Patients should seek immediate medical attention if they have any symptoms of progressive lower extremity weakness, loss of bladder or bowel control.

Hip pain and leg pain can get better even if you do not know the cause. We offer injection and non-injection therapy to treat chronic hip pain and leg pain. Possible treatment options that your doctor may send you to us for include:

• Hip Joint Injection
• Greater Trochanteric Bursa Injection
• Lumbar Selective Nerve Root Injection
• Sacroiliac Joint Injection
• Priformis Injection
• Lumbar Sympathetic Blocks
• Trigger Point Injections
• Spinal Cord Stimulation

Knee pain can be caused by a sudden injury, an overuse injury, or by an underlying condition, such as arthritis. Treatment will vary depending on the cause. Symptoms of knee injury can include pain, swelling, and stiffness.

Knee pain can be divided into three major categories:

• Acute injury: such as a broken bone, torn ligament, or meniscal tear
• Medical conditions: arthritis, infections
• Chronic use/overuse conditions: osteoarthritis, patellar syndromes, tendinitis, and bursitis.

Treatments for knee pain are as varied as the conditions that can cause the pain.

Medications

Medications might be prescribed to treat an underlying medical condition or for pain relief.

Physical therapy

Sometimes strengthening the muscles around the knee will make it more stable and help guarantee the best mechanical movements. This can help avoid injuries or further worsening of an injury.

Injections

Injecting medications directly into your knee might help in certain situations. The two most common injections are corticosteroids and lubricants. Corticosteroid injections can help arthritis and other inflammations of the knee. They usually need to be repeated every few months. Lubricants that are similar to the fluid already in your knee joint can help with movement and pain.

Leg Pain – Leg Aches

Leg pain is any type of pain or discomfort in the leg, from the hip joint to the heels. Leg pain is a fairly common complaint. Your legs are made up of joints, muscles, tendons, ligaments, nerves and blood vessels all of which are subject to injury, infection or other conditions that can cause leg pain.

Leg pain may last briefly or be constant, and affect your entire leg or only a particular area. Your pain may feel achy, piercing or tingling. Pain-like sensations often described as pins-and-needles, prickling, or burning sensations are called paresthesias. Leg pain may be simply irritating and uncomfortable, or so debilitating that you cannot put weight on your leg or walk.

Leg pain can arise from a variety of conditions ranging from accidental trauma to nerve conditions. In the absence of trauma or other symptoms, leg pain is commonly caused by a muscle cramp, also called a “charley horse.” In some cases, leg pain can originate in another part of the body such as the back. This type of leg pain is called referred leg pain. If you are experiencing other symptoms along with your leg pain, be sure to tell your health care provider. This information will help your doctor determine a diagnosis.

Leg pain may also be a symptom of deep vein thrombosis (blood clot in the leg), which is a serious and life-threatening condition. The blood clot in the leg can break loose and cause a pulmonary embolism in the lung, a heart attack, or even stroke. 
Seek immediate emergency medical care if you are experiencing leg pain after mild exercise or exertion, or if you are experiencing pain, swelling, redness, and warmth in the calf.

Leg pain that originates in the lumbar area and travels down the buttocks, accompanied by loss of bladder or bowel control, is a sign of a pinched nerve. This serious condition should be evaluated as soon as possible in an emergency medical setting. If your leg pain is persistent or causes you concern, contact a medical professional.

90,000 Why do legs hurt from hip to foot? Causes and therapy

Feet throughout a person’s life experience a great deal of stress. Even in a seated position, the legs are tense, not to mention walking or running. Therefore, such a phenomenon as pain in the legs overtakes every second person in one form or another. Sometimes they are short-lived, quickly pass without health consequences. But, as a rule, painful sensations appear abruptly and make a person run to a specialist or start self-medication.The latter option is definitely not recommended, because an unclear cause of leg pain, incorrect treatment can lead to a worsening of the condition. After all, only a doctor can correctly diagnose by conducting an examination and prescribing an effective therapy. An important point is the timely appeal to a specialist.

A reasonable question arises: “Which doctor should I go to if my legs hurt from hip to foot?” The first step is to visit a therapist, who will draw up an anamnesis and write out a referral to the necessary specialist.This can be a surgeon, podiatrist or vascular surgeon. It all depends on the nature of the pain and the symptoms identified. If you experience pain in your feet and legs while walking, it is difficult for you to take the first steps, you feel regular leg numbness, this is a reason to go to the clinic.

In case of untimely treatment, pain that occurs only in the area of ​​the knee joint becomes total and spreads throughout the lower limb. Such ubiquitous pain from hip to foot can be a side effect of another disease, such as cancer, abnormalities in the spine or muscles, etc.e. The specialist classifies it and will be able to provide effective intervention (medication, and for advanced cases, surgery), therefore, in this case, the patient needs to be able to clearly and adequately assess his pain.

In this article we will understand why the legs hurt from the hip to the foot. So let’s get started.

Causes and Symptoms

There are a number of diseases that can cause pain in the legs from the hip to the foot. They have different symptoms, sometimes similar, and sometimes radically different depending on the pathology.Below we will take a closer look at the main and most common variants of diseases that cause a condition in which the left leg hurts from the hip to the foot or the right one.

