Knee pain can appear in many forms. Arthritis, an injury, and gradual wear and tear as you age can all have an effect on your activities and comfort level. If you’re unable to walk or climb a stairs because of your pain (and have tried several non-invasive methods to find relief), knee replacement surgery may be the best way to get your life back. While the benefits of the procedure may significantly outweigh temporary discomfort, it’s important to have realistic expectations regarding your recovery timeline and knee replacement pain after surgery.

What does knee replacement surgery recovery look like?

During knee replacement surgery, your doctor will make an incision before moving your knee cap and cutting away any damaged bone, cartilage, and joint surfaces. Artificial joints will then be attached and tested by bending and rotating your knee before your doctor closes your incision with stitches.

Whether you’re having a total or partial knee replacement will have an effect on your pain level and recovery.

A traditional total knee replacement will typically require one to three months of recovery with the use of a walker or a cane. On the other hand, a partial knee replacement is much less invasive. Patients usually walk without assistance within two weeks. This is because the incision is much smaller and there is significantly less blood loss. While this may sound more appealing than a total knee replacement, only about 10% of patients are good candidates for a partial knee replacement procedure.

After your surgery, you’ll follow weight-bearing guidelines. How much pressure your new knee can initially support will depend on the condition of your natural bone, as well as the type of prosthesis you have.

Also note that every patient heals at a different pace. Practicing knee-strengthening exercises before surgery can help you recover more quickly, but an elderly patient, smoker, or someone who suffers from other medical conditions may take longer to heal. Talk to your doctor about your medical history to gain a better understanding of what to expect from your personal recovery journey. Always follow their directions exactly for recovery.

What causes pain after knee replacement surgery?

Researchers continue to study the many causes of pain after knee replacement surgery. Some are biological and due to conditions present before surgery, while others are due to complications that arise during surgery.

On the biological side, patients suffering from arthritis may experience increased sensitivity because of the ongoing pain that was present before surgery. As we’ll explain below, inflammatory responses and allergy-related problems can also contribute to persistent pain. Another source of pain is referred pain originating from the hip due to a change in alignment.

If you are experiencing ongoing pain after knee replacement surgery, but do not have a medical history of arthritis or the previously mentioned issues, you may be dealing with surgical complications. While your doctor will take steps to prevent problems, it’s still possible for these to rare issues to occur:

• Infection
• Nerve injury
• Prosthetic loosening
• Poor alignment or rotation
• Incorrect sizing
• Instability
• Stiffness

Remember to stay open and honest with your doctors. This will help them properly diagnose and treat the problem to get you the pain relief you’re looking for.

Where will I feel knee replacement pain?

As mentioned above, knee replacement pain can come in many different forms depending on the cause. Knee pain is to be expected due to the surgical procedure itself, with swelling, bruising, and the introduction of prosthetic parts.

Beyond that, it is possible to feel pain in parts of the body other than your knee. This is known as referred pain.

Your hips, lower back, groin area, and calves may initially hurt due to the change in your stance and the way you walk. Of course, it is also typical to feel sore due to extended amounts of time in bed during your recovery.

Knee replacement pain: The week following surgery

You should expect to stay in the hospital for several days following knee replacement surgery. This is often considered the most painful stage of the recovery process. Your doctor will prescribe medications to help you manage your pain level.

In addition to icing your knee, you may be encouraged to move your foot and ankle to increase blood flow and lower the risk of swelling and blood clots. Your doctor may also use blood thinners, support hose, and compression boots to prevent further complications.

Generally the day after surgery, a physical therapist will show you exercises that will help you recover your range of motion and continue to heal. You may even be asked to get up and take a few steps (with assistance). Patients who get up and put a safe amount of weight on their new knee typically experience a quicker recovery.

After leaving the hospital, most patients continue to take some form of pain medication for two to six weeks. Your doctor will determine the best method of pain relief for your specific needs, whether it is over-the-counter medications or something stronger.

Knee replacement pain after three months

Swelling and bruising can continue for three months or more following knee replacement surgery. However, it varies from patient to patient and depends on the condition you were in before surgery. Many patients are back to their activities without the pain they had before surgery by this stage of recovery.

If you find that any movement or activity is still exceedingly painful after three months, you may be experiencing chronic pain. Chronic pain is defined as pain persisting for three months or longer. It’s a condition that affects roughly 20% of knee replacement surgery patients. It can develop and increase in intensity in the weeks and months following surgery. This can have a huge impact on your overall quality of life. Talk to your doctor for help.

Pain after knee replacement: six months

If you are still experiencing pain six months after surgery, you may be wondering how long it will be until you feel normal again. Unfortunately, there is no easy answer.

In some cases, it may take up to a year for all of your swelling to completely go away. Your knee will continue to recover for years to come, as scar tissue forms and your muscles become stronger with continued physical therapy and light exercise.

As previously mentioned, if you are still experiencing debilitating levels of pain at this stage, you could be suffering from chronic pain. While you may be tempted to “tough it out,” it’s important to talk with your doctor. Together, you can find what is causing your persistent pain and come up with a plan to fix it.

Knee replacement pain, a year and beyond

The goal of knee replacement surgery is to help you get back to the activities you love. Your doctor will encourage you to stay fit through activities like swimming, cycling, and even golf. This type of exercise will help you stay limber and pain-free.

On the contrary, there are certain activities that could negatively affect the prosthetic joint materials in place. Even normal use will begin to wear out the implants, but excessive weight or activity can cause your knee replacement to loosen and become painful. You may need to avoid running, jogging, high-impact exercises, and contact sports for the rest of your life following surgery.

The good news is that studies show more than 90% of total knee replacements are still functioning properly 15 years after surgery. Staying healthy and following the advice of your doctor will help you achieve these long-term benefits.

While it’s possible for pain to persist for a year and beyond, it shouldn’t be debilitating. Scar tissue can continue to heal, as well as the muscles in your knee, but if you’re suffering from ongoing pain after a year, always talk to your doctor.

How to treat knee replacement pain

If you’re frustrated with the pain you feel on a daily basis, you have options for relief. Consider the following treatment options and talk with your doctor about which route is best for your specific needs.

Non-invasive remedies

If you’re suffering from knee replacement pain, you’ll by exploring simple at-home remedies, such as applying ice packs or hot compresses.

Knee braces are also popular for many patients. If your pain is associated with repetitive movements or specific stresses, a brace may help. It can restrict or stabilize joint movement to reduce your discomfort. Some patients wear a brace during certain activities or times of day. This can help keep their knee in a better position.

Physical therapy can also correct the effects of repetitive stress. A physical therapist uses a regimen of specific exercises and stretches to condition your muscles, tendons, and ligaments. Range of motion exercises and weight bearing activity are also important for maintaining muscle strength. In addition, physically fit people tend to have less pain and better recoveries, both short-term and long-term.

Medications

A daily regimen of commonly available medications could help you manage your pain. Your doctor may recommend aspirin, naproxen, or ibuprofen to inhibit the production of inflammatory molecules in the body, thus reducing the associated pain.

For more severe forms of pain, talk to your doctor about other knee pain medications.

Knee injections

Injections for knee pain have proven to be effective for patients who have tried several other treatments, but aren’t quite ready to consider more interventional procedures.

Corticosteroid injections are a great option for treating flare-up pain and swelling in your knee caused by fluid buildup. If this type of injection fails, your doctor may consider using a hyaluronic acid injection. Hyaluronic acid provides lubrication and acts as a shock absorber to provide padding for the knee.

Unfortunately, injections are a short-term solution. Most procedures will alleviate the pain for about four weeks to six months. Doctors don’t recommend receiving more than two or three shots per year. They’re best used in conjunction with other pain-relieving methods, like physical therapy.

