What's Causing Your Leg Pain, Burning and Numbness?

Aching calves, burning legs, numbness in the feet — pain and discomfort in the lower extremities is a common complaint that sends many of us to our doctors seeking relief.

But unless the cause is something obvious, like a fall, pinpointing the source may require some medical detective work. Trying to tough it out, though, will not get you any closer to the answers.

“Leg pain that comes on acutely with a bang, is severe and doesn’t resolve within minutes probably needs to be seen right away,” as it could be a sign of a more serious condition, says Dr. Benjamin Wedro, a clinical professor of medicine at the University of Wisconsin and an emergency physician at Gundersen Medical Center in Lacrosse, Wis. “There’s no trophy for suffering.”

Here are some of the potential causes of leg and foot pain:

Blood Vessel Distress

Pain that occurs when walking or exercising may be the result of claudication or decreased blood supply to the legs. This condition is most often a symptom of peripheral arterial disease, or PAD, a narrowing of the arteries that deliver blood to your limbs, typically caused by the buildup of plaque or fatty deposits. Smoking, high cholesterol, high blood pressure and obesity are major risk factors for PAD.

“The leg pain from PAD tends to occur when you’re active,” says John Fesperman, a family nurse practitioner at Duke Primary Care in North Carolina. “When you’re active, muscles need more blood. The lack of adequate blood triggers pain, which is known as intermittent claudication. Once you stop moving, the pain usually disappears.”

Deep vein thrombosis, or DVT, a blood clot in a deep vein that develops after extended periods of inactivity, can also cause major leg pain. Long flights or car rides make it difficult for the leg to return blood back to the heart. If that blood return slows or stops, it can create a clot within the vein. And if part of a clot breaks off and travels to the lungs, it can cause a pulmonary embolism, a serious and potentially fatal blockage of blood flow to the lungs.

DVT usually occurs in only one leg, Wedro says, causing it to swell and turn a bluish hue. “The onset of pain is gradual and tends to occur over a course of hours,” he says.

Peripheral Neuropathy

In some people, leg and foot (and sometimes arm and hand) pain can be the result of neuropathy, a disorder of the peripheral motor, sensory and autonomic nerves that connect the spinal cord to our muscles, skin and internal organs. Neuropathy can cause numbness, tingling and a heavy sensation. “It usually starts in the feet and may cause a burning sensation in the legs,” Fesperman says. In some cases, people may lose their ability to feel sensation in their legs, which can put them at risk for injury and infection.

Neuropathy can be brought on by many factors, including infection, toxins and the effects of alcoholism, but diabetes is the most common cause. According to the Neuropathy Association, approximately 60 to 70 percent of people with diabetes will at some point develop peripheral neuropathy. It can also affect people who have pre-diabetes and may not be experiencing any other diabetic symptoms.

Electrolyte Imbalance

Healthy muscle function depends on nerves being supported by a well-balanced mix of electrolytes — minerals like sodium, potassium, calcium and magnesium that have an electric charge. Electrolytes transmit signals that support nerve, heart and muscle function, and affect the amount of water in your body as well.

But certain medications; dehydration; and conditions like diarrhea and kidney disease can alter your electrolyte balance. When electrolyte levels become too low, it can cause leg pain. For example, when sodium, which attracts water to cells, is depleted, cells straining to compensate for the lack of fluid can bring on painful cramps.

Diuretics prescribed to control blood pressure are the most common culprits, Fesperman says, because they can deplete electrolytes in the blood. “Potassium and calcium mediate muscle contraction,” he says. “An imbalance in either or both can cause muscle cramping.”

By reducing blood flow, dehydration can cause electrolyte imbalance, and cramps, as well. Likewise, if you drink too much water, you can flush out too many electrolytes.

Back Problems

Conditions that affect your back often lead to pain in the legs as well. Spinal stenosis, in which the spinal canal gradually narrows, pressuring the nerves, usually affects people over 50 and can be caused by arthritis, scoliosis or spinal injury. The pressure can impinge on nerve roots as they leave the spinal cord to form the sciatic nerve, the body’s largest. The irritated nerves can cause significant pain.

