Leg pain that appears while walking can come from more than one source. Two conditions that may produce activity-related discomfort are peripheral artery disease (PAD) and sciatica or other spine-related nerve problems.
Because the symptoms can overlap, people sometimes assume their pain is caused by a pinched nerve when circulation is part of the problem, or assume circulation is the issue when the spine is responsible. Understanding the typical patterns can help you know what information to share with your healthcare provider.
What Is Peripheral Artery Disease?
PAD occurs when arteries supplying the legs become narrowed, most commonly because of atherosclerosis. Reduced blood flow may become noticeable when leg muscles need more oxygen during activity.
A classic symptom is claudication, which may feel like cramping, aching, burning, tightness, fatigue, or heaviness in the calf, thigh, hip, or buttock.
What Is Sciatica?
Sciatica describes symptoms that occur when the sciatic nerve or related nerve roots are irritated or compressed. It may be associated with a herniated disc, spinal degeneration, or other back conditions.
Sciatica often causes pain that travels from the lower back or buttock into the leg. Patients may also experience tingling, numbness, burning, or weakness.
Clue #1: What Makes the Pain Start?
PAD-related claudication is closely tied to muscular activity. A patient may be able to walk a fairly predictable distance before discomfort begins.
Nerve-related pain can also appear with walking, but it may be influenced by posture, spinal position, sitting, standing, coughing, or certain movements.
Clue #2: What Makes the Pain Stop?
This distinction can be especially useful.
With PAD, simply stopping the activity is often enough for discomfort to improve because the muscles’ demand for blood decreases.
With spinal stenosis or some nerve conditions, patients may need to sit down, bend forward, or change position before they feel better. This is sometimes called a “shopping cart” pattern because leaning forward on a cart can relieve symptoms.
Clue #3: Are There Foot or Skin Changes?
PAD can produce signs that are not typical of sciatica, including:
- A foot that feels colder than the other
- Changes in skin color
- Reduced hair growth on the lower legs
- Slow-healing wounds
- Weak pulses in the feet
- Rest pain in more advanced disease
These symptoms raise additional concern about circulation.
Clue #4: Are Back Symptoms Present?
Sciatica may be accompanied by lower-back discomfort, shooting pain, electric sensations, or symptoms that follow a recognizable nerve pathway.
PAD does not originate from the spine. However, a person can have both PAD and degenerative spine disease, so back pain does not automatically rule out a vascular problem.
Risk Factors Also Matter
Your medical history helps guide the evaluation. PAD is more common in people with a history of smoking, diabetes, high cholesterol, high blood pressure, kidney disease, or other cardiovascular disease.
If you have several of these risk factors and your legs consistently hurt during walking, it is reasonable to ask whether circulation has been evaluated.
How Is PAD Checked?
A common first test is the ankle-brachial index (ABI). This noninvasive test compares blood pressure in the ankle with blood pressure in the arm. An abnormal result can support a diagnosis of PAD.
Depending on the findings, vascular ultrasound or other imaging may be recommended.
Why the Correct Diagnosis Matters
Treatment for nerve compression is very different from treatment for narrowed arteries. Assuming all leg pain is “sciatica” can delay the identification of PAD, while assuming every walking problem is vascular can overlook a spine or nerve disorder.
At Vascular Centers of America, our specialists evaluate circulation-related causes of leg pain and use vascular testing to determine whether reduced blood flow is contributing to your symptoms.
If leg pain is limiting how far you can walk, contact Vascular Centers of America to discuss whether a vascular evaluation is appropriate.