Neuropathy is a result of disease, damage or dysfunction of one or multiple peripheral nerves, resulting in burning pain, tingling, weakness or numbness and other emotional, mental and physical symptoms. It can be extremely challenging when multiple areas of the body are affected. However, symptoms can be lessened and managed with a change of lifestyle and a variety of treatments. Continue reading
What causes leg pain? How can it be prevented and treated? There are many reasons for leg pain. Some are more serious than others. It’s best to see your doctor as soon as possible if you are experiencing pain and/or swelling in the legs. Leg pain can be a symptom of a blood clot which if not treated immediately can cause stroke or heart failure.
Here are the most common causes of leg pain.
Osteoporosis is a condition of the bones where they are thin and subject to increased risk for fracture. Muscle and bone pain is a well-documented symptom of severely deficient vitamin D. Vitamin D and calcium are important bone builders and are recommended supplements for treatment and prevention of osteoporosis. Leg cramps that occur at night are often a signal that your calcium, magnesium, and/or potassium blood levels have dropped to low levels. If low calcium, magnesium or potassium levels continue over long periods of time, this may lead to excessive bone loss and osteoporosis.
A fracture usually results from traumatic injury to bones causing the bone tissues or bony cartilage to be disrupted or broken. There are different types of fractures including simple, compound, incomplete and complete. Simple fractures (“closed fractures”) are sometimes not obvious and not seen by the eye, as the skin has not been injured. Fractures can cause leg pain. Compound fractures (“open fractures”) cause a tearing or rupturing of the skin and are more prone to infection. Fractures can cause leg pain. Treatment is immobilization to gain realignment of the bone.
- Shin splints
Shin splints (medial tibial stress syndrome) refers to the pain that results from stress on the tissues that connect muscles to the shin bone (tibia). They also may come from the small bone of the lower leg and ankle, (the fibula). The most common cause of shin splints is stressful activities that constantly pound on the legs and feet. It is a common complaint among basketball players, tennis players and runners. Physicians usually recommend that people with shin splints take an extended period of rest to let that area heal.
A strain (also known as “pulled muscle”) is an injury to a muscle or tendon in which the muscle fibers tear as a result of overstretching. A tendon is a fibrous cord of tissue that connects muscles to bones. Strains often occur in the lower back and in the hamstring muscle in the back of your thigh. Mild strains can be treated at home by resting the effected area, but you should see a doctor if you can’t walk more than a few steps without significant pain, can’t move the affected joint, or have numbness in any part of the injured area. Strain is generally treated by applying cold pack, elevating, compressing the area, and rest.
A sprain is an injury to a ligament caused by tearing of the fibers of the ligament. The ligament can have a partial tear, or it can be completely torn apart. Sprains most often occur in the ankle, knee and wrist. For most sprains home treatment is effective. Elevate the area, rest, apply cold pack, compress the area with elastic wrap or sleeve. See a physician or trusted health-care professional if pain is more severe or not subsiding.
- Internal bleeding
Internal bleeding is bleeding occurring inside the body. It can be a serious medical emergency depending on where it occurs (e.g. brain, stomach, lungs), and can potentially cause death and cardiac arrest if proper medical treatment is not received immediately. Internal bleeding (also called internal hemorrhage) is a loss of blood that occurs from the vascular system into a body cavity or space. It can result in pain, swelling, dizziness, muscle weakness, blood in urine, stool, or vomit, or noticeable bruising
- Peripheral arterial disease (PAD)
Peripheral arterial disease (PAD) happens when there is a narrowing of the blood vessels outside the heart. The cause of PAD is atherosclerosis. Atherosclerosis is caused by a build up of plaque (made up of fat and cholesterol) on the walls of the arteries. The arteries supply blood to the arms and legs.
- Deep vein thrombosis (DVT)
A deep vein thrombosis (DVT) is a blood clot that forms in a vein that is deep inside the body. Most deep vein clots occur in the lower leg or thigh. If the vein swells, the condition is called thrombophlebitis. DVT can be very serious and lead to heart attack or stroke or a serious problem in the lung, called a pulmonary embolism. Treatment includes medicines to break up and prevent blood clots, relieve inflammation and swelling. Sitting for long periods of time can increase the risk of blood clots. Elevating the area and applying moist heat can be helpful. Always take plenty of breaks, stretch, and drink plenty of liquids.
Shingles can be a cause of leg pain. Shingles is a disease caused by the varicella-zoster virus. This is the same virus that causes chickenpox. Symptoms include pain and red blisters on the skin that appear on one side of the body. Symptoms usually begin with muscle aches and pain. The pain can be a severe shooting pain, or burning or tingling, electrical sensation. Blisters usually go away after 14 days but the pain of shingles can last for weeks, months and even years.
Alcoholism can lead to a condition known as alcoholic polyneuropathy (also known as “alcohol leg“). This is a neurological disorder in which multiple peripheral nerves throughout the body malfunction at the same time. It causes the degeneration in neurons of both the sensory and motor systems. People with alcoholic polyneuropathy experience pain and motor weakness usually beginning first in the feet, legs and hands and then moving inwardly toward the center of the body. Treatment is abstaining from alcohol, nutritional supplements, and pain management.