Venous congestion

This is a pathology associated with an excessive volume of blood in the veins, which can be caused by blockage by blood clots. The blood does not have the ability to flow back, which leads to reddening of the skin. If the disease is caused by another pathology, then this condition can last up to several days and clearly requires the intervention of a specialist.The most likely cause of the disease is an uncomfortable leg for a long time. At the same time, the leg swells, turns blue, becomes colder than other parts of the body, severe pain and discomfort appear. The consequence can be limb atrophy. In addition, such a global disturbance of blood flow leads to thrombophlebitis, thromboembolism and thrombosis. If you do not take action, tissue necrosis and gangrene will occur. What is the threat when the right leg hurts from hip to foot? More on this below.

Most often, venous hyperemia occurs as a consequence of varicose veins, which is also the cause of pain in the legs.Varicose veins are thinning of the walls of veins, the formation of nodes due to their expansion and lengthening. Every third woman and every tenth man in the world suffer from this type of pathology.

The causes of varicose veins, when the legs hurt from the hip to the foot, are high physical activity or their complete absence, rapid weight gain, genetic predisposition and hormonal imbalance. Less common causes include stress, sports overload, and uncomfortable shoes.A characteristic feature of varicose veins is the appearance of spider veins on the legs.

Osteoarthritis

A disease accompanied by thinning and atrophy of cartilage in the joint. The percentage of pathology is especially high among older and elderly people. Arthrosis appears as a result of pathology in the metabolism of the joint, leading to a loss of elasticity of the cartilage. Experts call the causes of arthrosis hormonal disruptions, metabolic disorders, genetics, disruptions in the bloodstream, old age, the presence of rheumatoid arthritis, etc.But the most common prerequisite for arthrosis is considered to be inadequate load on the joints. All this is accompanied by aching leg pain from hip to foot.

Overweight, trauma, acute purulent arthritis, unhealthy diet, intoxication and frequent colds can also cause arthrosis. The risk of developing arthrosis is also high in people of some professions, such as miner, fisherman, bricklayer.

The disease is accompanied by inflammation of the joints, which characteristically crunch due to abrasion of the cartilage.Arthrosis can lead to permanent joint destruction and further disability. And if the right leg hurts – from the hip to the foot?

Atherosclerosis

Chronic pathology of blood vessels associated with the formation of cholesterol plaques and plaques, while the vascular walls are affected, they lose their elasticity. Over time, the vessels thicken and narrow, disrupting blood circulation. Atherosclerosis is considered a very dangerous disease, since it is recognized only in the later stages and can cause ischemia and heart attack.With age, the incidence rate rises, therefore, experts call atherosclerosis an aging disease. This disease is most widespread in developed countries, since the nutrition of most of the population is not correct due to the modern urban rhythm of life.

Symptoms of atherosclerosis are chills in the extremities, “swelling” of the legs, as in a prolonged stay in an unchanged position, pallor of the skin with a clear vascular pattern. Late stages of atherosclerosis are characterized by pain localized to the thighs, buttocks, and calves, resulting in lameness, tissue degeneration, ulceration and wounds, reddening of the fingers, and necrosis.

What does it mean when a leg hurts and a tingling sensation in the thigh and foot?

Tunnel-fascial syndrome

The most common disease in compression neuropathies. It appears as a result of the destruction of cartilage in the vertebral joints. It causes compression of the tissues in the inguinal ligament, which leads to soreness in the inner region of the thigh and groin, lameness that manifests itself during physical exertion, leg cramps at night.

Lack of treatment can lead to muscle dystrophy.There are several types of tunnel syndrome, depending on the location of the pain. In Roth disease, the outer thigh is affected, and in piriformis syndrome, soreness occurs in the foot and ankle. Most often, fascial tunnel syndrome overtakes people whose profession involves repeated flexion and extension of the legs.

It happens that the left leg hurts from the hip to the foot.

Osteochondrosis

It is a consequence of degenerative processes in the intervertebral discs and directly in the vertebrae, which leads to the destruction of cartilaginous and connective tissues.As a result, the intervertebral space is reduced and displacement occurs. The causes of the disease can be infections, injuries, flat feet, genetics, intoxication, aging and working conditions.

At the initial stage, osteochondrosis proceeds latently, therefore, treatment is problematic. Gradually there are pulling pains from the hip to the foot.

Osteochondrosis can be localized in any part of the leg where there is articular cartilage. The main symptom of the disease is rapid fatigue of the lower extremities.Due to the elderly age of patients, this symptom is usually ignored at the initial stage; a person resorts to the help of a specialist only when the disease flows into an acute form. Other symptoms of osteochondrosis include pain in the hip, knee and calf muscles, cramps, leg numbness, redness of the affected joint, aggravation or relief of leg sensitivity. Pain syndrome usually appears during physical exertion or immediately after it.

What is the cause of severe pain from the hip to the foot?

Herniated disc

This is one of the side effects accompanying osteochondrosis.With a hernia, the intervertebral disc protrudes between the vertebrae, pressing on the root of the nerve in the spinal canal. It also causes discomfort in the buttocks and lower back. But more often the legs hurt from the hip to the foot.

The causes of intervertebral hernia, in addition to osteochondrosis, are: spinal injuries, overweight, high physical activity or, on the contrary, a sedentary lifestyle, improper posture, etc.