Sciatica, a painful inflammation of the sciatic nerve, is typically experienced on one side of the body, and can travel from your lower back down your leg to your feet or even toes. Sciatica is difficult to diagnose and sometimes goes away on its own. It can be brought on by spinal stenosis.

“Sciatic and spinal conditions may come on gradually over time but may also have an acute onset,” Wedro says. “Over time, what had been tolerable becomes an acute issue. Sciatic nerve inflammation caused by changes in the back, such as arthritis, muscle spasm or injury, may radiate into the buttocks and down the leg.”

If the leg pain is accompanied by the loss of bladder or bowel control or numbness near the anus or vagina, seek emergency care immediately. You may have cauda equina syndrome, a rare disorder affecting the nerve roots at the lower end of the spine. Without immediate treatment, the spinal cord can shut down and you may develop permanent paralysis.

Arthritis

There are many types of arthritis. Osteoarthritis, the most common form, breaks down the cartilage in your joints, causing a buildup of painful bone spurs, cartilage loss, inflammation or soreness. Rheumatoid arthritis, an autoimmune disease, attacks the lining of the joints, also causing inflammation and pain.

Although arthritis is a joint disease, the pain it causes can be felt in the surrounding leg and foot muscles. “Any joint under stress can cause pain,” Wedro says. “The pain is within the joints. But the muscles around it try to protect it and you can go into spasms and get secondary muscle pain.”

Getting Treatment for Leg Pain

The appropriate treatment for leg pain depends on the underlying cause. Diabetics may need to improve their blood glucose control to prevent diabetic neuropathy, while arthritis sufferers may need medication or surgery.

“All treatments aim for long-term control of symptoms,” Wedro says. “There may not be one cocktail that works for everybody. It all depends on what has caused the leg pain. It will be trial and error for you and your doctor to find the treatment that works.”

The bottom line? Take all leg and foot discomfort seriously. “Pain means part of the body isn’t working right,” Wedro says. “The problem might be a disaster that is life- or limb-threatening, or it may be an inconvenience that might resolve with a little time and care. But if you have pain, see your doctor. Never dismiss it.”

This article originally appeared on nextavenue.com and was written by Winnie Yu.

14 Everyday Habits Setting You Up For Big-Time Back Pain

Back pain sends more patients to doctors than any condition other than the common cold. In fact, it’s the fifth most common reason for hospitalizations and third most common cause of surgery. And 56% of people with lower-back aches say symptoms disrupt their daily routines, including sleep and sex (consider these 3 best sex positions for back pain). Talk about a pain in the...back.

There are many possible causes of back pain, which means there are also many non-invasive solutions, according to Todd Sinett, a chiropractor and coauthor of The Truth about Back Pain. "Back pain is rarely one catastrophic event," he says in the book, "but several situations combining to create pain." And it turns out that some seemingly insignificant everyday habits can take a big toll on your back over time.

Here, the top 14 mistakes that may be causing your aches and how to correct them.

1. You're a desk jockey.

Did you know that sitting puts 40% more pressure on your spine than standing? Let’s be honest: Maintaining proper posture is probably the last thing you’re thinking about when under a major work deadline. And on a jam-packed day, regular stretching breaks may not seem like a wise way to spend your time. But skipping these habits may cause your back to suffer. That’s because back muscles will weaken if you don’t use them; inactive joints lose lubrication and age more quickly.

Fix It: Sitting at a 135-degree angle can reduce compression of the discs in the spine, so lean back slightly every now and then. Do it when you take a phone call or a coworker stops by to chat, Sinett recommends. Make sure your office chair supports the curve of your spine, he says: Your lower back should be supported, and your head should be straight—not lurching forward—when you look at your computer screen. Get up and walk around for a couple of minutes every half hour—take trips to get water, use the bathroom, or grab papers off the printer. (Or make your own standing desk with these easy tips.)

