An Overview

Many medical conditions are associated with both pain in the legs and fatigue, and determining the cause of these symptoms requires a trip to the doctor or podiatrist. To make a diagnosis, your doctor or podiatrist needs a thorough understanding of your history, including what brings on your symptoms, what improves them, and what other symptoms occur. Leg pain can range from a mild nuisance that comes and goes, to debilitating pain that makes it difficult to sleep, walk, or engage in simple everyday activities. Leg pain and numbness can be experienced in many forms, for which some patients describe the pain as aching, searing, throbbing, or burning.

Pain in the legs can occur as a result of conditions that affect bones, joints, muscles, tendons, ligaments, blood vessels, nerves, or skin. Leg pain can occur in the foot, ankle, knee, behind the knee, thigh, down the back of the leg, or in any part of the leg. It can occur at night, while lying down, or while running or exercising, depending upon the cause. Also depending on the cause, leg pain can occur in one leg only, or in both legs. Typically, the pain is a result of tissue inflammation emanating from injury or disease. Either injury or chronic disease can cause inflammation to any of the tissues of the leg leading to pain. Since the leg contains a number of different structures and tissue types, a wide variety of conditions and injuries can bring on pain.

Again, depending on the cause of the pain, other symptoms, like weakness, numbness, throbbing, cramps, aching, or a tingling sensation, may accompany the pain. Diabetic neuropathy (nerve damage from diabetes), is a common cause of tingling, burning, and numbness in the legs that can at times be painful. For diagnostic and therapeutic purposes, it is important to differentiate the exact type and location of any pain in the legs. Peripheral artery disease can cause claudication – pain that occurs in the legs usually when walking or exercising. Blood clots (deep vein thrombosis), can be another cause of leg pain. Pain in the knee and ankle joint pain is common with the arthritis conditions. The pain of sciatica (from disc disease of the spine), may radiate down the leg and is another frequent cause of leg pain.

Overtraining

Overtraining is a type of overexertion that can cause both fatigue and muscle aches. Usually seen in competitive athletes, it can occur too in ordinary fitness enthusiasts who exercise intensely over an extended period of time. Other symptoms of overtraining can include irritability, insomnia, anxiety and increased susceptibility to infection.

Circulatory Causes

Disorders that decrease circulation to the legs can cause aching and fatigue. An example of such a disorder is peripheral arterial disease ( PAD). Caused by atherosclerotic plaques that block arteries in the extremities, it’s similar to the plaques that block coronary arteries in coronary artery disease. PAD classically causes leg pain while walking or climbing stairs, and improves with rest. Frequently, there is an overall feeling of fatigue due to decreased circulation.  It typically affects older individuals with a long history of cigarette smoking, and other cardiovascular disease risk factors, such as high cholesterol and diabetes. PAD is a potentially dangerous disorder, as it may also accompany a serious degree of coronary artery disease.

Autoimmune Disorders

Autoimmune disorders occur when the immune system mistakenly recognises part of the body as a foreign invader and attacks it. These disorders typically cause pain in the area under immune attack, as well as constitutional symptoms, such as fever and fatigue. Polymyalgia rheumatica is an example of an autoimmune disorder that can cause leg muscle aches and fatigue. Other symptoms include fever, malaise, and unintended weight loss. Polymyalgia rheumatica typically affects older individuals. Like most autoimmune disorders, it affects women more often than men.

Fibromyalgia and Chronic Fatigue Syndrome

Fibromyalgia and chronic fatigue syndrome (CFS), are diagnoses of exclusion. This means that they are not so much causes of leg pain and fatigue, but are diagnoses given when other causes cannot be determined. Fatigue, headache, muscle aches and sleep disturbance are among the symptoms common to both syndromes. Fibromyalgia symptoms are more closely associated with increased pain perception, with CFS symptoms more aligned with fatigue and flu-like complaints.  Given their similarities, however, these differences may represent a spectrum of outcomes from a common underlying disorder. Depression is a common feature of both syndromes, which when treated, frequently improves the symptoms. This fact does not necessarily imply that the syndromes are fundamentally psychiatric, since depression can lead to fatigue and increased pain sensitivity.

Deep Vein Thrombosis (DVT)

This is a blood clot in the deep veins of the leg, rather than the superficial varicose type veins. It typically causes a one-sided swollen, hot, painful leg.

Sports Injuries

Musculoskeletal injuries sustained by sporting activity fall into four broad groups, and this applies for leg injuries too. Activities like jogging, running and hiking, create repetitive impact forces that overload muscles and tendons. Shin splints produce severe localised tenderness in the muscles, and sometimes bone pain.

Hamstring strain is yet another overuse injury, often associated with running. It gives rise to an acutely painful area in the rear of the thigh muscle, due to a partial tear. This usually develops because of inadequate flexibility training, or poor warm up and stretching exercises before an activity.

Are you represented in any of the areas indicated? Don’t ignore your condition, take the required action to preserve your quality of life.

Your feet mirror your general health . . . cherish them!