Tendoperiostopathy

Inflammatory process at the junction of bones and tendons.Pain from hip to foot bothers only during the movement of the legs. The causes can be considered physical overload, age, uncomfortable shoes, infections (acute or chronic), flat feet, etc.

Injuries

Leg bruises are the most common injuries in the lower extremities. They are independent and combined. The intensity and extent of damage depends on the location of the injury.

Fractures are also not inferior to bruises in terms of prevalence. They are open and closed, with and without displacement, probable (painful movement, swelling) and reliable (unnatural position of the limb, crunch).

Stretching occurs when running, walking at a fast pace, playing sports, etc. The muscles are constantly tense, there is aching pain from the hip to the foot, swelling.

The rupture of the ligaments can be either minor or leading to complete separation of the muscle. It occurs with a sharp bend of the leg at the start or stop when running. Ligament rupture is accompanied by pain, hematoma, and muscle spasm.

Crash syndrome – prolonged (more than 8 hours) compression of the tissues of the legs by debris (during the destruction of buildings, for example).It occurs as a result of accidents, accompanied by muscle edema.

Thrombophlebitis

Many people complain that their legs hurt from hip to foot at night.

This can mean inflammation of the walls of the veins and the occurrence of a blood clot. Distinguish between superficial and deep vein thrombophlebitis. The latter option is the most dangerous, since a blood clot can break off and enter the pulmonary artery, which will be fatal. Thrombophlebitis is accompanied by pulling pains in the leg, fever, and skin flushing.The leg may swell at the site of blood clot formation, the skin turns blue, the veins expand and are clearly felt on palpation.

Erysipelas

An infectious disease caused by streptococci. Manifested by chills, weakness, headache and muscle pain, sometimes nausea and vomiting, fever, and palpitations. A well-defined redness appears on the skin that is hot to the touch and painful.

Metabolic disorders

If the water-salt balance is disturbed, pain in the hip and numbness of the foot may also occur.This happens with dehydration caused by infection or poisoning, and it can also indicate diabetes.

Panniculitis is a pathology of adipose tissue. It is inflammatory and leads to the destruction of fat cells and their replacement by other tissues. The result is nodules and plaques. At the same time, seals appear under the skin at different depths.

Sciatica

This is not one disease, but a set of pathologies resulting from pressure on the sciatic nerve.Pain manifests itself in the entire back, as well as in the legs, since the sciatic nerve is the longest and thickest in the human body. Sciatica occurs where the nerve endings of the sciatic nerve become irritated or pinched. The factors causing sciatica are pregnancy, hernias in the intervertebral space, osteochondrosis, diabetes, thrombosis, etc.

Symptoms of sciatica are pain syndrome of varying intensity in the back of the thigh to the foot, high muscle tone in the back, discomfort, lameness, urinary incontinence, convulsions and numbness.

In addition to diseases, there are a number of factors that can lead to pain in the lower extremities, and they are not directly related to the legs. Smoking, sciatica, impaired metabolism and anorexia can provoke pain. Elderly amputated people are most often affected by phantom pain. This phenomenon has not been fully studied, therefore, it is not possible to save a person from these pains. If we talk about young people, then pain in the legs in this case is caused by high physical exertion, contraception (a side effect of which is varicose veins), bad habits (alcohol and smoking) or pregnancy.The latter puts a lot of stress on the legs and spine, as the weight increases dramatically. During pregnancy, the risk of varicose veins and blood clots increases.

How to identify a pathology from which the legs hurt from the hip to the foot?

Diagnostics and treatment

Before taking tests, it is necessary to visit a number of specialists, namely a therapist for a general consultation, a traumatologist (to exclude the connection of pain syndrome with previous injuries), a surgeon (checking the state of blood vessels), a rheumatologist (analysis of joint disorders ), a phlebologist (ultrasound of the veins), a neurologist (with convulsions and numbness), sometimes an oncologist (if a malignant tumor is suspected).

At the initial stage of the diagnosis of pain in the leg from the hip to the foot, the patient is assigned a series of clinical tests. The further sequence of actions will depend on the results for making the correct diagnosis and prescribing the correct therapy. There are a lot of studies to determine the cause of leg pain:

1. Complete blood count (special attention is paid to indicators of leukocytes and erythrocytes to detect infectious inflammatory diseases).
2. Analysis of water-electrolyte pathologies (urea, electrolytes, creatinine).
3. Blood glucose test showing possible diabetes mellitus.
4. Biochemistry blood test (uric acid and cholesterol levels).
5. Microbiological research (scraping for chlamydia).
6. X-ray examination.
7. Tumor markers (if a tumor is suspected).
8. Research for rheumatoid factor (serological analysis).
9. If tuberculosis or osteomyelitis is suspected, a puncture biopsy of the bone is taken.
10. Duplex scanning (vascular examination).
11. Vascular angiography (in the diagnosis of atherosclerosis).
12. MRI (magnetic resonance imaging) and CT (computed tomography).
13. Rheovasography (examination of the arteries of the legs).
14. Skeleton scintigraphy (prescribed if metastases are suspected).
15. LID (Ankle Pressure Index) shows constrictions in the arteries.

