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Understanding Leg Pain
Posted by Dr. Ben Kim
Over the past several months, many people have visited our clinic or written letters asking what they can do about various aches, pains, and cramps in their legs.
Here's an example of such a note that came in this past week:
I'm 83 and have a problem that has slowly developed over the past year. More and more I am experiencing cramps in my legs and inner thighs. They interrupt sleep and this morning it was extremely hurtful in my left leg. I have searched medical books that I have, but (haven't been able to find out) what is wrong.
I'm sure there is something natural that my system is lacking, but I don't know what. Is there anything you can recommend that I can try?
Without doing a comprehensive physical evaluation that includes appropriate neurological and orthopedic testing, I am unable to give individually-tailored recommendations on what a person with such symptoms can do to get better.
I can, however, write about some common health issues that can create discomfort in one's legs and what I would do for each of these issues.
Potential Causes of Aches and Pains In One's Legs
A simple blood test can reveal low electrolyte levels and/or dehydration.
Part of the solution for both issues is to ensure steady intake of water-rich foods, mainly vegetables and fruits.
It can also be helpful to ensure regular intake of healthy foods that are rich in calcium, magnesium, potassium, and sodium, as listed here:
Calcium-Rich Foods Magnesium-Rich Foods Potassium-Rich Foods Sodium-Rich Foods Sardines Brown rice Banana Celery Chinese cabbage Almonds Potato, with skin All leafy vegetables Spinach Spinach Orange Beets Wild salmon, with bones Swiss chard Tomato Beet greens Kale Lima beans Artichoke All organic meats White beans Avocado Acorn squash Wild fish Bok choy Peanuts Lima beans Broccoli Hazelnuts Sunflower seeds Pinto beans Okra Almonds Red beans Black-eyed peas Spinach
If dehydration or low electrolyte levels are the result of taking a diuretic for high blood pressure, I recommend that you read my article on understanding blood pressure to learn some steps that you can take with your food and lifestyle choices to improve your blood pressure naturally and reduce the need for medication. Be sure to work with your primary care doctor if you want to reduce your intake of medication.
2. Intake of Cholesterol-Lowering Statin Drugs
Statin drugs like lipitor, mevacor, zocor, pravachol, and lescol can cause intermittent muscle cramping. If you are worried about your blood cholesterol level, be sure to read my article on understanding cholesterol. Again, any changes that are made with medication intake should only be done under the supervision of your primary care doctor.
3. Cramps Caused By Overexertion or Chronic Tightness
Appropriate rest and regular stretching are simple solutions to cramps caused by overuse and chronic tightness, respectively.
4. Physical Injury
Leg pain can be caused by any number of physical injuries, the most common of which are tendonitis, muscle strains, muscle tears, and sometimes even a hairline fracture. All of these conditions are best treated with appropriate rest and follow-up rehabilitation. If a physical injury doesn't improve with a solid period of rest, it is best to have it evaluated by a qualified practitioner, who may be able to facilitate a recovery by providing treatment that can improve blood circulation or address the possible presence of scar tissue.
Leg pain caused by a degenerative or metabolic arthropathy can occur in and around the joints of the feet, ankles, knees, and hips.
People who suffer with degenerative arthritis tend to feel pain while they are actively using their joints, while those who suffer with metabolic arthropathies like gout, psoriatic arthritis, and rheumatoid arthritis can have bouts of pain even while they are at rest.
Both types of arthritis are best addressed with a vegetable-based diet (as described in Experience Your Best Health), daily intake of essential fatty acids, and daily intake of a high quality green food product that comes with friendly bacteria for the GI tract.
6. Nerve irritation
Nerve irritation can be caused by tight muscles, tendons, or ligaments, all of which can put pressure on a nerve or group of nerves throughout the lower extremities. This type of pain is usually felt during physical activities or specific positions that stress the soft tissue(s) that are encroaching on the involved nerve(s). Appropriate stretching and exercise will usually alleviate these cases of nerve irritation.
Nerve irritation can also occur due to pressure on a nerve or group of nerves by bone spurs that can develop in and around the spinal column. This type of pain typically arises with activity and diminishes with rest.
Both types of nerve irritation can usually be identified through simple neurological and orthopedic tests. Pain that arises due to either type of nerve irritation can present in a variety of ways, but the most common presentations are sharp, shooting pain, burning pain, and a feeling of pins and needles.
Leg pain that is the result of an infectious process is usually accompanied by a fever and other flu-like symptoms like the chills and nausea. Rest does not typically lead to any relief.
Leg pain that is due to an infection can usually diagnosed by blood work that shows increased white blood cell numbers and by ruling out other potential causes. In some cases, a biopsy is performed to verify the presence of an infectious process.
This is one category for which I would not hesitate to take antibiotics. For me, the disadvantages of taking antibiotics are far outweighed by the potential limb or life-saving benefit of antibiotic use in the case of an infected bone or joint.
8. Blood Clot
Often referred to as deep vein thrombosis, leg pain that does not fit any of the categories listed above should always be evaluated for a potential blood clot in a deep vein.
Blood clots can develop in deep leg veins due to any number of factors, the most common of which are prolonged sitting, bed rest, recent trauma or surgery, fractures, and regular use of estrogen-based drugs like birth control pills.
The potential dangers of a deep vein thrombosis are two-fold. First, it can break off and travel through the cardiovascular system and eventually land in the lungs, heart, brain, or any number of other organs and cause significant damage to the organ that it finds. The second major danger of a deep vein thrombosis is impairment of local blood circulation, paving the way to wounds that won't heal and possible gangrene formation.
Leg pain that is caused by a blood clot usually presents in one leg only with tenderness and a feeling of warmth in the painful region. Sometimes, it is accompanied by swelling and redness.
Pain that fits this description should never be massaged, as pressure on one's muscles can potentially cause the clot to break off and travel through the cardiovascular system.
I consider deep vein thrombosis to be a condition that requires supervision and guidance by a hematologist. An anticoagulant medication can be life-saving in the case of a deep vein thrombosis.
A build-up of plaque in blood vessels in the legs can diminish blood flow to the region, which in turn, can cause leg pain. This type of pain is sometimes called arterial claudication, and almost always follows a pattern of arising during activity and disappearing with rest.
As far as I know, the best way to treat and prevent arterial claudication is to follow a clean, vegetable-based diet, and to avoid sugar and unhealthy oils.
If you have leg pain that isn't going away with appropriate rest, stretching, and a clean diet, I recommend that you print this article and take it with you to your doctor. Ask him or her to rule out each of the major causes of leg pain listed above. Hopefully, this process will allow you to identify and address the root cause(s) of your leg pain.
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