Genicular nerve block with radiofrequency ablation

Instead of more invasive surgical options, many patients turn to a genicular nerve block to treat and diagnose persistent knee pain. A genicular nerve block uses anesthetic injected into one or more of the genicular nerves to interrupt pain signals being sent to the brain.

Unfortunately, a genicular nerve block’s effects only last eight to 24 hours. Doctors use genicular nerve blocks to test the effectiveness of the procedure on a person’s knee pain. Many patients who experience relief with genicular nerve blocks will then get radiofrequency ablation. When combined, these two procedures can offer pain relief that lasts anywhere from six months to a year.

Revision surgery

In rare, but serious cases, you may need knee replacement revision surgery to ease or cure your chronic pain.

Most doctors agree that unless the cause of pain is clearly identified as implant-related, revision surgery has been shown to result in poor outcomes. Your doctor will be able to determine if this is the best option for you based on your medical history and pain level. The majority of patients do not have to undergo an additional surgery.

If you’re in Arizona and are experiencing persistent knee replacement pain, contact our pain specialists today. Our team of experts at Arizona Pain are highly skilled in all areas of pain management. We are committed to finding treatment options that are compatible with your medical history and lifestyle. You don’t have to suffer alone. Get help today.

More than just a break from the challenges of the day, sleep helps the body heal and better deal with life’s daily stresses. If you experience calf pain at night, a full measure of shut-eye may prove elusive. Here are some common causes of calf pain at night, along with suggestions to prevent and relieve it.

What are the different types of calf pain at night?

Lower leg pain at night is different for everyone who experiences it. Even if the causes are the same, the types of pain you feel may vary from person to person (and even from night to night!).

Three common types of calf pain at night include:

• Leg cramps
• Muscle soreness
• Referred pain from other conditions

Leg cramps at night (a.k.a. charley horses)

You likely know how these cramps feel. They can last for a few seconds or stretch on for agonizing minutes.

Leg cramps occur when the gastrocnemius muscle of the calf spasms involuntarily. In addition to pain, this typically feels like your calf muscles are tight or knotted and can be so severe as to make it hard to flex your feet. About 60% of people experience nocturnal leg cramps at some point in their lives.

Muscle soreness

Muscle soreness is another very common type of lower leg pain at night.

We may not even realize it’s there until we turn out the light and lay down. Muscle soreness has many causes and can range from mild and fleeting to severe and debilitating.

Referred pain from other conditions

Referred pain is pain that does not necessarily originate from the calf itself but the calf is affected by it at night.

Lower leg pain in this instance may be a result of injury to another part of the body that forces the calf to compensate all day, resulting in soreness at night. For example, sciatica is a common cause of referred calf pain at night.

Why does calf pain at night happen?

Calf pain at night may be fleeting, or it may occur regularly. For those who regularly experience lower leg pain at night, there are a few common calf pain at night causes to look for, including:

• Dehydration
• Pregnancy
• Sciatica
• Shin splints
• Parkinson’s disease
• Deep vein thrombosis (DVT)
• Varicose veins
• Diabetic neuropathy
• Torn or strained Achilles tendon
• Injuries

Note that you should always talk to your doctor if you’ve been experiencing calf pain at night for an extended length of time, or if it becomes severe enough to limit your overall quality of sleep.

Dehydration

The simplest cause to remedy and one that is often overlooked, dehydration can cause leg cramps at night (and at any other time of day).

If you’re dehydrated, you may feel tired and your urine may be dark yellow (instead of the pale straw color of proper hydration). Muscles in all parts of the body may cramp and feel tense.

Pregnancy

Add pain in the legs at night to the long list of ways that pregnancy can make you uncomfortable!

The additional weight of a growing baby causes the arches of the feet to flatten a bit, forcing your calf muscles to work harder. This can create muscles soreness that you notice at night when you lay down to rest. Many pregnant women also experience sciatica in the lower legs as the baby grows and compresses the sciatic nerve.

Sciatica

Sciatica is a common cause of pain in the legs at night. The sciatic nerve is the longest and widest nerve in the body, originating in the lumbar spine and traveling across the buttocks and down the hips to end in each foot.

Any injury along the length of this nerve can result in referred pain anywhere along its length (including the calf). In addition to pain, calf pain at night caused by sciatica may be accompanied by tight muscles and restricted movement and numbness or tingling.

Shin splints

Shin splints affect the front of the calf and occur when the muscles and the tendons on the shins are overworked. The resulting inflammation can be painful, especially at night.

Simple activities like walking on flat ground may be restricted by painful shin splints.

Parkinson’s disease

Parkinson’s disease is a neuromuscular disease that has, as a primary symptom, involuntary muscle contractions. These contractions can affect any muscle group in the body, including the lower legs.

Deep vein thrombosis (DVT)

Deep vein thrombosis is a serious medical condition that can be fatal.

If you have long periods of inactivity (i.e., during a long flight or car ride), blood clots can form in the lower leg and travel through the blood stream to the lungs. This could cause a fatal pulmonary embolism. Treat this as a serious medical emergency, especially if you’re feeling other pulmonary embolism symptoms.

Varicose veins

Varicose veins occur when the walls and valves of your veins weaken and expand, sometimes due to age and sometimes as a result of another condition.

You can see these larger veins clearly at the surface of the skin as twisted, sometimes raised, and deep purple. If you have varicose veins and are on your feet throughout the day, you may experience an aching soreness in your lower legs at night.

Diabetic neuropathy

Nerves all over the body are damaged by continually fluctuating blood sugar levels that come with diabetes.

Diabetic neuropathy is a common complication that causes pain in the lower legs at night, following by tingling sensations and finally numbness.

Torn or strained Achilles tendon

Often the first indication of an Achilles tendon tear or strain (tendinitis) is pain in the calf. This can feel like soreness and quickly change into a stabbing pain in the lower leg whenever the foot is moved.

Other injuries

Strains, sprains, and broken bones in the legs can all result in calf pain at night that ranges from a dull ache to a sharp pain.

When should I see a doctor about calf pain at night?

If you are experiencing calf pain at night that seems unrelated to minor muscle overuse or that changes over time, talk to your doctor.

While it may be easily related to an underlying medical condition, it is possible that lower leg pain at night could be a symptom of something serious. At a minimum, talking to your doctor about calf pain at night can set your mind at ease and help you get a good night’s sleep.

Note that new calf pain after long periods of inactivity or travel can be caused by a blood clot, and this is an emergency medical situation that requires immediate attention. If your regular doctor is not immediately available, go to the nearest emergency room for treatment.

How to relieve calf pain at night

Of all of the causes of calf pain at night, there is one that is very simple to treat: dehydration. Ensuring that you get adequate amounts of water during the day for your body and activity level is crucial and is an easy treatment for pain caused by an electrolyte imbalance.

For all other conditions that can cause calf pain at night, here are some treatment options, broken down by each cause.

Pregnancy

In many cases, leg cramps at night will resolve themselves shortly after the baby is born. As long as there is no threat of blood clot, sometimes leg and foot massages can help relieve muscle soreness.

Some expectant mothers report good pain relief (and better sleep) when they use a transdermal magnesium spray, stretch regularly, and use a heating pad to relax tight, sore muscles.

Sciatica

The best way to treat calf pain at night caused by sciatica is to treat the underlying condition.

If a herniated disc is causing sciatic pain that extends into your calf, treating that may immediately relieve your pain. Otherwise, physical therapy and stretching can relieve pain, as can regular exercise.

Shin splints

Shin splints are best treated with a period of rest and ice, as well as the proper use of NSAIDs for pain and inflammation.

To prevent shin splints from occurring, proper stretching and warm-ups are important. Additionally, wearing supportive, properly fitted shoes can help exercise safely and in comfort.