2. You have a long commute.
Just like at your desk, hunching over a steering wheel can tighten chest muscles and cause your shoulders to round. Slumping posture can zap energy and make you look heavier, not to mention cause back and neck problems. Back pain is the number one complaint of the patients of Darran W. Marlow, director of the chiropractic division at the Texas Back Institute, and he advises them to first think about their driving posture.

Fix it: "Be sure you sit at a 90-degree angle, close to the wheel so you don't have to stretch," he says. "Extending your leg puts your back in a compromised position, but many people don't even realize they're doing it."

3. You skip the gym.
Research shows that 40% of people become less active after back pain strikes—a strategy that's likely to delay healing or even make their condition worse.

Fix it: In fact, most sufferers would benefit from more exercise—particularly frequent walks, which ease stiffness, says spine surgeon Raj Rao, MD. For instant relief, he recommends stretching your hamstrings and hips. You can also try these 4 Exercises To End Back Pain

4. You don't do yoga.

By improving circulation and lowering stress, just about any kind of exercise promotes back pain recovery. But yoga may be best.

University of Washington researchers say yoga eases lower-back pain faster than conventional exercises. In a different study, 101 patients were randomly assigned to one of three groups. The first group took weekly yoga classes and practiced at home; the second group participated in weekly exercise sessions developed by a physical therapist, plus practiced at home; and the third group received a self-help back care book. After three months, the yoga group had better back-related functioning, compared with the other two groups. And after 6 months, patients who took yoga reported less back pain and better back-related functioning. Because it promotes deep breathing and relaxation, as well as stretching and strength, yoga may help with both emotional and structural triggers of back pain.

Fix it: You can find yoga classes everywhere—at gyms, YMCAs, and local studios. Make sure to tell the instructor about your pain so she can help modify certain moves for you. 

5. You're a crunch addict.
Sit-ups and crunches may actually cause more back pain than they prevent, according to Sinett. We hear all the time how a strong core protects your back, which is true. But crunches don’t work the ab muscles that stabilize your back. In fact, they can contribute to pain by causing what Sinett calls core imbalance, "a condition of excessive compression, which results in the spine curving forward in a C-like shape."

Fix it: You don’t have to ditch crunches entirely, but you should do them slowly and use proper form. Include them as part of a broader core workout that also strengthens your transverse abdominus. This muscle is particularly important for a strong, steady core that supports your back, and the best way to strengthen it is with (non-crunch!) exercises like these. Added bonus: You’ll whittle your middle and beat hard-to-torch belly fat while improving posture and relieving back pain.

6. You're not the best eater.
Research shows that eating habits that are good for your heart, weight, and blood sugar are also good for your back. Finnish research found that people who suffered from back pain were more likely to have clogged arteries to the spine than healthy control subjects. Healthy circulation brings nutrients to the spine and removes waste, says Sinett. If this doesn’t happen, inflammation can result, and inflammatory chemicals in the back can trigger nerves to send pain signals to the brain.

Fix it: A back-healthy diet is one that reduces inflammation, according to the The Truth about Back Pain. The book’s plan advises avoiding excess caffeine and processed foods (read ingredient labels for the following: hydrogenated or partially hydrogenated oils, enriched wheat flour, words ending in -ìose, and additives that end in -ìates or -ites), and eating more whole grains, soy, nuts and seeds, protein (chicken, fish, lean meat), vegetables, and fruit.

7. Your life's in your purse.
A stuffed-to-the-gills handbag may cause back damage that's comparable to a sports injury! When you tote a heavy bag, your shoulders become imbalanced, says Sinett. Your body elevates the shoulder carrying the bag, which throws your spine off-kilter. Doing this every day can cause back muscles to ache over time.

Fix it: First, carry the lightest bag possible. (Some of today’s styles—with chains, studs, and other hardware—are heavy even when empty.) The American Chiropractic Association recommends that your bag—when fully loaded—weighs no more than 10% of your body weight. Alternate which shoulder you carry the bag with from day to day, and consider splitting your stuff between two bags (one for each arm), which will painproof your load by distributing it more evenly.

