How to tell the difference between nerve pain, circulatory pain and muscle pain in the legs
Nerves, arteries, and muscles, oh my!
Nerve pain referred from the spine into the limbs is called radiculopathy. It often can refer anywhere the nerve travels. For instance, your sciatic nerve exits out of the lower back and supplies the whole lower extremity. If the nerve is irritated, it can refer pain all the way to the toes.
I have had patients tell me that they feel a burning sensation, a “giving way” sensation, tingling, pins and needles and numbness. Neurogenic claudication occurs when the nerves are getting compressed in the spine and causes leg pain. This type of pain is usually felt with activity.
Spinal stenosis is a condition that causes a narrowing of the spinal canal. In this case, pain can be experienced with walking on level surfaces. It’s usually better with sitting or forward bending in the trunk. Walking on an inclined surface or walking while leaning over onto a grocery cart will sometimes feel better in that you may be able to walk further with less pain because walking on an incline decreases the natural curve in the lower back and gives the nerves a little more space.
Circulatory pain can be caused by problems with the arteries and/or veins. My patients who have this typically tell me that their legs feel cold or heavy. They also tell me that they might have a deep ache that is not tender to touch. Cramping and throbbing can also be symptoms. Pain typically increases with activity without relation to the position of the spine and it will subside with rest. Smoking can affect this pain due to the constriction of the blood vessels caused by smoking. To check your circulation, there are several medical tests that you can take that include an ultrasound and a test called the Ankle-brachial index. The ABI compares the blood pressure in the arm to the blood pressure in the leg. If you aren’t sure whether or not you have any problems with your circulation, talk to your medical provider about these tests.
Muscle pain can be caused by increased activity, dehydration, overuse, injury, or medical issues including fibromyalgia, dystonia, flu, hypothyroidism, Lyme disease and many others. Typically, localized muscle pain is due to overuse, injury, or tension. Whole body muscle pain is usually due to some other process like the flu or Covid. Muscle pain can also be a side effect of different medications.
Many of my patients describe their muscle pain as sore, tender, local to one area of the body, spasm, tight, and/or stiff. It may be alleviated with the application of heat or ice and over the counter medications. Soaking in an Epsom salt bath is also helpful. This pain may be alleviated with light activity and light stretching.
Take good care,
Sharon