Diabetes is a group of metabolic diseases in which a person has high blood sugar, either because the pancreas does not produce enough insulin, or because the cells in the body do not respond to the insulin that is produced. People with diabetes can experience diabetic neuropathy. The most common symptoms of diabetic neuropathy are numbness, tingling and pain in the legs or feet, and also a risk of skin damage. Treatment of diabetes involves keeping the blood sugar levels normal, usually with diet, exercise, and appropriate medications (insulin).
Sciatica (sciatic neuritis, sciatic neuralgia, or lumbar radiculopathy) is a set of symptoms including pain caused by general compression or irritation of one of five spinal nerve roots of each sciatic nerve or to the left or right or both sciatic nerves. Symptoms include lower back pain, buttock pain, and pain, numbness or weakness in various parts of the leg and foot. Other symptoms include a “pins and needles” sensation, or tingling and difficulty moving or controlling the leg. Typically, symptoms only manifest on one side of the body. The pain may radiate below the knee. Treatment varies depending on the cause of the problem (pregnancy, herniated disc, tumor, etc.). Spinal manipulation, surgery, physical therapy, and pain management are typical treatments.
- Peripheral neuropathy
Peripheral neuropathy is a result of nerve damage. It often causes weakness, tingling, numbness and pain, usually beginning in your hands and feet but also in the legs and other parts of the body. Peripheral neuropathy distorts and sometimes interrupts messages between the brain and the rest of the body. Pain and other symptoms often appear symmetrically, for example, in both feet followed by a gradual progression up both legs. Next, the fingers, hands, and arms may become affected, and symptoms can progress into the center of the body. Treatment includes exercise programs and physical therapy, eating a balanced diet, taking vitamin supplements, and limiting or avoiding alcohol consumption.
Cancer can be a cause of leg pain. Cancer is caused by an uncontrolled division of abnormal cells in a part of the body. Cancer cells are called “malignant” cells. Cancer expands locally by invasion and systemically by metastasis. Traditional treatments include surgery, radiation, chemotherapy. Alternative treatments are becoming more popular. Particular dietary considerations and lifestyle changes have been shown to be effective in cancer prevention.
Arthritis can be a common cause of leg pain. Arthritis is inflammation of joints due to infectious, metabolic, or constitutional causes.
Arthritis leg pain generally is associated with specific joints (e.g., knees or hips). When cartilage around a joint wears down, a person may feel pain, stiffness, and experience swelling at the joint. Arthritic joints may also be warm and have limited movement. Treatment for arthritis pain can include pain treatment, exercise, resting the joint, elevating the effected body part, change in lifestyle, and nutritional or diet changes.
Myalgia isn’t a disease but is a symptom of many diseases and disorders. The most common causes are the overuse or over-stretching of a muscle or group of muscles. Myalgia has also been referred to as muscular rheumatism. Leg pain which is caused by muscle pain can be generally classified as myalgia. Treatments vary depending upon the cause of the problem, but can include pain treatment, exercise, resting the joint, constrictive wrap, cold packs, elevating the effected body part, change in lifestyle, and nutritional or diet changes.
- Muscle cramps
Leg pain can be caused by a muscle cramp in the leg. A muscle cramp is an involuntarily and forcibly contracted muscle that does not relax. Cramps can be prevented by having adequate nutrition and hydration, exercising safely (warming up), and maintaining flexibility t factors. Cramps can be stopped by stretching the muscle. A cramp can last a few minutes or several hours. Cramps of the legs and feet, are common. A cramp of the calf is very common and known as a “charley horse.”
Dehydration can be a cause of leg weakness, pain, and cramping. When a person is dehydrated it means that the body does not have as much water and fluids as it should. The severity of the dehydration (mild, moderate, or severe) is determined by how much of the body’s fluid is lost or not replenished. When it is severe, dehydration is a life-threatening emergency and a person could become unconcious and risk death, heart failure or stroke. Hydration is important in pain management.
- Hamstring injury
A hamstring injury is a common injury to the leg and common cause of leg pain. It is caused by the straining of the hamstring (also known as a “pulled hamstring”). This injury is defined as an excessive stretch or tear of muscle fibers and related tissues of the hamstring muscles — the group of three muscles that run along the back of the thigh, and is common among dancers, runners, and soccer, basketball, football, or tennis players. It occurs with activities that involve running with excessive stopping and starting. Surgery may be needed to repair a torn muscle but generally homecare treatment is advised, including rest, elevation, cold packs, and pain treatment.
Trauma to the leg can be the cause of leg pain. Trauma can be a serious injury or shock to the body, as from violence or an accident. Most leg injuries in children and teenagers occur during sports or play. The risk for injury is higher in sports, such as football, wrestling, snowboarding, in-line skating, soccer, biking, skiing, and skateboarding. Knees, ankles and legs are often injured. Elderly adults with osteoporosis (thinning bones) are more at risk for fractures. Treatment for trauma to the leg varies depending on the injury and may include surgery.
