Why Do My Legs Hurt When I Walk?

Allan Lee, DPT

September 2009

Walking our beautiful mountains is a great way to get your heart rate going, enjoy the great outdoors, and shed some unwanted pounds.  With our area housing some of the best hiking trails in the Tri-State region, this old fashioned exercise is easy, fun, convenient, and free.  The only equipment required is a comfortable pair of shoes and a water bottle.  Sounds perfect doesn’t it?  Unfortunately, walking isn’t so easy for everybody.  This article looks at three non-arthritic conditions that can cause leg pain and may affect walking, as well as, some ways to treat and manage them.  The conditions are peripheral artery disease, chronic venous insufficiency, and lumbar spinal stenosis.

Peripheral artery disease (PAD) is a form of atherosclerosis where fat and cholesterol line your arteries.  Symptoms include cramping and tight pain that is felt in the muscles below a narrowed artery. It’s felt commonly in the buttocks, thigh, calf or foot, but occurs most often in the calf. The pain begins with walking, gets worse until you stop, then goes away with rest. This is a result of the muscles starving for oxygen due to restricted blood flow.  For treatment, the latest research has found that a highly structured, supervised exercise program can help people increase the distance they are able to walk before the discomfort begins. These programs usually involve closely monitored therapeutic exercise and endurance training.

Like PAD, chronic venous insufficiency is a condition of poor circulation, however, the veins become the culprit.  In people with chronic venous insufficiency, the valves in our veins are damaged and are unable to return blood from the feet and legs back up to the heart.  Symptoms usually involve swelling, dermatitis and cellulitis.  The legs feel achy and heavy accompanied by a tight bursting-type pain when walking.  Treatment includes posturing techniques to improve blood flow, vein-pumping leg exercises, and compression stockings.  Surgical treatment is reserved for the most serious cases.

Spinal stenosis is a condition in which the spinal canal narrows, squeezing the spinal cord or one of its many branches that exit out of the spinal column.  When you have lumbar spinal stenosis, the pain is normally felt in the legs and can be accompanied by weakness, numbness, or nocturnal leg cramps.  Since stenosis and PAD resemble, a key difference is that trunk flexion will help relieve lumbar spinal pressure therefore reducing pain in those with stenosis.  A physical therapy program aimed at strengthening back and abdominal muscles is often successful at preventing surgery.  Other physical therapy treatments include soft tissue mobilization, modalities such as heat or ice, and patient education. 

So don’t let painful legs stop you from enjoying our stunning hiking trails, downtown city streets, or your own back yard.  These are conditions that can be treated and can return you to a physically active lifestyle.

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