Finally, you may need to reevaluate your training program. Shin splints often occur after you increase your mileage or distance when running or walking. If you’re suffering from severe pain, you may need to decrease your training program or switch to a few weeks of low impact exercise instead.

Parkinson’s disease

Treating lower leg pain in Parkinson’s patients is all about managing this progressive disease while making patients as comfortable as possible.

For lower leg pain at night, over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen sodium can go a long way to relieve inflammation and pain. Other treatments like soaking in an Epsom-salts bath and gentle massage and stretching can also help to prevent calf pain at night.

Deep vein thrombosis

Deep vein thrombosis is more likely in patients who are inactive and overweight. Important treatments for this include losing weight and increasing activity. If you need to be sitting for long periods of time, compression socks can help prevent clots.

Additionally, for those who are particularly at risk, medications like blood thinners may be in order. Talk to your doctor before travel or other long periods of inactivity if you have risk factors for this serious condition.

Varicose veins

Calf pain at night from varicose veins can be prevented with the use of support stockings during the day.

Additionally, alternating between standing and sitting can help to give your legs a rest. If the pain of your varicose veins becomes unbearable, talk to your doctor to explore other treatment options.

Diabetic neuropathy

The key to preventing calf pain at night caused by diabetes is to work hard to get your blood sugar under control.

The cause of diabetic neuropathy is nerve damage caused by fluctuating blood sugar levels. It makes sense that finding a balance in diet and medication can help prevent further damage. Work with your doctor to find that balance, and then follow your treatment recommendations going forward.

Torn or strained Achilles tendon (and other injuries)

For active people with tendinitis, torn Achilles tendon, or other injuries that lead to calf pain at night, the recommended treatment may be the hardest for them: rest. Activity can cause further inflammation and irritation to an already-inflamed and irritated muscle or tendon. Taking time off from vigorous activity gives the injury time to heal properly.

During the acute phase of injury, applying ice in a 20-minutes-on, 20-minutes-off schedule can provide relief and decrease inflammation. NSAIDs can provide temporary relief of pain and inflammation as well, but take care to follow directions for use. Long-term use of even over-the-counter NSAIDs can cause serious side effects. Depending on the severity of your injury, you may also need to consider physical therapy, braces, or surgery with your doctor.

Each cause of calf pain at night is as unique as the person experiencing it. If lower leg pain at night is keeping you up, it may be time to talk to a pain specialist. If you’re in Arizona, contact the team at Arizona Pain for more help with your calf pain at night. 

Living with hip pain can be frustrating and debilitating, especially when it has an effect on how you go about your daily routine. You may find it difficult to simply walk upstairs or get adequate sleep. Dealing with this type of discomfort can even put a strain on relationships with the people who care for you every day. Whether the cause of your pain is due to an injury or a medical condition, your doctor may recommend hip replacement surgery if all other options have been unsuccessful. Unfortunately, pain after hip replacement surgery can occur as well.

As with any surgery, it’s normal to have concerns before you undergo any procedure. It’s important to know, though, that the benefits often outweigh the possibility of complications and pain after hip replacement surgery. This post covers the information you need to know regarding pain after hip replacement surgery. We also discuss ways to cope with it and things to be aware of during your recovery.

What are normal amounts of pain after hip replacement surgery?

During a hip replacement, your surgeon will remove damaged sections of your hip joint and replace them with artificial parts made of metal, ceramic, or plastic. In the long run, these parts should improve your range of motion and reduce any pain you currently experience. However, like any surgical procedure, a hip replacement can cause short-term pain.

It is difficult to determine how much discomfort you will experience after surgery because every person and case is unique. Always talk with your doctor about the type and severity of pain you’re experiencing during your recovery and follow their directions for pain management.

Typically, many patients may find relief from over-the-counter medications, such as Tylenol (acetaminophen). The Food and Drug Administration (FDA) considers 2,000-3,000 milligrams per day to be safe, but you should consult with your doctor regarding an appropriate regimen for your specific needs. For example, if you are elderly or have a history of liver problems, you will need a smaller dose.

Many patients won’t find relief from over-the-counter medications and will need a prescription for something stronger. Your doctor will determine if a prescription pain killer is appropriate for your pain management and will provide a schedule of how much you should take and how often.

Recovery restrictions after hip replacement surgery

You can expect to spend about three days in the hospital following surgery, though you may need to stay longer if your doctor recommends it. Your doctor or a physical therapist will discuss precautions you should be aware of for the weeks after your surgery. During this time, you will usually need to use crutches or a cane to stabilize your movements to prevent further injury.

Your physical therapist will also help you learn how to use a shower bench and raised toilet seat to make daily functions easier during your recovery.

Patients with a desk job can usually return to work within a month, but physicians don’t recommend driving for several months. If your job requires more extensive physical activity, you will have to plan on staying home a number of months.

In terms of an overall recovery, you can expect to feel mostly back to normal within three months, but a full recovery can take approximately one year. Your doctor will be able to anticipate specific restrictions you may face due to your current condition and medical history.

Additional challenges for men

Recent studies show that women often have better outcomes than men following hip replacement surgery. Researchers looked at 97,000 cases of hip and knee replacements at an Ontario hospital and found that men:

• Were more likely to make a trip to the emergency room within 30 days
• Suffered from more heart attacks
• Needed revision surgery more often
• Were more likely to suffer a serious infection after surgery

If you’re at a higher risk for complications, make sure to talk to your doctor about all of your concerns.

Where will I feel pain after hip replacement surgery?

You can expect to experience some discomfort in the hip region itself, as well as groin pain and thigh pain. This is normal as your body adjusts to changes made to joints in that area.

There can also be pain in the thigh and knee that is typically associated with a change in the length of your leg. This is one of the many reasons why it’s important to closely follow a physical therapy routine following your surgery. You will be asked to do various exercises during the day. Some patients continue to work with a physical therapist at home to learn how to correctly sit, stand, get out of bed, and walk. This process can be invaluable to get your mobility and strength back.

While it is common to experience some pain at the site of your incisions, new advances in technology have made this aspect of the procedure much easier. Smaller instruments allow for incisions of just three inches, rather than the larger incisions that were necessary in the past. This improved technique allows for less damage to the muscle and soft tissue. This can reduce the level of pain you can expect to experience after surgery.

How long does hip replacement pain last?

Every patient’s recovery time is unique based on several personal factors. Most people, though, experience surgical pain for approximately two to four weeks following hip replacement surgery.

Your activity level, medical history, and any pain you’re dealing with before surgery have an effect on how long it will take you to make a full recovery. If you don’t have other health issues, such as diabetes or high blood pressure, you can expect to recover faster.

Most people report feeling better every week as they continue to do physical therapy stretches and exercises. You may still need to adhere to a continuous schedule of pain medications after surgery. Doctors also recommend sleeping with a foam wedge between your legs for about three months. This can help stabilize your hip at night.

Why am I still experiencing pain?

Nearly 200,000 people in the U.S. undergo hip replacement surgery every year, making it one of the safest surgeries to perform. In fact, the success rate is incredibly high with only 2% of patients reporting surgical complications like joint infection.

However, if you are still experiencing significant pain after surgery, you should contact your surgeon as soon as possible to find out what is causing the pain to persist. This will ensure that treatment is given in a timely manner to prevent further damage. If pain persists beyond what is considered to be normal, it could be due to one of several risk factors.

Hip replacement surgery pain causes may include:

• Infection
• Fracture
• Dislocation
• Change in leg length
• Loosening
• Aging prosthetic hip joints

Let’s look at these in more detail.

Infection

An infection most often occurs at the incision site, but is easily treated with antibiotics. A more serious internal infection may require another surgery to remove the artificial parts that were put into place.