Since leg pain is often only a symptom and not an underlying cause, treatment depends on the characteristics of the course of the disease based on an examination performed as directed by a specialist.For example, varicose veins of the first stages do not require hospital treatment. However, in the case of varicose veins, as well as with complicated atherosclerosis and exacerbated intervertebral hernia, urgent hospitalization and surgery are required. Thus, in order to exclude a painful symptom in the legs, it is necessary to cure the very disease that caused them. We found out why the legs hurt from the hip to the foot.

Recommendations

The main recommendations for all patients are:

1. Compliance with a special diet.In particular, with vascular pathologies, it is necessary to significantly reduce the amount of fatty and cholesterol-rich foods.
2. Weight loss. At the same time, not only observing the correct diet, but also applying a little physical activity. To do this, there are many gentle exercise complexes that strengthen the muscles of the back and pelvis. With varicose veins, there are also sets of exercises, for example: flexion and extension of the leg at the knee, movement of the feet in a circle, turning the foot to the side, flexion and extension of the toes.
3. It is imperative to regularly change the modes of activity during the day, avoiding a long stay in the same position. Therefore, in the office, you can do some exercises, for example, rolling from heel to toe or walking in place with your knees high.
4. Regular exercise to strengthen your abdominal muscles relieves tension in the spine, which reduces the risk of lower back and leg pain.

It is important to know that if a leg hurts from hip to foot, treatment must be timely.

Orthopedists to relieve tension from the back and legs recommend after a working day to lie down with legs raised up, take a bath, do a foot massage and wear only comfortable shoes. In the treatment of varicose veins, muscle relaxants are usually prescribed to relieve tension from the muscles. In order to improve blood circulation in vascular problems, special medications are prescribed. In complex therapy, vitamin complexes are often prescribed.

Manual and physiotherapy, as well as remedial gymnastics and special types of yoga, helps to get rid of pain.In any case, both preventive and curative measures should be taken only after meeting with a specialist. After all, self-medication is life-threatening, as well as the use of traditional medicine techniques.

Eight out of ten people consider leg pain to be the norm, admitting that they have experienced it at least once in their life. Many people complain of pain in the calves or heels, while not considering it necessary to seek qualified help. This is especially true for the elderly, who tend to write off all pain in the legs for age-related changes.But timely measures taken will help to avoid many problems in the future. Therefore, the main thing is to listen to your body and pay attention to the signals given to them, not to ignore them. The saying “the wolf’s legs are fed” takes on a completely different meaning when it comes to the likelihood of losing these very legs due to illness. In any case, it makes sense to watch your back and legs and take preventive measures to avoid problems.

PAIN IN THE HIP JOINT | orto.lv

Pain caused by a hip joint disease radiates to the groin, lower back, leg (knee and in rare cases lower) or the muscle of the hip joint.Therefore, people do not always associate such pain with problems in the hip joint.

The doctor will discover and evaluate the real causes of pain. Often, problems with the hip joint can be combined with diseases of the spine and knee joint. Therefore, it is important to perform an accurate diagnosis in order to determine the causes of pain and choose the appropriate treatment.

Anesthetic injections into the hip joint (which are done under ultrasound control) are often used for diagnosis, so that, by briefly removing pain in the hip joint, it is possible to assess whether other pains persist and to clarify their cause.Considering that the ORTO clinic specializes in the treatment of diseases of the musculoskeletal system, you can get help and advice from an orthopedic traumatologist, spinal surgeon and neurologist in one place.

Contact an orthopedist-traumatologist if:

• Hip pain persists for several days;
• you wake up in pain at night;
• You are forced to change positions frequently when standing or sitting because of pain or discomfort in your hip joint.

Pain in the groin. Groin pain is often felt along with pain in the hip joint. This pain resembles tension, throbbing. If the pain in the hip joint is in the buttocks and not in the groin, it may indicate compression of the sciatic nerve or inflammation of the hip joint.

Low back pain is one of the most common symptoms of hip pain. The pain is usually described as dull and throbbing.If the cause is left untreated, there is a risk of severe limitation of movement.

Leg pain can be caused by problems in the hip joint. For example, pain caused by problems in the hip joint can radiate to both the groin and the leg, including the knee. Releasing pain can manifest itself as weakness or itching. If leg pain persists within a few days, it is advisable to see an orthopedic traumatologist to find out the cause of the pain.

Stiffness and a feeling of being “hooked” are characteristic signs of hip osteoarthritis.However, they can be the consequences of, for example, rheumatoid arthritis.

Restricted hip movement may be a sign of injury or deforming osteoarthritis. Restrictions of movement in the hip joint can manifest themselves, for example, in the form of difficulty or inability to bend down to put on / take off shoes. It can be difficult or even impossible to walk up and down stairs.

Lameness. For problems with the hip joint, walking is often difficult and painful, so the person is limping.If you notice that you are limping due to pain, see an orthopedic traumatologist immediately. Otherwise, in an effort to relieve pain, you unknowingly hold your sore hip joint higher than the other. The result is a habit that gradually changes the mechanics of the musculoskeletal system. The length of the leg is reduced as part of the thigh bone is lifted above the thighbone of the second leg. These patients have different leg lengths after surgery on the damaged hip joint.A long course of therapeutic exercises is needed to gradually restore the correct position of the hip joint and align the length of the legs.

Crunch in the hip joint. A crunching sound is produced by ligaments when a person stands, walks, or otherwise moves the hip joint. If the crunch is painless, it does not say anything bad about the state of health. A crunching hip joint accompanied by pain may indicate damage to the hip joint.If the crunch in the hip joint is painful, you should contact an orthopedic traumatologist to find out the cause and start appropriate treatment.