8. Your mattress is really old.

Can't remember the last time you replaced it? Your back may be in trouble. A good mattress lasts 9 to 10 years, according to the National Sleep Foundation, but consider replacing yours every 5 to 7 years if you don't sleep well or your back throbs. A study at Oklahoma State University found that most people who switched to new bedding after 5 years slept significantly better and had less back pain.

Fix it: When you do replace your mattress, take a Goldilocks approach: Pick one that’s not too squishy or too hard. Very firm mattresses can increase pressure on the spine and worsen pain, say Spanish researchers. A study of 313 people revealed that those who caught Zzzs on medium-firm mattresses were more likely to report pain improvement than those on firmer ones. To help ease nighttime discomfort even more, tuck a pillow under your knees if you sleep on your back, between your knees if you're a side sleeper, or beneath your stomach and hips if you snooze on your belly.

9. Your bike isn't quite right.
Do you routinely get a sore back after even a leisurely bike ride? You may need to adjust your equipment. Anywhere from 30 to 70% of bike riders experience some form of back pain, according to Jennifer Chu, MD, an associate professor of rehabilitation medicine at the University of Pennsylvania and a chronic pain expert blogger for Wellsphere. You don’t need to give up on this great form of exercise, but you should make sure your bike is properly fitted for you, advises says former US Olympic cycling coach Ed Burke, PhD, of Colorado Springs, CO.

Fix it: Try this quick test: When you straddle a road bike or hybrid, the bar should be about 1 to 2 inches from your crotch. On mountain bikes, allow 3 to 6 inches. As for your seat height, your down leg should be fully extended when the heel of that foot is on the pedal in the 6 o'clock position. Now put the ball of that foot on the pedal; there should be a slight bend in your knee in the down position. You should be able to keep a slight bend in your elbows and not feel stretched out when holding the handlebars. If your bike isn't adjusted properly, check with a local bike shop or bike club to find someone who can properly fit it for you.

Another tweak that can help: Tilt the front tip of your saddle down about 10 to 15 degrees. This simple adjustment takes pressure off your lower spine and pelvis, research shows. When researchers made this adjustment for 40 recreational cyclists who had back pain, the pain went away in 72% of the group—and another 20% reported significant reduction in pain.

10. You love high heels.

Or flip-flops. Both lead to foot instability, which can in turn affect your back. High heels force you to arch your back, making your spinal muscles work harder. Backless shoes like sandals cause your feet to move from side to side, according to Sinett, which distributes your body weight unevenly and can cause pain.

Fix it: You don’t have to forgo trendy footwear—just don’t walk long distances in them. Commute in comfy flats or supportive sneakers, and consider adding cushioning inserts to uncomfy shoes. When Lehigh University researchers gave back-pain sufferers lightweight, flexible shoes with simple cushions, 80% reported significant relief within a year. (Try these 4 exercises every high heel-wearer should do.)

11. You ignore the pain.
Trying to block out pain could make it worse, finds research from the Rosalind Franklin University of Medicine and Science. A better approach: Let yourself consciously experience the hurt. In a standard pain test, psychologists had 68 back-pain sufferers plunge their hands or feet into ice water. When the volunteers were instructed to suppress the shock of the icy water, a key muscle in the back clenched. In contrast, the muscle didn't tense up when volunteers thought only about the shock. Over time, an increase in muscle tension intensifies pain, says lead researcher John W. Burns, PhD.

Fix it: Accepting pain may be the best way to mentally cope. "Try thinking about the sensory details of the experience, not the negative emotions," says Burns. "If you have a back spasm, describe the pain to yourself—if it's burning or throbbing—and remind yourself that it will pass."

12. You hold a grudge.
To err is human. To forgive could make your aching back feel simply divine. When researchers at Duke University Medical Center studied 58 women and men with chronic lower-back pain, they found that those who practiced forgiveness experienced less anger, resentment, depression—and aches. "Our emotions, muscle tension, and thoughts can directly influence the strength of our pain signals," says researcher James W. Carson, PhD.

