When people experience pain in their legs, it can fall into two major categories: acute or chronic.
Acute pain comes on suddenly and is often caused by injury or damage to the bones, tendons or ligaments in the legs. Among the most common causes of acute leg pain are broken bones, ligament or tendon tears, or something as simple as growing pains.
Chronic pain is pain that occurs for several weeks, is not necessarily the result of a specific injury or trauma and does not go away even after conservative treatment options have been tried.
Causes of Chronic Leg Pain
When acute injury or trauma to the structures of the leg are ruled out as the reason for leg pain, physicians will begin to look for other causes. These include degeneration and inflammation, which in many cases go hand-in-hand—and don’t always have their origins in the legs themselves.
Examples of degeneration and inflammation in the legs include:
- Osteoarthritis: When the cushioning cartilage between the joints of the hips and knees begins to break down, it causes inflammation and pain that radiates into the legs.
- Bursitis or tendonitis: Bursitis occurs when the small, fluid-filled sacs (bursae) that cushion the bones, tendons and muscles near joints become inflamed. Tendinitis is the result of swelling or irritation of tendons, the thick cords that attach muscle to bones such as the hips, knees and ankles.
But sometimes leg pain is actually caused by inflammation and degeneration in the spine. This results in pressure on the nerves that serve the legs. Some of the culprits include:
- Herniated disk: When the soft, jellylike center of a spinal disc leaks out through a tear in the disc’s tough outer layer it can irritate a nearby nerve. This may result in pain, numbness or weakness in the legs.
- Complex Regional Pain Syndrome (CPRS): This chronic condition can develop after an illness or injury which may not have directly damaged the nerves in the legs, yet still causes them to swell and be painful and sensitive to touch.
- Sacroiliitis: If there is inflammation of one or both of the sacroiliac joints that are located where the lower spine and pelvis connect, it can result in leg pain.
- Sciatica: The sciatic nerve leads from the lower back through the hips and buttocks and down each leg. When the nerve is compressed from a herniated disk, bone spur or spinal stenosis (see below) it can cause inflammation, pain and/or numbness in the affected leg.
- Spinal stenosis: When the spaces within the spine narrow, they put pressure on the nerves that travel through the spine and lead to pain, tingling, numbness and muscle weakness in the legs.
Get a Leg Up on Pain
Thanks to advances in interventional pain management techniques, patients with chronic leg pain can get long-lasting relief without the need for surgery or hospitalization.
Minimally invasive procedures require only small incisions and can be performed on an out-patient basis. Skilled pain management specialists use x-ray (fluoroscopic) guidance to deliver targeted treatments of medications or special medical devices to the source of the pain.
- DRG Stimulation uses a small electrical stimulator to intercept pain signals that originate in the bundle of nerve bodies called the dorsal root ganglion (which serves the legs) and replaces the pain with a tingling sensation before the signals reach the brain.
- Facet Joint Injections deliver anti-inflammatory steroids to irritated facet joints in the spine where the cartilage between the joints has worn down, resulting in leg pain.
- LinQ™ is a minimally invasive therapy for patients with chronic sacroiliitis that involves implanting a small bone graft into the sacroiliac (SI) joint to stabilize and fuse it.
- Lumbar Epidural Injections deliver highly anti-inflammatory steroids to the epidural space of the spinal cord to address leg pain that actually originates in the lower (lumbar) region of the back.
- Nerve blocks are injections of strong anti-inflammatory steroids directly to a specific spinal nerve root that is causing leg pain.
- Spinal Cord Stimulation enables the patient to cancel out pain without sacrificing the ability to feel other sensations. A small device with a wire that runs between the spine and an external remote is implanted under the skin. When the patient begins to experience pain, they use an external remote to activate the device which intercepts the pain with a message that is described as a gentle tingling.
- Vertiflex involves feeding a small h-shaped spacer through a tube and placing it between the vertebrae in patients with spinal stenosis to expand the space and relieve the pressure on affected nerves.
These specialized interventions should be performed by a board certified pain management specialist who has the training and expertise to identify and deliver these treatments to the exact source of the patient’s leg pain.
Dr. Ioannis Skaribas is fellowship-trained and double board certified in Pain Medicine and Anesthesiology. He has been performing minimally invasive treatments to address chronic pain for more than 25 years and is nationally recognized for his expertise in employing the latest advanced treatments such as LinQ™ and Vertiflex to help his patients with chronic leg pain.