90,000 pain in the leg from hip to foot, doctors’ answers, consultation

Hello! I really hope for your help.

I am 24 years old.

It all began in the summer, in June, after she fainted. Vomited, twisted stomach, lost consciousness. Since then, these are the symptoms – they keep growing, I don’t know what to do.A neurologist at a pliklinic diagnosed me with astheno-neurotic syndrome, but I read the description, something seemed to be not quite right … And the drugs that he prescribed do not help me much.

Muscles twitch, sometimes tremors begin. Weakness comes in attacks – it feels like the body is asleep, but the brain is not; arms and legs become heavy and relaxed. Weakness gives way to muscle tension. Previously, there were only calves, now the feet, palms from the back, wrists and the lower part of the thigh are attached.There is a very unpleasant feeling that the muscles are about to be reduced, and if you strain them, then it happens (this is the last two weeks). In addition, there is a burning sensation in the muscles. This week the tension in my calves did not go away for three days, then it let go, and my muscles ached wildly. In general, recently, muscle tension has become almost constant.

There are also chills, nausea, pressure on the eyes.

The gait changes sometimes – I put my leg on a full foot, the legs seem to be tense from behind. If, when I stand on straight legs, if I hit the back of the thigh, then my knees give way.In general, the muscles of the knees are also tense, especially on the left leg. My thigh and knee muscles relax as I tilt my body forward.

Very unpleasant sensations in the front of the throat (under the jaw) – like a lump or pressure; it is difficult to swallow, sometimes it becomes difficult to breathe. And when the food is difficult to pass, you have to push it through. Sometimes the muscle on the left front of the neck hurts.

Vertigo, paroxysmal. It starts with shaking me back and forth once. After that, the next day or every other day, it is very bad – the feeling that I will fall now, and as if waves through the brain from the bottom up.After that, I try not to leave the house, because I can’t even stand still, it seems to me that I am falling. It intensifies if you look in one direction, then in the other. Sometimes there is such a “glitch”: if you look

to something at an angle of 45 degrees, then I kind of drive back, but what I’m looking at is constantly moving away from me (similar to the effect in a movie when the hero stands still and the background recedes).

Headaches – begins under the skull on the left, then passes to the back of the head, on the right it also begins to hurt and crawls to the top of the head, where it passes.Sometimes he jerks something in his head (not for long, but unpleasant).

There are still pains under the jaw on the left (repeated visits to dentists did not give anything, that is, also nervous), ringing in the ears. Still sometimes there is a crunch in the back when inhaling and a pulling / stabbing pain in the spine on the left, at the level of the shoulder blades.

Still sometimes there is trembling all over the body, as if chilled.

The ears also hurt, the lymph node behind the left ear hurts and radiates into the jaw under the ear.

I had pulmonary tuberculosis in childhood. They were removed from the register at the age of 16.

All blood tests are normal (biochemistry, sugar, hormones, AIDS, hepatitis).
Lor did not find anything, according to my complaints about a sensation of swelling in my throat, she was sent to the Research Institute of Lor, where they also did not find anything and said that it was nervous.

The neurologist prescribed Vinpotropil and Pantogam (I drank a little of them, and it felt like I only got worse), Milgama’s course (finished, it didn’t get much better). Also Cortexin (also something does not bring relief)

X-ray of the cervical spine – showed nothing. The therapist still wrote “osteochondrosis”. Well, okay, she knows better.

ECG, FLG normal

EEG: “Weak diffuse changes in the BEAC of the brain of an irritative nature.General type of cortex reactivity. Local and paroxysmal changes were not identified. ”

REG: “Pulse filling in the carotid areas is normal. Pulse filling of VBP is normal. The tone of large-caliber arteries is reduced. The tone of medium-sized and small-caliber arteries is normal. Elastic properties of arteries are normal. Venous outflow is not changed. Functional tests of VBD are negative.”

Ultrasound of the abdominal cavity, kidneys – no abnormalities; thyroid glands – cysts 2.5 mm, but hormones are normal.

Concomitant diseases: superficial gastritis, hemorrhoids, it seems (this is what the computer leads to), cervical erosion.
I can’t do an MRI, for a trivial reason – there is no money.

Please tell me what it is and what I should do. Go to another neurologist, or is it really astheno-neurotic syndrome?

Why do legs hurt – Arnika Family Clinic, Krasnoyarsk

Many people experience leg pain. Some people endure pain symptoms for a long time. However, it is extremely important to diagnose the cause of the pain.

Our center employs professionals who will conduct an examination, find out why the discomfort or pain has arisen, in order to further prescribe the treatment that suits your case.Do not delay a visit to the doctor, because in many cases the cause of the pain can be very serious. It is not for nothing that the well-known truth says that it is much easier to cure an incipient disease than a neglected one.

How the leg works

Anatomically, the leg consists of three main parts: the foot, lower leg, and thigh. The foot contains many small bones. The thigh is made up of the most massive, strong bone in the skeleton: the femur, as well as the patella, which protects our knee joint.Two bones: the tibia and the tibia form the tibia. The place where the hip and femur meet is the hip joint. The junction of the femur and tibia forms the knee joint. The joint of the bones of the foot and tibia is the ankle joint. Injuries to the ankle or knee joints are always a serious danger, since the damage they cause is often irreversible.