Fix it: Forgiveness isn't a once-and-done act; it involves choosing, again and again, to replace anger and resentment with understanding toward someone who has done you wrong. Try this: First imagine someone you love. Think, May this person be at ease, happy, healthy, safe, and secure. Repeat, imagining yourself, then someone you don't know personally. Finally, bring to mind someone for whom you don't have good feelings.

13. You don't veg out.
It's not all in your head—chronic or acute stress can directly trigger back pain. When you’re under the gun, your whole body clenches up, including the muscles in your neck and back. But muscles that contract need to relax eventually, says Sinett. If you’re stressed all the time and those muscles stay tight, it can eventually cause major pain.

Fix it: Sometimes even just realizing that stress may be at the root of your pain can help, says Sinett. Then you can prioritize ways to calm down each day, be it through exercise, laughing with a friend or partner, reading a good book, etc. One particularly helpful therapy, research shows, is listening to music.

In an older Austrian study of 65 people who had herniated disks, researchers found that a combination of music and relaxation imagery significantly reduced lower-back pain. Everyone got standard medical care (painkillers, physical therapy), but half also listened to music and performed relaxation exercises every day. After 10 days, the music group reported less pain while climbing stairs, getting out of bed, and even sleeping. After 21 days, the music group's overall pain was more than 40% less than the nonmusic group. "Music helps reduce stress hormones and muscular tension," says researcher Franz Wendtner, a psychologist at the General Hospital of Salzburg.

14. You watch too much TV.
Parking yourself in front of the tube for hours and hours a day doesn't make your back very happy. For one thing, excess TV time is probably cutting into exercise time, and we’ve already explained how important exercise is to prevent/reduce back pain. In one Norwegian study of teens, those who sat in front of TV or computer for 15 hours a week or more were three times as likely to have lower-back pain as their more active counterparts (the average American teen watches three hours of telly a day). "They sit with the low back flexed—really hunched over—for hours," explains lead researcher Astrid Noreng Sjolie, PhD, a physiotherapist at Hedmark University College in Norway.

Fix it: Limit TV to shows you really want to watch, instead of idly channel surfing. And instead of fast-forwarding through commercials, do some stretches or strength moves during the breaks, which will prevent muscle strain from sitting still too long. If you have a kid complaining of back pain, make sure he walks at least one mile daily; this can cut back pain in half and give his still-developing spine a chance to stretch out.

This article originally appeared on prevention.com and was written by the editors of prevention.com

Overuse injury: How to prevent training injuries

Thinking of starting a new physical activity program or ramping up your current training routine? If so, you may be at risk of an overuse injury — which could ultimately prevent you from being active. Find out what can cause an overuse injury and how to safely increase your activity level.

Common causes of overuse injury

An overuse injury is any type of muscle or joint injury, such as tendinitis or a stress fracture, that's caused by repetitive trauma. An overuse injury typically stems from:

  • Training errors. Training errors can occur when you enthusiastically take on too much physical activity too quickly. Going too fast, exercising for too long or simply doing too much of one type of activity can strain your muscles and lead to an overuse injury.
  • Technique errors. Improper technique can also take its toll on your body. If you use poor form as you do a set of strength training exercises, swing a golf club or throw a baseball, for example, you may overload certain muscles and cause an overuse injury.

Risk factors for overuse injury

Although an overuse injury can happen to anyone, you may be more prone to this type of injury if you have certain medical conditions. Overuse injuries are also more likely to occur as you get older — especially if you don't recognize the impact aging can have on your body and modify your routine accordingly.

For these reasons, it's a good idea to talk to your doctor ((*and health care team)) before starting a new activity or ramping up your current routine. Your doctor may offer tips to help make physical activity safer for you. If you have a muscle weakness in your hip, for example, your doctor may show you exercises to address the problem and prevent knee pain.