Fracture

Unfortunately, it is possible for the healthy parts of your hip joint to fracture during surgery. While these will often heal on their own, larger fractures may need to be corrected with additional parts, such as pins or metal plates.

Dislocation

Certain positions can cause your hip to dislocate when the ball of your new joint becomes dislodged. In that case, your doctor will give you a brace to keep your hip in place. Some cases may require additional surgery for stabilization.

Change in leg length

While your surgeon will do several things to avoid this problem, sometimes a new hip can cause one leg to be longer or shorter than the other. Muscles surrounding the hip can be the culprit of this condition, but strengthening and stretching may help.

Loosening

It is considered rare because of medical advancements and the prosthetic parts used today, but it is possible for your new joint to have issues becoming fixed to the bone. In other cases, they simply loosen over extended periods of time. Surgery is needed to fix this type of complication.

Aging prosthetic hip joints

For patients who have undergone a hip replacement at a young age and remained relatively active, it is possible for the parts to wear out over time. New implants are making this increasingly rare, but a second hip replacement may be necessary in some cases.

What treatments can help chronic hip pain?

It’s important to talk to your doctor if you are still experiencing pain that affects your day-to-day life months after surgery.

Once the cause of your pain is established, there are a range of options available to help you get the relief you need. It is best to try non-invasive treatment options before turning to revision surgery or more invasive forms of pain management.

Physical therapy and rehabilitation

Exercises, stretches, training, and conditioning can help ease pain and improve your range of motion. Many patients recovering from hip replacement surgery tend to limit normal movement and activity due to pain, but this can increase your risk of further disability.

Working with an experienced physical therapist will guarantee that you have a routine designed specifically with your personal recovery in mind.

Transcutaneous electrical nervous system (TENS)

This non-invasive treatment option involves the placement of pads containing electrodes on your skin above nerves. These electrodes then emit electrical impulses that can block pain signals.

Only mild side effects from this treatment have been reported. This may include redness, burning, or stinging of the skin under the pads and temporary muscular discomfort. Because of this, this treatment can be used on older patients suffering from osteoarthritis and osteoporosis as well as others who are trying to avoid medications.

Medications

Whether you’re experiencing mild or severe pain, your doctor can help you devise a medication plan. NSAIDs like aspirin can manage acute cases of pain by inhibiting inflammation in joints and other tissues. However, NSAIDs can be harmful if taken long term. Side effects include gastric ulcers, acid reflux, and kidney damage.

If all other therapy options have failed, your doctor may consider opioid painkillers, such as morphine or oxycodone. Due to the highly addictive nature of these drugs, a pain specialist will assess your situation and any risks before prescribing this type of medication.

Nerve blocks and radiofrequency ablation

Pain-blocking injections can inhibit the pain signals of spinal nerves that serve the hip region. When a nerve block is administered, you will be numbed to reduce discomfort before the specialist uses imaging techniques to ensure an accurate injection. This will directly target the hip joint to reduce pain and inflammation.

Radiofrequency ablation is another procedure in which nerves are prevented from sending painful signals. This method may provide pain relief for a number of months by using thermoelectric energy to disrupt parts of the nerve responsible for pain signals.

Spinal cord stimulation

If the previous methods discussed are not successful, your doctor may recommend spinal cord stimulation.

This procedure involves the placement of a device within a targeted area of the spine. The implant includes electrodes that emit an electrical signal that overrides pain signals of the nerves responsible for a certain area, such as the hip joint. This is often connected to a control device outside the body. There, the patient can manage pain-correcting signals as needed.

Surgery

For most people, hip replacement surgery successfully improves hip pain and their overall quality of life. However, additional surgery may be needed if the pain persists and all other methods of pain management have proven to be unsuccessful.

This is often considered a last resort due to the invasive nature and additional recovery time. Your doctor will decide if this is necessary in your specific case.

Get help with your pain

At Arizona Pain, we are proud to offer a team approach for pain management. We offer on-site chiropractic care, behavioral therapy, a procedure center, and more.

If you are experiencing pain due to hip replacement surgery, make an appointment with our award-winning physicians to learn more about your treatment options. We are eager to help you find the relief you need so you can get back to living your life.

Getting a full, restorative night of sleep is something we take for granted, that is, until foot pain at night keeps us tossing and turning. Our feet work hard to support us every day, with little reward or attention until something goes wrong. When you begin to experience foot pain after lying down, here are our tips to relieve foot pain at night.

What causes foot pain at night?

We might be used to foot pain after a long hike or a grueling day on our feet, but there are other foot pain causes that aren’t necessarily connected to these common events. Foot pain can occur in anyone at any age. Child foot pain at night, in particular, can be especially challenging.

Here are the most common causes of foot pain, in adults and children alike.

Plantar fasciitis

The plantar fascia is a long band of connective tissue that stretches from your heel to the ball of the foot. It provides stability for walking and support for the arch of your foot. When the plantar fascia is injured due to overuse (or improper use), inflammation and tightness can cause tremendous foot pain at night.

This condition is known as plantar fasciitis. During the night, your plantar fascia may shorten as the toes point in sleep, making the first step in the morning excruciating. This pain generally gets better for a short period as the day continues, but after a full day of movement the pain flares up, resulting in foot pain at night.

Reflex sympathetic dystrophy

When the foot is injured, swelling and pain are the body’s reflexive, protective response. This tells you something is wrong so that you slow down and care for the injury.

However, sometimes the body takes it too far, offering an abnormal nerve response with excessive swelling, pain, and even temperature changes. The nerves of the foot are essentially hyperactive in their response. This can lead to very sensitive feet that experience painful sensations even with the slightest touch.

Peripheral neuropathy

Peripheral neuropathy involves pain in the nerves reaching towards the extremities. An injury the sciatic nerve, for example, can cause pain all the way down to the feet (where the nerve ends).

Other causes of this type of pain include poorly controlled diabetes (both types I and II), infections, and vitamin deficiencies.

Chronic overconsumption of alcohol

Overconsumption of alcohol leads to poor circulation in the body and a condition called alcoholic neuropathy.

In addition to foot pain at night, symptoms of this condition may also include:

• Burning sensation in the feet
• Muscle spasms
• Loss of muscle control or weakness

Morton’s neuroma

Affecting more men than women, Morton’s neuroma is the thickening of the nerves surrounding the toes—most often the third and fourth toes.

People with this condition experience burning, tingling, and cramping, all of which worsen at night.

Pinched nerves

Pinched nerves in the legs, hips, back, and feet can cause excessive foot pain at night.

In some cases, this occurs as a result of sleeping position. Minor adjustments can go a long way towards relieving this type of pain. In others, the pinched nerve becomes damaged due to injury or other trauma and must be treated to provide relief.

Restless leg syndrome

Those with diabetes, rheumatoid arthritis, low iron, and kidney failure may be familiar with restless leg syndrome that leads to nighttime foot pain.

With this condition, a dopamine imbalance confuses the nerves responsible for sending signals to the brain. More than just legs that cannot seem to be still, this syndrome also comes with burning, tingling, numbness, and pain after lying down. These symptoms occur from the waist down, including the feet.

Bunions

Bunions are hard deposits of bone on the side of the foot just below the big toe or pinkie toe joint (sometimes both). Left untreated, bunions can result in toe pain at night that feels like a stabbing pain sideways through the foot.

Swelling, stiffness in the morning, and soreness at the affected toe joint are also common.

Child foot pain at night: growing pains

The most common cause of child foot pain at night (and one that can wake your children from sleep) is growing pains. Most people assume that growing pains are caused by spurts of growth in the bones that outpace muscles, tendons, and ligaments, but bones grow at an approximately even pace throughout development.

