Numbness and pain in leg and foot

by Nathan Wei, MD, FACP, FACR

Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.

Click here: Second Opinion Arthritis Treatment Kit

This problem can occur as a result of a number of conditions. It will help if we talk about the structures that might be responsible.

First, could it be blood vessels. When arteries (the blood vessels that carry blood from the heart to the legs) get blocked, then lack of blood flow to the leg will cause pain, as well as numbness. The affected leg will feel cooler than the other leg also. The leg may turn blue or purple.

The common causes for this are atherosclerosis or a clot- an embolus. This condition is an emergency. Sometimes clot dissolving drugs may work. Other times the clot needs to be removed surgically. Sometimes the blocked artery needs to have bypass grafting done.

When the veins (blood vessels that carry blood back from the leg to the heart) get clogged as a result of blood clot, then pain and swelling may occur in the entire leg and foot. This is called thrombophlebitis and is a life threatening emergency!

Finally, the nerves. Nerve entrapment (pinching) may occur at any level in the leg from the low back on down. Probably the most common cause of pain and numbness in the leg and foot is a pinched nerve in the low back. This is called lumbar radiculopathy.

Lumbar radiculopathy may be treated in a number of different ways. When the pressure on the nerve is severe and the patient is losing function in the leg or losing function in the bladder or bowel, this is considered a surgical emergency.

Patients who have pain without significant loss of function can be managed more conservatively with physical therapy, medications, and injections. In severe cases where there is a progressive neurologic deficit or intractable pain,surgery may be required.

Nerves can also be pinched more peripherally and cause symptoms similar to radiculopathy. An example might be tarsal tunnel syndrome where the posterior tibial nerve is pinched at the ankle.

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