Leg Pain When Walking: Artery, Nerve and Muscle Causes and When to Be Seen

What it involves

MedlinePlus says peripheral artery disease is a narrowing of the arteries that supply the legs and feet, and that its main symptoms are pain, achiness, fatigue, burning or discomfort in the foot, calf or thigh muscles that appear with walking or exercise and go away after several minutes of rest. Spinal stenosis can cause a different pattern of leg pain.

Who this is for

• Adults whose calves, thighs or buttocks hurt after walking a certain distance
• Patients who need to stop and rest to ease leg cramping
• People with diabetes, high blood pressure, high cholesterol or a smoking history who notice leg pain
• Adults whose leg pain eases when they sit down or lean forward

What to expect

• Questions about how far you can walk, where it hurts and what makes it better, including rest, sitting or leaning forward
• An exam of your legs, feet and pulses, plus a look at your skin and nails
• Blood tests for diabetes, cholesterol and kidney function, and a blood pressure check
• A referral for circulation tests or spine imaging when the findings call for them

The pattern that points to the arteries

MedlinePlus says arterial leg pain typically shows up with walking or exercise and goes away after several minutes of rest, at first only on hills, at a faster pace or over longer distances, and over time with less effort. The legs may feel numb at rest, cool to the touch or look pale. It says people are at higher risk with diabetes, heart disease, high cholesterol, high blood pressure, a history of stroke, kidney disease needing dialysis or smoking. The peripheral artery disease guide covers that condition in full.

The pattern that points to the spine

The MedlinePlus spinal stenosis article describes numbness, cramping or pain in the back, buttocks, thighs or calves that is more likely to appear or get worse when you stand or walk and often lessens or disappears when you sit down or lean forward. That relief with leaning is a useful clue, and it is why a provider asks what position eases the pain. Weakness in part of a leg, poor balance when walking, or trouble controlling urine or bowels are more serious symptoms that need prompt care.

Muscle, vein and other causes

Not every leg ache on walking is an artery or a nerve. Cramping that comes at night or after exertion may be muscular, and the muscle cramps guide explains common triggers. Pain that radiates from the back down one leg may be sciatica, covered in the sciatica guide. Swollen, heavy legs at the end of the day can point to a vein problem, which the varicose veins guide describes. A provider sorts these by exam, history and a few focused tests.

What testing may follow

MedlinePlus lists the exam findings a provider looks for: weak or absent pulses in a leg, lower blood pressure in the affected limb, a whooshing sound over an artery, and skin or nail changes. Tests for arterial disease include an ankle and arm blood pressure comparison, Doppler ultrasound and angiography. For the spine, it lists MRI or CT scan, x-rays and electromyography. At Serenity By A Dr. Sareen the visit covers the history, the exam and blood work, and circulation studies or imaging are referrals.

What helps while you wait for answers

MedlinePlus says people with arterial disease are encouraged to stop smoking, balance exercise with rest by walking to the point of pain and alternating with rest, and take care of their feet, especially with diabetes, always talking to the provider before starting an exercise program. The diabetic foot care guide explains how to check your feet each day. Report any cut or sore that is slow to heal, because that is a warning sign in the legs.

When to get urgent care

Call 911 for sudden severe leg pain with a cold, pale or bluish foot, or for leg pain with sudden weakness, numbness or loss of bladder or bowel control. MedlinePlus also lists sores that do not heal, dark or blue skin, and pain at rest that eases when you dangle the leg over the bed as signs of more severe arterial disease. Do not wait for those to become emergencies. If you have leg pain on walking that has lasted more than a couple of weeks, book a visit.

Sources

• MedlinePlus: Peripheral artery disease, legs (medical encyclopedia)
• MedlinePlus: Spinal stenosis (medical encyclopedia)
• MedlinePlus: Peripheral Arterial Disease (health topic)