What diseases can provoke leg pain

Leg pains lasting more than three days are a serious reason to contact our center to find out their cause.The main causes can be diseases of the vessels of the legs, diseases of the spine, joints, muscles.

Painful sensations due to the affected vessels are especially common.

• If the outflow of venous blood is impaired, the pressure in the blood vessels rises, the blood in the veins stagnates, the nerves become irritated, and pain syndrome develops. Most often these are dull pains or heaviness in the legs, which are fraught with varicose veins over time.
• The disease of thrombophlebitis is manifested by a throbbing pain that turns into a sensation of subcutaneous burning.This pain is constant, especially in the calf muscles.
• The walls of the vessels become hardened with atherosclerosis of the arteries, which causes constricting pain in the calf muscles, which increases when walking. Usually cold feet in summer and winter, there is no clear pulsation in the area of ​​the big toes.

A fairly extensive group of diseases that are associated with the spine, but are manifested by pain in the legs.

• Hernias or protrusions lead to pain that we feel in the legs (radiating pain).In the spine itself, pain may be absent.
• Sciatica (or inflammation of the sciatic nerve) causes pain that radiates from the spine to the legs in the direction of the sciatic nerve.

Often the pains are attributed to joint diseases, they are characterized by a feeling of “twisting” of the legs. The syndrome can worsen when the weather changes. With an advanced disease, the pain can become constant, sometimes just excruciating.

• Gout is characterized by these attacks of pain.
• If the knee joint hurts, it may indicate the destruction of the cartilage in it.
• Flat feet are characterized by rapid fatigue when walking, a feeling of heaviness. The disease requires the daily performance of special exercises that are developed by a specialist. You can relieve pain by using orthopedic insoles.

Diseases of the peripheral nerves can cause pain.

• With neuralgia, there are paroxysmal pain in the direction of the nerve fibers.There is no pain between attacks, and attacks can last up to several minutes.
• Sciatica is characterized by high-intensity pain that runs along the back of the thigh or the entire leg.

The most acute pain accompanies muscle inflammation. Myositis is a rather dangerous disease that requires treatment and supervision by a doctor.

Leg pain is also caused by an infection of the bones (osteomyelitis). Usually the painful sensations are prolonged and sharp.

Sometimes the cause of pain is an injury (fracture, bruise, rupture of ligaments or muscles).

With osteoporosis, there is a very severe pain in the calves, leg cramps. The reason is the lack of calcium. Basically, this is a problem for women over 40 years old.

It also happens that pain sensations do not arise at once, but develop gradually, as a result of wearing uncomfortable shoes, excessive load, insufficient warm-up before training, or running on a hard surface.

• Severe pain in the lower leg, fever, redness of the skin, most likely, signal erysipelas.
• Phlegmon (inflammatory purulent process), lymphatic edema, thrombosis can be characterized by pulsating and bursting pain in the lower leg, dense edema.

If the pain lasts for three days, come to our center for help. You should especially be concerned if there is pain in all parts of the legs, there are feelings of weakness, cooling, there is swelling, or the skin becomes bluish.

90,000 Pain in the foot and ankle

Pain in the legs and ankles can make life difficult – physical therapy can help

You need legs and ankles to get around! Don’t let the pain take you away

Physiotherapy has been shown to help in the rehabilitation of injured limbs and to help with acute and chronic pain.

Foot and ankle pain can be caused by many different causes, but the innovative Sobe Rehabilitation can help you get back on track.

You spend an incredible amount of time using your legs every day, and if you suffer from foot and ankle pain, it can make a big difference in your life. It can cause fear and agony as you climb stairs, walk across the block to your office, or even drive.

Make an appointment with a Licensed Hallandale Beach Physical Therapist today and learn more about how our services can help you!

What will physiotherapy treatments look like for foot and ankle pain?

Whether you are suffering from acute trauma or chronic foot or ankle disease, you can find relief at Sobe Innovative Rehabilitation.Our physiotherapists in Hallandale Beach will conduct a thorough examination to determine the cause of your pain, and then a personalized treatment plan will be created especially for you.

Your treatment plan typically includes a combination of specialized, practical chiropractic, exercise and stretching techniques to restore joint mobility, improve balance, and strengthen the muscles of the foot and ankle.

Your treatment plan may also include balance board exercises and other specialized services.Sobe Innovative Rehabilitation will do everything it can to quickly relieve your pain and improve circulation. We will also evaluate and recommend lifestyle changes or orthopedic shoes to prevent new problems in the future.

General conditions causing pain in the foot and ankle

Pain in the foot and ankle may occur suddenly from an acute injury or develop over time due to a chronic illness.

According to Mayo Clinic , there are several common causes pain in feet and ankle , including:

Plantar fasciitis

Plantar fasciitis is an inflammation of the connective tissue on the sole of the foot.This can be due to overuse under aggravating circumstances, such as standing up constantly, improper posture, or shoes that do not have adequate arch support.

Fallen arches

Your foot contains several tendons that together form the arch. When the tendons are properly connected, your foot forms the correct arch. However, when the tendons are not properly tightened, your foot will form a very small arch or no arch at all.This is called “fallen arch” or “flat feet” and can cause pain or discomfort over time.