In many cases, growing pains are actually caused by other mechanical issues, such as:

• Gait imbalances
• Structural issues (i.e., being knock-kneed or pigeon-toed)
• Poor posture
• Flat feet or feet that point outwards
• Fatigue

All of these can lead to what feels like shooting, stabbing pains in the feet at night. Typically, growing pains are more severe at night and ease with activity.

When should I see a doctor for foot pain at night?

As stated above, occasional foot pain at night due to a long day or a grueling hike might result in sore muscles all over the body, including the feet. This type pain is nothing to be concerned about and should pass quickly.

However, you should consider seeing a doctor for foot pain at night if your foot pain:

• Is not related to abnormal exertion
• Persists for more than a night or two
• Begins to worsen
• Begins to change or move further into the body (i.e., calf pain or knee pain occurs, too)
• Impacts your mobility during the day
• Is accompanied by visible redness or swelling that is unrelieved by comfort measures (e.g., rest, ice, elevation, and over-the-counter medications)

Foot pain that lasts longer than a couple days is not always a cause for alarm, but it’s best to get it checked out just in case.

How to relieve foot pain at night

The best way to ease foot pain at night is to develop a toolkit of therapies that address the root cause of foot pain while relieving symptoms so you can get a full night’s rest.

Here are our tips for relieving your nighttime foot pain. Always discuss the best course of treatment with your doctor.

1. Start with a proper diagnosis

Successful treatment depends on a proper diagnosis of the cause of your pain. If you simply treat symptoms without addressing the underlying cause, you will continue to experience worsening symptoms (and may cause permanent damage).

2. Rest

Sometimes foot pain at night is a result of a pain condition that worsens with activity during the day.

If you can, takes some time off of your feet, resting those hardworking muscles, tendons, and ligaments.

3. Apply ice

Ice is a magical, free treatment that can ease pain and swelling and provide comfort to feet that ache at the end of the day.

If your feet are red, swollen, or painful to touch, apply ice on a 20-minutes-on, 20-minutes-off schedule for a couple of hours, elevating your feet if possible as you ice.

4. Consider over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs)

When taken correctly, NSAIDs like ibuprofen and naproxen sodium ease pain and reduce swelling. Talk to your doctor about taking NSAIDs before bed to ease your nighttime foot pain.

5. Check your mattress

Sometimes pinched nerves and nerve pain come down to your mattress. Too soft and your body collapses in on itself at night. Too hard and you cannot find a comfortable release into sleep.

You want a mattress that is just right, offering firm support that is also soft and comfortable. Shop for a mattress with a return policy that allows you to test it out and return it if it’s not right for you.

6. Wear a nighttime splint

One of the key treatments for foot pain caused by plantar fasciitis is a nighttime splint.

This keeps the foot in a flexed position so that the plantar fascia does not contract at night. A contracted plantar fascia can mean an incredibly painful first step in the morning. The splint helps maintain the natural length of this crucial tendon.

7. Try yoga

Our feet contain 25% of the bones in our body, have over 30 joints, and are made up of more than 100 muscles, tendons, and ligaments. Yoga that focuses on releasing, strengthening, and stretching the feet can help them become more balanced and suppler.

Find a great video of foot yoga, or bring together a few good stretches and massages for the feet on a daily basis.

8. Refine your nighttime routine

Consider revamping your entire nighttime routine to set the scene for a good night of sleep.  Keep your bedroom cool and dark, and reserve it only for intimacy, sleep, and reading before bed.

Develop a consistent nighttime routine that gets your body ready for sleep.

• Drink a relaxing herbal tea (lavender, chamomile, and valerian are all good choices)
• Give your feet some attention before bed by trying yoga for feet at night or self-massage
• Go to bed at the same time every night and wake up at the same time, too
• Turn all screens off at least one hour before bedtime

A nighttime routine helps you mark the end of the day and signals your brain to rest. This alone can go a long way towards a better and more healing night of sleep.

9. Explore physical therapy

Physical therapy helps to gently stretch and strengthen the feet, more so than simple exercise on its own. A physical therapist can also conduct a gait analysis to see if there are structural or mechanical issues that are causing your foot pain.

10. Ask about prescription medications

Although opioid therapy is not indicated for most types of chronic foot pain, there are prescription medications that may offer some relief.

For example, pregabalin, gabapentin, and duloxetine are medications that are used to treat nerve pain, including nerve pain in the feet. Depending on the cause of your pain, your doctor may also recommend muscle relaxers.

11. Try TENS unit therapy

Transcutaneous electrical stimulation (TENS) is a non-invasive treatment option that delivers a mild electrical current to replace pain signals to the brain.

While this does not address the underlying cause, it may help you rest as you try other treatments at the same time.

12. Consider injections

An injection of corticosteroids and a local anesthetic can be used to ease inflammation and swelling that leads to foot pain at night. For radiating foot pain that occurs due to sciatica, an epidural steroid injection or a lumbar sympathetic blockade may help ease pain.

13. Look at more interventional treatments

When conservative treatments do not provide relief, you may find that more interventional treatments are necessary. Spinal cord stimulation and other surgical interventions might be necessary to relieve your foot pain at night.

These more advanced procedures should always be done as a last resort, after you’ve attempted other more conservative therapies.

Learn more

At Arizona Pain, our goal is to help you get a good night’s sleep with the most comprehensive treatment approach possible. Our integrated pain management approach incorporates multiple therapies so you can get back up on your feet as soon as possible.

If you experience foot pain at night, schedule an appointment today to discuss all of your options.

If you have been diagnosed with diabetes, you already understand the challenges that lie ahead. One of the most frustrating and painful challenges is diabetic leg pain. Here are nine tips for preventing and managing the pain of diabetic peripheral neuropathy.

What is diabetic leg pain?

Diabetic neuropathy is a nerve disorder that originates as a comorbid condition of diabetes and the word “neuropathy,” which indicates a condition of the nerves. Also known as diabetic peripheral neuropathy, this condition is unfortunately common in patients with poorly controlled diabetes.

There are two types of diabetes: Type 1 and Type 2. Type 1 diabetes is a congenital condition (present at birth). Type 2 can develop over time in susceptible people. For both, blood sugar must be controlled either through medication or diet (or a combination of the two).

If blood sugar is not properly controlled, the small capillaries that deliver blood to the nerves become damaged. This damage occurs mainly on the periphery of the body—the legs and feet, most commonly—but it can occur anywhere. When the nerves are damaged, diabetic leg pain can occur.

The condition can affect several nerves in the limbs including sensory nerves, motor nerves, and autonomic nerves. Sensory nerves are those that receive sensations like pain or touch. Motor nerves control movement. And autonomic nerves control functions like blood pressure.

Risk factors

An estimated 50% of people with diabetes experience neuropathy. The condition is most common in individuals who have difficulty controlling their blood sugar levels.

While diabetes, especially with uncontrolled blood sugar, is the most common cause of peripheral neuropathy there are other risk factors. These include:

• Alcoholism
• Vitamin deficiencies
• Infections, such as Lyme disease or shingles
• Autoimmune diseases
• Repetitive motions

What does diabetic leg pain feel like?

We explore more of the symptoms in an earlier post here, but in general, symptoms can impact not only feeling but also movement. Diabetic neuropathy typically begins gradually with numbness or tingling in feet or hands, which then spreads throughout the limbs. Burning and sharp pains are also common.

Other symptoms that occur as the syndrome progresses are varied and can include the following.

• There may be changes in the skin, hair, or nails
• People often experience muscle weakness
• Sharp, shooting, or burning pain occurs
• Paralysis can also occur if the motor nerves are affected
• Changes in blood pressure causes dizziness or digestive problems (depending on the affected nerves)
• Wounds heal more slowly
• Some patients experience gastrointestinal issues
• Others have an increase in urinary tract infections

Symptoms follow a progression, but everyone who suffers from diabetic leg pain may experience them to different degrees. The progression depends on being alert for symptoms early on and taking action to slow the damage.

