Leg pain and foot pain vary in type and severity and typically depend on a person’s lifestyle and associated medical problems.1 In addition to leg pathology, leg pain may be caused by a condition affecting the lower back, hip, or pelvic region. The type of pain may differ based on the underlying cause.

This article provides a guide to the potential causes, specific diagnostic procedures, and the different types of treatment approaches available for leg and foot pain.

Spinal Causes of Leg Pain

Problems in the lower spine may affect the spinal nerve roots, causing pain to radiate into the leg and/or foot (radiculopathy). Common causes of leg and foot pain that originate in the spine include:

Compression of the spinal cord in the neck and/or cauda equina in the lower back can also cause leg pain.

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Blood Vessel Causes of Leg Pain

The arteries and/or veins in the legs may get inflamed or blocked, causing leg and foot pain. Common causes include:

  • Peripheral artery disease: Decreased circulation caused due to blocked arteries.2
  • Deep vein thrombosis: Blood clot in the deep vein(s) of the leg causing decreased or altered blood flow.3
  • Superficial thrombophlebitis: Blood clots in the superficial veins of the leg causing varicose veins or spider veins to form underneath the skin surface.4

Blood vessels may also get ruptured and cause bleeding within the tissue spaces of the leg, causing acute pain and swelling.

Pelvis and Hip Related Causes of Leg Pain

Pain from the joints and/or muscles of the pelvis and hip may be referred into the legs. Common causes include:

  • Piriformis syndrome: Spasm of the piriformis muscle in the pelvis impinging the sciatic nerve.

    See What Is Piriformis Syndrome?

  • Sacroiliac joint dysfunction: Abnormal motion or malalignment of the sacroiliac joint.

    See Sacroiliac Joint Dysfunction (SI Joint Pain)

  • Hip osteoarthritis: Wear-and-tear arthritis of the hip joint.

    Read about Hip Osteoarthritis on Arthritis-health.com

  • Trochanteric bursitis: Inflammation of a fluid-filled sac (bursa) on the side of the hip.

    Read about Hip Bursitis on Arthritis-health.com

Pelvic bone fractures or other hip joint problems due to trauma, overuse, or degeneration may also cause leg pain.

Leg Pain due to Nerve Damage

Certain medical conditions may cause damage to the peripheral nerves in the leg. Common causes are:

  • Metabolic conditions, such as type 2 diabetes mellitus5 or hypothyroidism.6
  • Infections, such as bacterial infection of the vertebral bone and disc, epidural abscess (accumulation of pus in the epidural space surrounding the spinal cord), herpes zoster, HIV, and/or Lyme disease.5

    See Osteomyelitis, a Spinal Infection

Rarely, autoimmune conditions such as Guillain-Barré syndrome, where the body's immune system attacks the peripheral nervous system may cause leg pain.5

Nutritional Causes of Leg Pain

Deficiency of certain vitamins and minerals may cause damage to the peripheral nerves (peripheral neuropathy) resulting in leg pain and/or weakness. Typical nutrient deficiencies include7:

  • Vitamin B12
  • Vitamin B6
  • Copper

Excessive intake of alcohol and heavy metals, such as arsenic, thallium, or mercury may also cause peripheral nerve damage and pain in the legs.

Causes of Foot Pain and Numbness

Certain conditions may cause pain and/or numbness in the foot with or without leg pain. Foot pain commonly occurs in:

  • Tarsal tunnel syndrome: Compression of the tibial nerve due to trauma, swelling, poorly fitting shoes, tendon problems, or enlarged arteries or veins.8
  • Peroneal neuropathy: Compression of the peroneal nerve due to trauma, tumors, or other systemic conditions.9

    See All About Neuropathy And Chronic Back Pain

  • Sural nerve entrapment: Compression of the sural nerve due to tumors, scar tissue, or from wearing tight ski boots.10
  • L5 and/or S1 radiculopathy: Compression of the L5 or S1 nerve roots in the lower back.

    See All about L5-S1 (Lumbosacral Joint)

Severe foot weakness can cause foot drop (inability to lift the foot off the ground).

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Risk Factors for Leg Pain

A few risk factors associated with leg and foot pain include:

  • Advanced age
  • Genetics
  • Poor posture
  • Occupations, such as heavy labor, sports, or military service

While the listed causes and risk factors are not comprehensive, one or more of these conditions are typically associated with leg and foot pain.

Read more: Leg Pain and Numbness: What Might These Symptoms Mean?

Several causes of leg pain can produce overlapping signs and symptoms. It is important to accurately diagnose the underlying cause of leg pain in order to effectively treat the condition as well as rule out serious problems, such as tumors, infections, or nerve damage.

References

  • 1.Brewer RB, Gregory AJ. Chronic lower leg pain in athletes: a guide for the differential diagnosis, evaluation, and treatment. Sports Health. 2012;4(2):121–127. doi:10.1177/1941738111426115
  • 2.Zemaitis MR, Bah F, Dreyer MA. Peripheral Arterial Disease. [Updated 2019 May 25]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK430745/
  • 3.Stone J, Hangge P, Albadawi H, et al. Deep vein thrombosis: pathogenesis, diagnosis, and medical management. Cardiovasc Diagn Ther. 2017;7(Suppl 3):S276–S284. doi:10.21037/cdt.2017.09.01
  • 4.Di Nisio M, Wichers IM, Middeldorp S. Treatment for superficial thrombophlebitis of the leg. Cochrane Database Syst Rev. 2018;2(2):CD004982. Published 2018 Feb 25. doi:10.1002/14651858.CD004982.pub6
  • 5.Grimm BD, Blessinger BJ, Darden BV, Brigham CD, Kneisl JS, Laxer EB. Mimickers of Lumbar Radiculopathy. Journal of the American Academy of Orthopaedic Surgeons. 2015;23(1):7-17. doi:10.5435/jaaos-23-01-7
  • 6.Hanewinckel R, Ikram MA, Van Doorn PA. Peripheral neuropathies. In: Neuroepidemiology. Elsevier; 2016:263-282. doi:10.1016/b978-0-12-802973-2.00015-x
  • 7.Staff NP, Windebank AJ. Peripheral neuropathy due to vitamin deficiency, toxins, and medications. Continuum (Minneap Minn). 2014;20(5 Peripheral Nervous System Disorders):1293–1306. doi:10.1212/01.CON.0000455880.06675.5a
  • 8.Kiel J, Kaiser K. Tarsal Tunnel Syndrome. [Updated 2019 Feb 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-.Available from: https://www.ncbi.nlm.nih.gov/books/NBK513273/
  • 9.Poage C, Roth C, Scott B. Peroneal Nerve Palsy. Journal of the American Academy of Orthopaedic Surgeons. 2016;24(1):1-10. doi:10.5435/jaaos-d-14-00420
  • 10.Brewer RB, Gregory AJ. Chronic lower leg pain in athletes: a guide for the differential diagnosis, evaluation, and treatment. Sports Health. 2012;4(2):121–127. doi:10.1177/1941738111426115
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