Tarsal canal syndrome

Tarsal canal syndrome occurs when the tarsal canal is never pinched or inflamed. This nerve runs from the ankle to the foot.

Fractures

A fracture occurs as a result of excessive force or injury to the bone, causing it to crack or break completely. A fractured foot or ankle can lead to weeks of downtime for proper healing.

Bursitis

Bursitis occurs when tendons rub against bursa or sacs that prevent friction, causing irritation and discomfort.

Tendinitis

Tendonitis occurs as a result of overuse of tendons, as a result of which they become inflamed for a long time.

Arthritis

Arthritis is a common inflammatory disease that affects the joints and leads to pain; the most common types, including osteoarthritis and rheumatoid arthritis.Both types of arthritis can severely affect the joints of the foot and ankle.

Stretches and strains

A sprain occurs when a ligament stretches or breaks too much, and tension occurs when a muscle or tendon is stretched.

Why did the foot / ankle pain appear?

Your feet and ankles are complex mechanical structures that must work together in harmony to function at their optimum.According to from the Arthritis Foundation, the ankle is made up of three bones that need to interact properly with each other, as well as various connective tissues that hold the joint together.

The foot is even more complex, containing approximately two dozen bones, 30 joints and over 100 muscles, tendons and ligaments. Because the feet and ankles are made up of many complex structures, pain in these areas is a very common condition.

An injury to your foot or ankle can cause pain so severe that you don’t have to put your weight on your leg.This leaves you with only two options; bouncing, risking injury to the other leg, or worse, getting stuck in a chair, unable to go anywhere and take care of yourself or others. Even mild pain can cause physical limitations in your daily life and burden those around you.

Ready to say goodbye to pain in your feet and ankles?

Don’t let the pain in your feet and ankles slow you down! Our Physiotherapy Practice in Hallandale Beach will help you determine your mobility, comfort, and overall functioning without the limitations of foot and ankle pain.

Contact Sobe Innovative Rehabilitation today to make an appointment. We’ll get you back on your feet in no time!

90,000 Low back pain radiating to the legs

By itself, lower back pain is unpleasant, but we do not always immediately go to the doctor, considering it a consequence of overload, hypothermia. Indeed, after some time after the “home” treatment, lower back pain may stop. And it is quite another matter when the pain from the lower back radiates to the leg.This is a clear sign of an exacerbation of a disease of the spine, or the appearance of another disease not associated with the spine. In any case, peripheral nerves are involved in the process, which requires a more serious attitude to this symptom.

Most often, the pain begins to give in one leg and is localized both in the buttock and in different areas of the thigh, lower leg, foot, often accompanied by numbness. The place where the pain spreads directly depends on which part of the nerve is under pressure.This can be pressure from the injured spine, a consequence of edema in the places where the nerve passes (tunnel syndromes), direct pressure of the tumor on the nerve, as well as the consequences of a leg or lower back injury.

Diseases of the internal organs located at the level of the lumbar spine can also cause pain in the lower back and leg. Gynecological inflammatory and oncological processes, diseases of the kidneys, urinary tract, duodenal ulcer, pancreatitis, ectopic pregnancy – these and other diseases do not go away on their own.Pain in the legs can be one of the first signs of the disease, and you need to see a doctor for a timely examination and proper treatment.

The clinic “Eleos” has all the possibilities for examination and treatment of diseases. Qualified doctors – a neurologist, therapist, traumatologist, gynecologist – will conduct an examination, diagnose and prescribe treatment, and specialists in the field of physiotherapy, massage, alternative methods of treatment will ensure that doctors’ prescriptions are fulfilled, full treatment, rehabilitation to restore lost functions and return to normal life.

90,000 reasons, which doctor to consult and how to treat, prevention

Many modern people suffer from pain in the legs. Some may not pay attention to the inconvenience for a long time, while others seek help from specialists to find out why the lower extremities hurt. It is extremely important to do this in a timely manner, since the disease is easier to cure in the initial stages, by finding the causes.

Table of contents:

1. Which doctor should I go to?
2. Types of pain
3. Causes of leg attacks
4. Therapy and prevention

Which doctor should I contact?

Usually a physician gives a referral to specialists in a polyclinic.You should go to them if the feet become numb, cold or weak; attacks last more than three days; the skin swells and turns blue, as a result of the injury, swelling appeared.

Just for this reason, if the pain in the leg from the hip to the foot does not subside, but, on the contrary, it becomes more and more, first you need to go to a therapist, who, after the examination, will send:

• to the surgeon;
• to a vascular surgeon;
• to an orthopedist – traumatologist.

Every disease has its own symptoms, characteristic signs and causes.On this basis, in order not to aggravate the situation, you should contact a medical institution and undergo the necessary examination, as a result, the doctor will prescribe the appropriate treatment for the pain syndrome.

The nature of pain

It is important to pay attention to the following symptoms:

• if you feel pain in your feet and legs when walking and it is difficult for you to take the first steps;
• if your leg regularly becomes numb, while the pain in it increases;
• if you experience pain attacks in your feet, even when wearing comfortable shoes.

All these facts should alert you and send you for examination to specialists. Leg pains are acute, systematic and chronic and, depending on this, have different dislocations. This circumstance affects the establishment of the diagnosis, and, therefore, the ability to cure the disease.