Can diabetic neuropathy be reversed?

Your body is incredibly resilient. There are many types of nerve damage that can be healed. In fact, one of the most frustrating things about some chronic pain treatments (e.g., radiofrequency ablation) is the fact that nerves heal and begin sending pain signals again!

But when it comes to leg pain caused by diabetic peripheral neuropathy, the damage is usually permanent and irreversible. This is why blood sugar control, weight management, and other preventative treatment is so important.

Recent research into diabetic leg pain

Over 100 million adults in the U.S. are either living with diabetes (or heading that way). Researchers have been hard at work in the past two decades trying to untangle a standard of care for diabetes and related diabetic leg pain.

It’s clear from the following studies that there are ways to better prevent and manage diabetic peripheral neuropathy. Here are five of the key findings.

1. Management and prevention of diabetic leg pain: It depends

Research in 2016 debunked other studies that focused on aggressive management of blood sugar. It appears that successful prevention strategies depend on the type of diabetes a person has.

Blood sugar control is most important for Type 1 diabetes, while controlling weight is the focus for Type 2.

2. Monitoring at-risk people is key

Because diabetes relies on patient compliance with treatment protocols, one of the best ways to prevent diabetic peripheral neuropathy is to monitor patients who might not comply with care.

Using better diagnostic tools and paying close attention to at-risk patients can prevent diabetic leg pain from developing or worsening.

3. Management of symptoms is multi-pronged approach

The symptoms of diabetic neuropathy are challenging to manage. Because of this, researchers are finding that the best treatment approach is a multi-pronged one. Crucial aspects include:

• Early diagnosis
• Prompt intervention
• Pain treatment

4. Exercise can reduce symptoms

Even if you are experiencing diabetic leg pain, exercise has been shown to relieve some of the most disturbing symptoms (e.g., pain, numbness, difficulty with movement).

In the simplest terms, exercise appears to prevent pain-inducing triggers from occurring and increase positive nerve signaling when it comes to movement.

5. Quitting smoking dramatically lowers your risk

One of the healthiest things you can do in general is quitting smoking.

It turns out that smokers with diabetes have a much higher risk of developing diabetic peripheral neuropathy than those who do not smoke. Smokers also have trouble regulating blood sugar and are more likely to be obese.

How to prevent, treat, and relieve diabetic leg pain

Our bodies are wonderfully individual, so your treatment path won’t be the same as every other patient. The best approach is to talk to your doctor to find the best way to prevent, treat, and relieve diabetic leg pain for you.

Here are nine tips to help manage and relieve diabetic leg pain.

1. Use exercise to promote overall health

Physical activity remains one of the most basic lifestyle modifications recommended to patients with diabetes. For patients with Type 2 diabetes, one of the key benefits of exercise may be prevention of diabetic leg pain.

Physical activity helps cells develop greater sensitivity to insulin. This helps the body better process it. Exercise also activates a special cellular activity that involves absorbing blood glucose, according to the American Diabetes Association.

Other benefits of exercise include:

• Weight loss
• Stress relief
• Reduced risk of heart attack and stroke
• Better circulation

These all improve health and reduce the likelihood of complications from diabetes, including diabetic leg pain.

2. Eat a diabetic-friendly diet

Very few people get excited when they hear the word “diet,” but focusing on food as medicine can be a way to prevent diabetic leg pain. In a 20-week pilot study of diet for patients with Type 2 diabetes, participants who switched to a plant-based diet had less pain, better nerve conduction, and weight loss.

But you don’t have to become a vegetarian to improve your diet. Following Michael Pollan’s “eater’s manifesto” can help:

• Eat food
• Not too much
• Mostly plants

Whole grains, lean proteins, and lots of fruits and vegetables are key here. Limiting processed foods, sugar, and excessive dairy can all help manage inflammation in the body and keep blood sugar levels stable.

Nutritional counseling can help you understand how simple changes to your diet can help.

3. Manage weight

Related to lifestyle changes that include diet and exercise are all of the steps you take to lose weight. Losing weight is an important step for reducing any types of leg pain, but especially diabetic leg pain.

Lower weight simply reduces the amount of pressure on the legs. Because obesity is a risk factor for developing Type 2 diabetes, weight loss can also help with prevention. Once a person is diagnosed with Type 2 diabetes, though, weight loss can also help to manage diabetes symptoms.

4. Maintain appropriate blood sugar levels

Maintaining stable blood sugar levels is key to preventing nerve damage that occurs with wild blood pressure spikes.

Work with your doctor to figure out an appropriate strategy for this. Some people with diabetes benefit from several small meals a day (instead of three big meals). Others might manage their weight and stabilize their blood sugar with a standard breakfast, lunch, and dinner.

Each person’s best practice will be different. Work closely with your doctor to find your most appropriate strategy.

5. Practice daily foot and leg care

Because early detection is key, proper foot and leg care is crucial in preventing diabetic peripheral neuropathy.

Check your feet and legs every day for cuts, scrapes, blisters, swelling, or redness. Apply moisturizer (massage for good circulation!). Keep your feet clean and dry. Wear clean socks every day, and invest in high-quality, properly fitted footwear.

6. Build healthier habits for compounded prevention

If you can only manage one change at a time (i.e., you can only change your exercise habits), that is certainly better than nothing. But the most powerful prevention and treatment occurs when you use each of these strategies together.

Changing your diet and adding exercise will help you with weight management. Symptom management plus diet and exercise magnifies the effects of each one of those tools.

Change is hard. It may seem like an insurmountable obstacle. But every step you take to prevent further damage from diabetic peripheral neuropathy means a better quality of life.

7. Try physical therapy

As diabetic leg pain progresses, it may become harder and harder to maintain the motivation to exercise. This is where physical therapy can be a lifesaver.

Physical therapists design a tailored set of exercises that help increase circulation, relieve pain, and stretch and strengthen the muscles of the legs. These sessions can also help manage both weight and blood sugar—two keys to easing leg cramps and other diabetes leg pain.

Another benefit of physical therapy is that it can ensure proper posture and gait training. If you have been walking off-balance due to leg pain, that can affect your whole body. A physical therapist can help you recognize that and work to fix it for better overall health and prevent other related pain issues.

8. Look into topical treatments and medications

Topical treatments can help relieve diabetic leg pain with few side effects or drug interactions. Consider using lidocaine patches and capsaicin cream to alleviate your pain.

Although opioids are not suggested for diabetic leg pain, over-the-counter pain relievers may provide relief when pain flares up. Other medications to treat this type of chronic pain may include tricyclic antidepressants.

9. Talk to your doctor about diabetic leg pain treatments

If more conservative approaches do not work and your pain is progressing, there are other options. Interventional strategies that can help relieve diabetic nerve pain include:

• Pain-relieving injections
• TENS unit therapy
• Nerve blocks

Get help with your diabetic leg pain

At Arizona Pain, or goal is to help you get your life back. We recognize the challenges that people with diabetes face, and we want to help you meet them head on.

If you are experiencing diabetic leg pain (or want to explore comprehensive strategies to prevent it), get in touch to schedule an appointment today. We can help.

Spending time outdoors can reduce stress and keep you healthy. In Arizona, picturesque trails cover every corner of the state, which makes hiking a popular activity year round. Unfortunately, time spent on the trails can result in knee pain, especially for older residents with aging joints. If you’re experiencing knee pain after hiking, you don’t have to suffer. There are plenty of ways to get your discomfort under control. Here’s what you should know.

Why do I have knee pain after hiking?

Our knees endure a significant amount of stress during daily activities, let alone hours spent on rocky and uneven trails. This is why knee pain is very common among avid hikers.