Avoiding overuse injury

Most overuse injuries are avoidable. To prevent an overuse injury:

  • Use proper form and gear. Whether you're starting a new activity or you've been playing a sport for a long time, consider taking lessons. Using the correct technique is crucial to preventing overuse injuries. Also make sure you wear proper shoes for the activity. Consider replacing your shoes for every 300 miles you walk or run — or at least twice a year if you regularly exercise.
  • Pace yourself. If you're starting a new fitness program, avoid becoming a weekend warrior. Compressing your physical activity for the week into two days can lead to an overuse injury. Instead, aim for at least 150 minutes of moderate aerobic activity or 75 minutes of vigorous aerobic activity — preferably spread throughout the week. It's also a good idea to take time to warm up before physical activity and cool down afterward.
  • Gradually increase your activity level. When changing the intensity or duration of a physical activity, do so gradually. For example, if you want to increase the amount of weight you're using while strength training, increase it by no more than 10 percent each week until you reach your new goal.
  • Mix up your routine. Instead of focusing on one type of exercise, build variety into your fitness program. Doing a variety of low-impact activities — such as walking, biking, swimming and water jogging — in moderation can help prevent overuse injuries by allowing your body to use different muscle groups. And be sure to do some type of strength training at least twice a week.

Recovering from overuse injury

If you suspect that you have an overuse injury, consult your doctor. He or she will likely ask you to take a break from the activity that caused the injury and recommend medication for any pain and inflammation.

Be sure to tell your doctor if you've recently made changes in your workout technique, intensity, duration, frequency or types of exercises. Identifying the cause of your overuse injury will help you correct the problem and avoid repeating it.

When you think the overuse injury has healed, ask your doctor to check that you've completely regained strength, motion, flexibility and balance before beginning the activity again. When you return to your activity, pay special attention to proper technique to avoid future injuries.

Playing it safe

Don't allow an overuse injury to prevent you from being physically active. By working with your doctor, listening to your body and pacing yourself, you can avoid this common setback and safely increase your activity level.


This article originally appeared on Drugs.com

Non-Invasive Manual Osteopathy Relieves Low Back Pain

Researchers from the University of North Texas have determined that non-invasive osteopathic manual therapy will reduce low back pain in a majority of cases – avoiding expensive and invasive back surgery.

The University of North Texas researchers and Texas College of Osteopathic Medicine researchers conducted their research on 455 patients – 269 (59%) with back pain with low severity and 186 (41%) with severe low back pain.

The researchers performed their treatment research with randomization and double-blindedness using what is referred to as “sham-control.” “Sham control” refers to treatments that appear to be the same as the studied treatment but are not the prescribed treatment. In other words, they appear to be the treatment but they are not.

The researchers oversaw the treatment of the back pain patients over eight weeks of therapy, and then assessed the outcomes of the treatments after twelve weeks.

The patients were treated six times per week with Osteopathic Manual Treatment – also referred to as biomechnical treatment.

At the assessment most of the patients reported substantial improvement in pain reduction and back functioning for their particular movements. The majority of patients reported at least 50% or more reduction in pain.

Those with severe back pain had more than double the chance of significant improvement after treatment with Osteopathic Manual Therapy than those who were treated with sham treatment. And those treated with OMT had 80% chance of significant improvement on the standardized Roland-Morris Disability Questionnaire – which qualifies the mobility of the patient – as compared to those treated with the sham (placebo) therapy.

The researchers concluded that:

“The large effect size for Osteopathic Manual Therapy in providing substantial pain reduction in patients with chronic Low Back Pain of high severity was associated with clinically important improvement in back-specific functioning. Thus, Osteopathic Manual Therapy may be an attractive option in such patients before proceeding to more invasive and costly treatments.”

Osteopathic manual therapy utilizes the patient’s own relative muscle strength to help align, balance and strengthen those muscles and ligaments that support the spinal column. While most conventional medical treatments focus upon the spinal column and nerves in an isolated manner, often requiring expensive surgeries that often fail, osteopathic manual therapy utilizes safe and non-invasive guided treatments that allow the spinal region to reposition itself, rendering greater support for the lumbar region.

This article originally appeared on realnatural.org and is written by Case Adams.