When the legs hurt from the hip, then you can declare sciatica. This is a pathology of the sciatic nerve, which is the longest in the human body.In some cases, the pain syndrome even reaches the foot. If the leg is pulled and an attack occurs inside the leg while walking, then an option such as the pathology of the adductors (the muscles in the inner thigh that move the leg) should be considered. When a person has osteochondrosis of the lumbar region, pain will be felt along the entire length of the strangulated nerve. Pain from hip to knee can cause diseases of bones, joints, nerves, tendons, muscles, vessels of the lower extremities, spine.

Why do seizures occur?

Conditions influencing the formation of diseases and causing pain in the legs:

• metabolic disorder;
• injuries;
• infections;
• malignant tumors.

Let us analyze the reasons why pain may appear.

1. Vascular pathologies in the body are often a prerequisite. There are disturbances in the outflow of blood in the veins, stagnating and increasing the pressure on the vessels. As a result of these processes, nerve endings are irritated, a pain syndrome is formed, which is dull in nature. Similar sensations are formed in the left and right legs. This is a symptom of incipient varicose veins.

2.Another reason, among other things, is a vascular disease called thrombophlebitis. Pain in the legs at night with this pathology is constant, pulsating, often developing into a burning sensation. They appear in the ankle area.

3. In atherosclerosis of the arteries, pulls the leg, in addition, it can provoke the appearance of pulling pains in the ankles, increasing with movement. With this disease, the walls of blood vessels become denser, the attacks are of a constrictive nature, the feet remain cold in different seasons of the year.

4. In case of dysfunction of the spine, the pain goes from the hip to the very foot, the spine itself may not bother. Sciatica is noted in this group of diseases, in other words, inflammation of the sciatic nerve. The pain is strong enough and is located on the back of the legs when walking. It feels like a cord was inserted under the skin and gradually pulled.

5. Such a secondary disease as a lesion of the sciatic nerve occurs in osteochondrosis of the lower back, spondylitis, spinal tumors.The pains are located in front and inside the leg and are established by palpation. If, bending the knee in the supine position, the patient can feel pain, the knee reflex is lowered. With these signs, you should consult a doctor, because it is important to recognize pain syndrome as a result of nerve inflammation from psoitis, when flexion in the hip is difficult. Thanks to laboratory tests, the presence of a pathological process is determined.

6. Diseases of the joints are a too common cause of pulling pains in the legs.This sign is noted when changing atmospheric conditions. With advanced ailments, such weather pains are frequent and unbearable, especially in people suffering from gout. Pain in the knee when walking may indicate the destruction of cartilage, although to verify this or eliminate this possibility, you need to check in the hospital.

7. In osteoporosis, seizures originate in the hip and knee joints. This disease worries mainly women during menopause.

8. Diabetes mellitus may be a prerequisite for severe aching pain in the leg from the hip to the foot. In this case, the pain is accompanied by swelling, tingling, numbness. The skin on the ankles becomes dry and flaky. These are quite serious symptoms and are treated immediately. How to remove puffiness, read the article Causes of edema of the lower extremities.

These are the most well-known reasons. But in addition to aching pains, sometimes there are paroxysmal pains that provoke neuralgia.It happens that the pain does not stop for a long time, even at night, and can last for several minutes. Myositis, in other words, muscle inflammation also causes severe pain, they must be treated in a hospital. Osteomyelitis causes acute and long-term seizures.

There are many causes of pain in the hip when walking. On this basis, it is difficult, and sometimes impossible, to accurately determine the source of the appearance of the house, and even more so to carry out the correct therapy. You should contact a clinic where professionals will conduct an examination to exclude all serious conditions that are dangerous to the patient’s life.Doctors do not deny that significant weight, which creates additional stress on the limbs, causes pain in the feet, especially if its size is small.

Preventive measures and treatment

Orthopedists recommend:

• After a day at work, you should definitely lie down with your legs raised on the headboard.
• Take foot baths with strongly infused tea.
• Carry out a foot massage.
• Wear only comfortable shoes.

Treatment of pain syndrome is usually carried out in a hospital and under the supervision of a physician. Specialists prescribe muscle relaxants that relieve muscle spasm. A vitamin and mineral complex is offered. To improve blood circulation in the affected area, drugs are prescribed to increase blood supply. Manual therapy, gymnastics and physiotherapy are used to treat and relieve pain.

Considering the fact that in most cases the leg becomes numb and hurts due to impaired blood circulation in the lower extremities, then for prevention it is recommended to adjust the diet, exclude foods high in cholesterol from the menu, stabilize your own weight and regularly strengthen your legs with the help of physical exercise.For people whose work activity is associated with prolonged walking or standing on their feet, it is necessary to carefully select shoes, which should be relatively loose so that the feet do not bend, have a small heel for accurate weight distribution along the plane of the foot. Any treatment should be carried out under the supervision of a specialist. As a result of strengthening the abdominal muscles, pain in the lower extremities decreases, which appear due to diseases of the spine.

First, it is worth carrying out diagnostics, in which the cause of the pain syndrome is established, and then therapy is prescribed.In the practice of doctors, there are situations when pain in the legs helps to timely detect problems with the kidneys and heart. Pain relieving ointments and gels can independently alleviate this condition, but only a specialist should treat the disease.

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