For many people, this pain occurs around or behind the kneecaps and can also cause stiffness. This type of pain typically worsens while walking downhill or up stairs because of the excessive pressure you put on your knees in these situations. Research suggests the force on your knee joint is up to eight times your body weight when going downhill. Furthermore, the force on your knees is two to three times heavier by simply walking up stairs.

Other hikers report inner knee pain in the area closest to your inner legs, which is usually due to a tear or sprain. This may be the result of a specific injury or one of many overuse conditions that cause inflammation.

What causes knee pain after hiking?

In order to begin treating knee pain after hiking, you first have to find the cause of your pain. A diagnosis from your doctor is the first step toward developing a plan for relief.

These are some of the most common causes of knee pain after hiking, along with the symptoms that typically follow. Talk to your doctor if you believe you may be experiencing one of these injuries or conditions.

1. Bursitis

If your knee feels warm, tender, and swollen, you may be experiencing bursitis. This pain typically occurs on the inner side of your knee below the joint.

Knee bursitis is due to inflammation of a small fluid-filled sac called a bursa. These sacs reduce friction and cushion the pressure points between your bones and the tendons, muscles, and skin near your joints. When they become inflamed, they can lead to pain.

While this condition is often caused by frequent kneeling or a blow to the knee, it can also develop after overuse or strenuous activities.

2. Knee tendinitis

Sharp, shooting pain and tenderness above or below your kneecap may be an indication of tendinitis. You may also have swelling and a burning feeling in your kneecap.

This condition is typically brought on by repetitive stress on the knee. Tendons are bands of fibrous tissue that connect muscle to bone. Tiny tears in the tendon can occur, which eventually become weak and inflamed.

3. Tendinosis

In contrast, tendinosis doesn’t involve inflammation. It will be painful, but there is usually no redness or burning feeling as there is with tendinitis. You may also experience stiffness and restricted movement due to the tendons beginning to break down.

Again, this condition is generally caused by overuse and hobbies that put repeated stress on the knees. It is more common in older individuals as the joints become less flexible due to aging. Patients with arthritis are also more prone to tendinosis.

4. Meniscus tear

If you hear or feel a popping sensation in your knee while hiking, it’s likely that you’ve experienced a meniscus tear. This commonly occurs when you forcefully twist your knee, especially while putting your weight on it. Perhaps you were going down a steep hill or kneeling down while carrying a heavy backpack.

Each knee has two menisci, pieces of cartilage that cushion your shin and thigh bone. When torn, you’ll experience swelling and stiffness, along with a sharp pain when twisting or rotating your knee.

5. ACL damage

One of the most commonly injured ligaments in the knee is the anterior cruciate ligament (ACL). An ACL injury tear or sprain can take place because of sudden stops or changes in the direction you’re moving, as well as excessive flexing of the ankle.

Signs and symptoms include:

• Rapid swelling
• Severe pain
• Loss of range of motion
• A loud “popping” sensation
• Instability while putting weight on your knee

6. Synovial plica syndrome

The plica is a fold in the tissue surrounding your knee joint. It is surrounded by a fluid-filled capsule called the synovial membrane.

Synovial plica syndrome is a result of your plica becoming inflamed after stressing or overusing it. This usually happens in the middle of your kneecap. You may be able to feel your swollen plica when you press on this area.

Pain related to this condition is usually achy, rather than sharp or shooting. It may also worsen while using stairs or bending down.

7. Iliotibial band syndrome

The iliotibial band is a thick band of tissue that connects muscles to other structures in the lower body. It runs from the hip region all the way down to the back of the knee.

Iliotibial band syndrome, also referred to as IT band syndrome, is a condition in which this tissue becomes inflamed, tight, or swollen. Pain will typically present on the outside of your knee and can spread up the thigh to the hip.

Again, this condition occurs with overuse of the joint. It may result in knee pain that intensifies in response to movement.

8. Patellofemoral pain syndrome

Patellofemoral pain syndrome is a condition in which you feel pain in the kneecap or at the front of the joint. It is often called “runner’s knee” because it’s more common in people who participate in sports that involve running and jumping.

The pain is usually dull or aching, but can be aggravated by walking up or down stairs, kneeling, and sitting for extended periods of time.

9. Knee osteoarthritis

Unfortunately, overuse in older individuals can lead to osteoarthritis. This condition is the progressive degeneration, or loss, of cartilage from a joint over time.

While osteoarthritis can be found in any part of the body, it is commonly seen in the knees. Severe and advanced cases of osteoarthritis may lead to direct bone-on-bone contact, which can cause chronic pain.

How to prevent knee pain after hiking

As with any medical injury or condition, prevention is your best line of defense. With a few changes and modifications to your hiking routine, you can get back to enjoying the great outdoors without pain.

Try these simple steps for preventing pain:

• Choose supportive footwear: Hiking involves uneven terrain, rocks, and a lot of other obstacles. Finding supportive and comfortable hiking boots is essential. They should fit properly and offer plenty of cushion to relieve excess pressure on your joints. Be sure to replace them as needed after excessive wear.
• Stretch before you hit the trails: Start your hike with a stretching routine that warms up your muscles. Focus on letting your legs loosen up with long, slow stretches that promote elasticity.
• Reduce the weight of your gear: A heavy backpack puts unnecessary strain on your knees. Think about what you really need before each hike. While essentials like sunscreen and water are important, find ways to lighten your load. Instead of water bottles, try a lightweight water pouch.
• Invest in support garments: Get additional knee support in the form of a brace. This will restrict or stabilize joint movement to give you stability. Some hiking enthusiasts also find relief from kinesiology tape.
• Get a hiking pole: There is research to suggest that hiking poles are effective in redistributing some of the pressure you feel in your knees. Especially while hiking downhill, hiking poles can allow your arms and shoulders to absorb some of the impact. They also serve as an added layer of protection from falls that could cause serious injury.
• Take your time: Take trails with a slow and steady approach. Going too fast will only put additional strain and pressure on your knees. Try carefully side-stepping when you’re trying to navigate steep downhill areas. This will help shorten and soften your steps.

Treating knee pain after hiking: 5 approaches

If you’re already suffering from knee pain after hiking, there are several options that could bring you relief. Some are simple at-home remedies, while others will require guidance from your doctor.

1. At-home remedies

You should typically start with simple at-home remedies before moving on to more invasive treatment options, especially if your pain is mild.

At-home care includes:

• Applying ice or cold packs to your knee. This will help reduce swelling and restore your range of movement. Repeat three times per day for 10-20 minutes.
• If your knee responds positively to heat and mild activity, alternate the application of heated and cold packs.
• Trying to keep your affected knee(s) elevated while resting. You can do this with a few pillows, but remember that it’s important to elevate your entire leg all the way down to your ankle.

2. Physical therapy

In some cases, a specific routine of conditioning and stretching is needed to retain or regain flexibility. Physical therapy can help heal the pain you’re currently experiencing, while also conditioning your knees to prevent further injury.

A skilled physical therapist will develop a plan that is specific to your goals and comfort level.

3. Medications

For many patients, conventional over-the-counter medications provide significant relief from pain associated with hiker’s knee, especially during the acute phase of healing after an injury. These include non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin, naproxen, and ibuprofen.

These drugs act by inhibiting the production of inflammatory molecules in the body, thus reducing the associated pain.

However, in serious cases, these medications may not provide adequate relief. If you have stopped participating in rigorous activity, but are still experiencing significant knee pain, your doctor may recommend more advanced treatments.

4. Knee injections

If your knee pain has not improved with conventional therapies, your doctor may suggest interventional pain management.

