Tired, Aching Feet

There are many conditions or symptomatic complexities that can make your legs feel sore, tired and painful.

In order to determine the cause of the pain, you must first try to define the pain by examining the following questions:

• What is the nature of the pain? For example, is the pain dull
  or sharp?
• What part of the leg hurts? Is the pain localized (confined to a particular area) or diffused (spread out over a whole area)?
• How long does the pain last? Is it short-term or long-term?
• When does the pain hit? For example, does the pain gradually set in, or do you feel it all of a sudden?
• What is the course of the pain? Does the level of pain remain steady, or does it get progressively worse or better?
• What factors aggravate the pain? For example, does exercise or particular activities make it worse?
• What kind of treatment have you attempted, helpful or not?

NERVE PAIN

Damage to the nervous system can produce a variety of chronic pain syndromes in the leg.

• The pain may be localized or diffuse depending on the
  nerves involved.
• The pain may be sharp and shooting in nature.
• The pain may cause tingling, numbness or burning.

Injury in one location may actually cause pain in another. For example,
a back injury that affects the sciatic nerve will cause pain in the back of
the leg.

Other examples of nerve pain include:

• Peripheral Nerve Injury
• Tarsal Tunnel Syndrome
• Morton's Neuroma

MYOFASCIAL PAIN SYNDROMES

Also called fibromyositis ("myositis" means inflammation of muscle tissue) or fibromyalgia ("myalgia" means muscle pain), myofascial pain syndromes result following chronic injury to muscles and their surrounding connective tissue. The disorder is characterized by aching pain, tenderness and stiff muscles, and mainly affects areas where a tendon connects to other muscles. There may or may not be an associated or underlying condition.

INTERMITTENT CLAUDICATION

When arteries harden and become blocked, circulation decreases, resulting in achy, crampy, tired feeling legs. This condition, called intermittent claudication, occurs when your muscles are not receiving all the oxygen they need, and usually occurs during exercise or anytime you walk long distances. You will typically feel pain in the calf, but the pain can also arise in the foot, thigh, hip or buttocks. You can relieve symptoms with rest, though they will recur when you try to walk or exercise again.

BONE PAIN

Bone pain is often due to shin splints, periostitis or stress fractures. Typically, the anterior compartment muscles – the three muscles that lie directly beside the lower leg bone on the front of the leg are affected, usually following running type exercises.

• Shin splint – A shin splint affects the outside of the shin,
  and is caused when the Tibialis anterior muscle, one of the muscles responsible for flexing your foot upwards, is overused during activity. A shin splint occurs from the constant flexing of the muscle.
• Periostitits – This condition occurs when irritation progresses from the muscle to its insertion into the bone, causing the outer lining of the bone (the periosteum) to become inflamed.
• Stress fracture – When the irritation progresses to the bone, and bone resorption predominates over bone production with actual injury to the bone, you have a stress facture. Stress fractures of the lower extremity typically occur in the tibia
  (large lower leg bone) and the metatarsal bones (long bones in the foot).

RESTLESS LEG SYNDROME

If your legs feel uncomfortable in any position, particularly during rest and sleeping, and you feel the need to constantly move them, you may have a condition called restless leg syndrome. The cause of this condition is unknown.

Treatment of any type of leg pain relies on the proper diagnosis. The first step in generalized leg pain is to determine the system that is involved before defining the specifics.

Analgesics – non-narcotic and narcotic – are used to help relieve
leg pain.

• Non-narcotic analgesics, sold over the counter,
  are used for mild pain and include:
• Aspirin
• Acetaminophen (Tylenol)
• Ibuprofen (Motrin)
• Naproxen (Aleve)

Here is a list of some popular nonsteroidal anti-inflammatory drugs (NSAIDs) used for mild to moderate pain. A prescription is required for these drugs.

• Celebrex
• Vioxx
• Bexstra

Narcotic analgesics require a prescription and are used for moderate
to severe pain. These are typically opioids, and include propoxyphene, codeine, hydrocodone, oxycodone, and morphine. They are often combined with aspirin and acetaminophen. Narcotic analgesics
are addicting.