If you are experiencing leg pain and unsure of the cause, see your doctor or trusted health care provider to determine the cause of your discomfort and to seek treatment.
WHAT IS NEUROPATHIC PAIN?
Nerve pain can be extremely uncomfortable and even fatal. There are different types of nerve pain and neuropathy. Neuropathy can effect the internal organs or the extremities and joints.. Peripheral neuropathy can result from problems such as:
- traumatic injuries
- metabolic problems
- exposure to toxins
- medication side effects.
WHAT ARE THE SYMPTOMS OF NERVE PAIN?
Symptoms of nerve pain or neuropathic pain include tingling and numbness extremities. Many patients report sharp shooting pain, or a burning, throbbing and aching feeling. The loss of sensation is described as the feeling of wearing a thin stocking or glove. These sensations are caused by nerve damage to the brain and spinal cord throughout the rest of the body. Diabetic neuropathy is a category of nerve disorders for people with diabetes. Some of the more common conditions which may be associated with diabetic neuropathy include:
- third nerve palsy
- mononeuropathy multiplex
- diabetic amyotrophy
- a painful polyneuropathy
- autonomic neuropathy
- thoracoabdominal neuropathy.
According to the Mayo Clinic definition of neuropathy,
“Peripheral neuropathy, a result of nerve damage, often causes numbness and pain in your hands and feet. Autonomic neuropathy is a nerve disorder that affects involuntary body functions, including heart rate, blood pressure, perspiration and digestion. It isn’t a disease. Autonomic neuropathy refers to damage to the autonomic nerves.
“Depending on the affected nerves, symptoms of diabetic neuropathy can range from pain and numbness in your extremities to problems with your digestive system, urinary tract, blood vessels and heart. For some people, these symptoms are mild; for others, diabetic neuropathy can be painful, disabling and even fatal.”
WHAT IS THE LATEST RESEARCH?
The most exciting recent research is that of Dr. Yu-Wen Chen, PhD, Associate Professor, Department of Physical Therapy, China Medical University. Dr. Yu-Wen Chen is the lead researcher, along with other colleagues, who studied the effects of exercise on neuropathic pain. The most recent study focused on the protein known as Hsp72, known to protect cells from a variety of stresses. The study, appearing in the February 2013 issue of Anesthesia & Analgesia, used rats, divided into four groups: normal sedentary rats, normal rats with exercise, sedentary diabetic rats and diabetic rats with exercise. Diabetes was chemically induced into the control group diabetic rats.
After two weeks, the diabetic sedentary rats exhibited signs of diabetic peripheral neuropathy (DPN). They demonstrated abnormal responses to temperature and pressure, both of which are indications of neuropathic pain. However, the diabetic rats that had exercise showed delayed progress of tactile and thermal hypersensitivity. According to the results, the study showed that exercise significantly effected body weight loss and diabetes-induced blood glucose levels and body weight loss. Says Dr.Yu-Wen Chen and the other authors of the study,
“These results suggest that progressive exercise training markedly decreases diabetes-associated neuropathic pain, including thermal hyperalgesia and mechanical allodynia. In rats, this protective effect is related to the increase of Hsp72.”
This study was similar to another study also conducted by Dr. Yu-Wen Chen and others last year, which concluded significant reductions in neuropathic pain in rats assigned to swimming or treadmill running.
Dr Chen and colleagues examined the effects of exercise on neuropathic pain induced by sciatic nerve injury in rats. After nerve injury, some rats performed progressive exercise — either swimming or treadmill running — over a few weeks, and the researchers recorded observable pain. The researchers concluded that significant reductions were found in neuropathic paor treadmill running. Exercise reduced abnormal responses to temperature and pressure — both characteristic of neuropathic pain. Exercise also led to reduced inflammation-promoting cytokines in sciatic nerve tissue — specifically, tumor necrosis factor-alpha and interleukin-1-beta. In the experiments, exercise reduced abnormal pain responses by 30 to 50 percent
WHAT EXERCISE IS RECOMMENDED FOR NEUROPATHIC PAIN?
Currently doctors agree that low-impact exercise for about 20 minutes a day, is often best for chronic nerve pain because it is much less strenuous on joints and feet. This would include:
- water aerobics
- recumbent stationary bike
- elliptical trainer.
Less intensive exercises improve: blood circulation, and increase movement and heart rate, three things which can lesson the symptoms of neuropathic pain. Muscle damage can be a result of excessive exercise and can be especially painful for someone who already suffers from nerve pain. It’s always best to check with your trusted physician or health care provider before beginning a new exercise routine.
This article is written by Jean Voice Dart, M.S. Special Education from Illinois State University. Jean is a published author and has written hundreds of health articles as well as hosting a local television program, “Making Miracles Happen.” She is a Registered Music Therapist, Sound Therapist, and Master Level Energetic Teacher, and is the Executive Director, founder and Health and Wellness Educator of the Monterey Bay Holistic Alliance. The Monterey Bay Holistic Alliance is a registered 501 (c) 3 nonprofit health and wellness education organization. For more information about the Monterey Bay Holistic Alliance contact us or visit our website at www.montereybayholistic.com.
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