UNDERSTANDING CHRONIC LEG PAIN

Pain is nothing but a symptom of an underlying problem. Pain in the legs is a normal phenomenon, which everyone would have witnessed at one point or another. Pain is classified as chronic if it is present for more than three months.

There are a number of reasons why you might be experiencing chronic leg pain. Chronic pain is an enduring pain that maybe sharp, stabbing or a dull ache. Chronic pain is mostly caused by problems in the nerves, joints, or blood vessels in one or both legs. The most likely causes for chronic leg pain are as below:

Causes Of Chronic Leg Pain:

• Arthritis: Inflammation of the joints causes pain, swelling, and stiffness. The most common types of arthritis are osteoarthritis and rheumatoid arthritis. Osteoarthritis occurs due to degeneration caused by wear and tear, injury, age, or overuse of the joints. In this condition, cartilage wear and tear results in the bones rubbing against the joints resulting in inflammation. Rheumatoid arthritis is an autoimmune problem where our body attacks the healthy cartilages resulting in an erosion of the cartilage that causes inflammation with symptoms of pain, stiffness, and swelling.
• Thrombophlebitis: A blood clot can result in swelling and inflammation of a vein. This condition is called thrombophlebitis and is a very common condition of the legs. The symptoms include pain, tenderness, warmth, redness, and swelling in the area. Thrombophlebitis can be classified into superficial thrombophlebitis or deep vein thrombosis the latter being a more serious problem which needs immediate medical attention.
• Plantar fasciitis: This disorder causes pain in the heel and bottom of the foot. This is caused by inflammation of the plantar fascia (a structure which gives our sole its shape). This happens due to overuse as with athletes or obese people.
• Peripheral neuropathy: Damage to the nerves of the legs causes numbness and tingling in the beginning but can later progress to pain. The main cause of peripheral neuropathy in the legs is diabetes, but there could be other reasons like kidney disease, alcohol dependence, which results in peripheral neuropathy and subsequently leg pain.
• Sciatica: In this condition, the pain stems in the lower back and travels through the buttocks down to the sciatic nerve in the back of the legs. In this type pain is usually experienced or worsens when people stand for a long period of time and tends to reduce on resting or flexing the legs.
• Peripheral artery disease: This is a spectrum of circulatory conditions caused due to narrowing of arteries, which results in reduction of blood flow to the extremities resulting in chronic leg pain and is quite common among smokers and people who are extremely obese.

Symptoms Of Chronic Leg Pain:

• Pain that can be sharp, dull, burning, or aching.
• Stiffness.
• Numbness and tingling.
• Cramps.

Diagnosis And Tests:

The leg pain is assessed by asking the patient various questions related to the condition. A thorough review of the past medical history is also done by the physician. After this, a detailed physical examination is performed in order to determine the cause of the leg pain. The physician will then decide if diagnostic testing, such as x-rays and blood tests need to be performed.

Blood tests such as WBC count, ESR, CRP are performed in case the physician suspects any type of infection. In case of any other medical illnesses being suspected, blood tests related to those conditions are performed.

X-rays are performed in case a fracture or calcification in a joint is suspected. In case of deep vein thrombosis condition, an ultrasound Doppler scan may be helpful. In case a more detailed study of the bones and joints is required, then CT scan may be ordered. CT may also be helpful in finding any hidden fractures. MRI may be ordered for a variety of causes such as to evaluate the back in case sciatica is suspected in order to evaluate the bones, joints, and soft tissues. Nerve conduction studies are ordered in case the doctor needs to evaluate the nerve function. The physician may also order for joint aspiration in case of inflammation of the joint is suspected as the reason for the leg pain in which case fluid is aspirated from the joint and sent for further analysis. In conditions where detailed study of the arteries is required, arteriogram or other such tests might be recommended.

Treatment Of Chronic Leg Pain:

The treatment for the leg pain is based on the diagnosis. When the reason for the leg pain is established, then the treatment is directed towards both controlling the pain as well as treating the underlying problem.

The common treatment modules include, over-the-counter anti-inflammatory medications and prescription medications, adequate rest, and ice and heat packs but all these have their own limitations as most of them are aimed at mere symptomatic relief and are not actually the cure for the underlying disease as such.

Yoga and Ayurvedic massages and therapies are extremely effective in managing pain.

There are various therapies in Ayurveda that aim at reduction of pain as well as treating the underlying cause. The treatment is specific for a specific diagnosis. These various therapies can be classified into local therapies that give pain relief majorly and also contribute to treating the underlying diseases and other panchakarma therapies that remove the disease from is roots which in turn gives pain relief.

The local therapies include – Podikkizhi (Herbal powder massage), Ilakkaizhi (Herbal leaves massage), kativasthi (Pooling medicated oil in the back), Pizhichil (Pouring medicated oils as a stream), Nhavarakkizhi (Massage with rice boiled in medicated milk)
Panchakarma therapies include – Kashaya Vasthi (enema with medicated decoctions) Ksheeravasthi (Enema with medicated milk) and Sneha vasti (enenma with medicated oils). These therapies are extremely effective in relieving pain and strengthening the core muscles. They help in arresting and treating the underlying health condition rather than mere symptomatic relief thereby providing long lasting relief with no side effects.

Managing weight is also an extremely important component in the cure for chronic leg pain.