Source: Spine Health / By: Grant Cooper, MD
Leg pain and numbness can be experienced in many forms—some patients describe the pain as aching, searing, throbbing, or burning, or like standing in a bucket of ice water.
The pain can also be accompanied by neurological symptoms, such as a pins-and-needles sensation, numbness, or weakness. The weakness may be persistent, or it may come on suddenly or unpredictably, often described as the leg “giving out.”
Leg pain may be caused by a problem in the leg, but often the root cause of the problem starts in the lower back, where the sciatic nerve originates, and then travels along the path of the nerve (called sciatica).
Or it could start at the L3-L4 level, where a nerve branches off from the lumbar spine and travels through the front of the thigh.
The medical term for leg pain that is caused by irritation of a lumbar nerve root is lumbar radiculopathy.
Because the lumbar nerves travel through various parts of the leg and foot, a diagnosis of anyone with leg pain, foot pain, and/or leg or ankle or foot weakness or numbness, should include an examination of the lower back.
Leg Pain Symptoms and Descriptions
Not all leg pain derived from low back problems presents the same way. Some typical descriptions of leg pain and accompanying symptoms include:
- Burning pain. Some leg pain is experienced as a searing pain that at times radiates from the low back or buttocks down the leg, or it may present as intermittent pain that shoots from the lower back down the leg and occasionally into the foot. Words that patients use to describe this type of burning leg pain include radiating, electric, or shooting pain that literally feels like a jolt. Unlike many forms of low back pain that can often be a dull ache, for many, leg pain can be excruciating and nearly intolerable. This type of burning pain is fairly typical when a nerve root in the lower spine is irritated, and it is often referred to as sciatica.
- Leg numbness or tingling. Anyone who has had a leg or foot “fall asleep” and then gradually return to normal can imagine what numbness in a leg would feel like. Not being able to feel pressure, or hot or cold, is unnerving. Unlike the short-lived numbness of an asleep limb, numbness coming from a low back problem can be nearly continuous and can severely affect a person’s quality of life. For example, it can be difficult or almost impossible to walk or drive a car if one’s leg or foot is numb. Typical symptoms can range from a slight tingling sensation to complete numbness down the leg and into the foot.
- Weakness (foot drop) or heaviness. Here, the predominant complaint is that leg weakness or heaviness interferes significantly with movement. People have described a feeling of having to drag their lower leg and foot or being unable to move their leg as quickly and easily as needed while walking or climbing stairs, for example, because of perceived weakness or slow reaction. Patients with foot drop are unable to walk on their heels, flex their ankle, or walk with the usual heel-toe pattern.
- Constant pain. This type of pain is normally felt in the buttock area, so it is not technically leg pain but it may accompany some form of pain felt in the legs. It may also be pain that occasionally radiates past the buttock into the leg. This type of pain is usually described as “nerve pain,” versus an aching or throbbing pain. It is typically present only on one side, and is commonly called sciatica or lumbar radiculopathy. It may often be relieved by stretching, walking, or other gentle movement. While the pain is typically on one side, it can occur on both sides if both sides are affected.
- Positional leg pain. If leg pain dramatically worsens in intensity when sitting, standing, or walking, this can indicate a problem with a specific part of the anatomy in the low back. Finding more comfortable positions is usually possible to alleviate the pain. For example, bending or leaning forward slightly may relieve pain from spinal stenosis, while twisting (as in a golf swing) can increase facet joint related groin, hip, and leg ache.
For most leg pain symptoms, an accurate diagnosis of the underlying cause of problems is an important first step in getting effective treatment.