What Other Symptoms and Signs May Be Associated With Leg Pain?
Depending upon the cause and the individual situation, symptoms of leg pain may have a wide range of presentation. People describe the pain in a variety of ways, including sharp, dull, heavy, aching, or burning. It may be constant or intermittent or made better or worse with activity or rest. There may be other associated symptoms, depending upon the cause.
People can often feel or palpate pain from muscles and joints, meaning that touching the area reproduces the pain. This may be difficult if the pain originates in one of the muscles deep in the buttock. An example is piriformis syndrome, where the piriformis muscle, one of the muscles that helps rotate the hip and located beneath the gluteus maximus, becomes inflamed and irritates the sciatic nerve that runs beneath it. Physical exam may not be able to confirm the diagnosis suggested by a history of increasing hip pain and sciatica with a normal back exam.
Pain also may radiate from its source to another location, sometimes confusing the patient and the care provider. For example, hip problems may initially present with knee pain; this is especially true in children and it is important to look at the hip whenever a child limps or complains of knee discomfort. With some injuries and arthritic conditions, pain gradually resolves as the muscle or joint warms up during activity, but other times, the pain is worse with use.
Patients who suffer from claudication develop pain with exercise, but as the blood vessels narrow over time, the amount of activity required to bring on the pain decreases. Also, this type of pain tends to resolve with rest. As the disease progresses, at some point, the patient may complain of pain at rest, not requiring exercise or activity to bring it on.
Those who have a blood clot causing ischemia (decreased oxygen supply to the tissues) tend to have an acute onset of pain that is intense and involves the whole extremity below the area of the arterial blockage. There may be associated numbness or paralysis. Sometimes the body is able to dissolve the clot on its own and as the blood supply is restored, the pain resolves. Most often, though, this true emergency requires treatment to dissolve or remove the clot to prevent loss of the leg.
People with neuropathy tend to describe their pain as a burning sensation, while those who have sciatica describe intense sharp pain. Sciatica may also cause changes in sensation along the path of the inflamed nerve root.
Nighttime symptoms of pain and leg cramps may be associated with restless legs syndrome, a sleep disorder.