Steroid knee injections can help reduce pain and inflammation in a specific area. While some patients respond to one injection, others may need several injections over time. Most people experience pain relief and reduced inflammation for approximately six months.

5. Surgery

The last resort in cases of severe knee pain is surgery. However, your doctor will generally only recommend this after trying a range of other options that aren’t invasive.

In general, the need for surgery will be due to serious damage caused by aging, injury, or excessive overuse. Your doctor will either repair and replace torn ligaments or replace the knee as a whole (arthroplasty).

Find help

Hiking is a great way to unplug, get exercise, and enjoy the beauty of the great outdoors in Arizona. Don’t let knee pain stop you from enjoying one of your favorite hobbies.

The team at Arizona Pain can work with you to pinpoint the exact cause of your knee pain after hiking. It could be due to any of the different injuries and overuse conditions discussed in this article. You can rest assured knowing we will find the cause and develop a treatment plan that works for you.

If you’re in Arizona and need more help with your knee pain, contact our pain specialists today at Arizona Pain.

You might consider chiropractic care as something that only “fixes” the spine, but it’s so much more than that. A misaligned spine can contribute to serious conditions, some of which can lead to sciatic pain. Fortunately, seeing a chiropractor for sciatica can help not only relieve sciatic pain but also treat the underlying condition that caused it. Here’s how.

How does chiropractic care for sciatica work?

Visiting a chiropractor for sciatica can help relieve pain that occurs as a result of pressure on your sciatic nerve. The focus of your visit will depend on your underlying condition, but in general, chiropractors aim to bring your spine into healthy alignment.

Not only does healthy spinal alignment support overall wellness, but it also allows the body to function more efficiently. If one part of the body is compensating for spinal misalignment, this can begin to have a ripple effect. Pain may begin to appear in other areas of the body due to the stress of imbalance. Sciatica chiropractic care seeks to bring the whole body back to proper alignment and balance.

Why is sciatica so hard to treat?

Sciatica is the name for a particular type of pain that originates in the sciatic nerve.

Your sciatic nerve is the longest (and widest) nerve in the body, running from the lower back, across the glutes, and down the side of the hip to the lower leg and foot. Any injury, damage, or pressure along this nerve can cause pain that makes daily life challenging.

Sciatica is hard to treat because the underlying conditions that are leading to damage must be diagnosed and addressed. Diagnosing those underlying conditions can take time. Unfortunately, until that is complete, sciatica symptoms can only be temporarily relieved.

In general, sciatica does not go away on its own and will likely get worse over time if left untreated.

Do I have sciatica?

Sciatic pain is unmistakable and can be very intense. Some people experience a sudden onset of pain, while others notice a gradual worsening of symptoms.

The most common symptoms of sciatica include the following:

• Lower back pain
• Pain that radiates down the legs
• Increased pain with long periods of sitting or standing
• Pain when going from sitting to standing (or vice versa)
• Pain in the hip
• Burning pain
• Weakness and pain in the legs
• Feeling of “pins and needles” along the leg and in the toes
• Numbness
• Tight calves

These symptoms are most often experienced on one side of the body only. If you experience loss of bowel or bladder control or extreme weakness in the lower limbs, this is considered a medical emergency. Get treatment immediately.

There are a number of risk factors for sciatic pain. One of the most common is also the only underlying condition that usually resolves itself (and the pain): pregnancy.

Other risk factors include:

• A sedentary lifestyle: Sitting too much increases your chances of nerve pain
• Age: Older people are more at risk for underlying conditions that cause sciatica
• Obesity: Obesity is comorbid for a variety of sciatica-related conditions
• Occupation: Heavy lifting or repetitive motion activities can place you at higher risk

What does a chiropractor for sciatica do?

Seeing a chiropractor for sciatica connects you with a healthcare provider that takes your full wellness into consideration.

You’ll likely undergo a series of spinal manipulations and adjustments. Some of these are manual adjustments, and others of these involve specialized equipment (e.g., handheld tools or a chiropractic table). They may also recommend other therapies, such as at-home stretches or nutritional changes.

Chiropractic techniques for sciatica

Chiropractic techniques for sciatica focus on aligning your spine and bringing strength and stability to the whole spinal structure. To do this, your chiropractor may utilize the following techniques.

Note that there are over 200 different types of chiropractic adjustments. Your doctor will work with you to determine which will be most effective for your underlying condition.

Diversified technique

This high-velocity, low-amplitude technique moves misaligned vertebra back into place. The characteristic “cracking” sound is actually the sound of small gas bubbles in the joint being released. This is a harmless, painless side effect of treatment.

Spinal mobilization

The goal of this chiropractic technique for sciatica is similar to the diversified technique but gentler. Instead of a high velocity thrust, spinal mobilization uses steady, firm pressure to the spine to guide it into alignment.

Myofascial release

When tight fascia is contributing to sciatica, myofascial release can help. Once your chiropractor identifies the area of tightness, they’ll apply steady pressure until the fascia begins to release. This also increases blood flow to the area and can promote healing.

Palmer upper cervical adjustment

While sciatic pain originates in the lower back, there are conditions in the cervical spine that can travel down to the lower spine. If this is the case, an upper cervical adjustment may be a good tool.

Chiropractic exercises for sciatica

When you feel the pain of sciatica creeping up but can’t schedule a chiropractic appointment right away, there are chiropractic exercises for sciatica that can mimic the effects of in-office chiropractic care. Only do these once approved to do so by your doctor.

• Cobra pose: This pose compresses the lower vertebrae and then provides release
• Child’s pose: Offers a long, lengthening stretch along the whole spine
• Knees to chest: Rocking on your back with your knees to your chest gives a gentle opening and massage to the back muscles at the same time

At-home stretches will not replace seeing a chiropractor for sciatica, but it can be a stopgap measure until your next appointment. Ask your chiropractor for suggestions on the most helpful pain-relieving stretches for sciatica for you.

Beyond chiropractic

Many chiropractors don’t just offer manipulations and adjustments. Doctors of chiropractic have extensive, general medical training and may also specialize in complementary treatments. This can include things like:

• Recommendations for lifestyle changes (including ergonomic recommendations)
• Exercise and nutritional counseling
• Information on supplements
• Complementary treatments (e.g., meditative exercise, acupuncture, and biofeedback)

Because they are focused on holistic treatment options, chiropractors may recommend concurrent treatment options to address your overall wellness, not just your sciatic pain.

What can I expect during my chiropractor appointment?

At your first chiropractic appointment, expect to spend a good amount of time discussing your medical history. Your chiropractor will want to know:

• What symptoms you are currently experiencing
• How long you have had those symptoms
• Pain level on a daily basis and what makes it worse or better
• Diagnosis (if any) from other doctors
• Family history
• General lifestyle information (e.g., diet and activity levels)
• Current medications or treatments
• Any other health concerns you have

If you have a diagnosis from your doctor, your chiropractor will want to see that, as well as any tests or X-rays you have to support the diagnosis.

After they gather all of this information, your chiropractor will conduct a physical exam. This is usually conducted while you are fully clothed. It usually consists of range of motion exercises and palpation of the painful area.

If you do not have a formal diagnosis, your chiropractor may order imaging studies (e.g., X-rays or CT scans) to see if there is any visible injury or spinal misalignment.

From all of this information, your chiropractor will then affirm your doctor’s diagnosis and develop a treatment plan, or they will have more information to make a diagnosis of their own.

Once a diagnosis is confirmed, they’ll start care depending on the best approach for your condition.

Will chiropractic care for sciatica hurt?

This is one of the most frequently asked questions that is completely understandable. After all, you are already in pain. Why would you want to receive treatment that hurts?

The good news is that most patients find chiropractic care for sciatica to be pain-free. In fact, most people experience immediate pain relief after treatment. Sometimes the adjustment may cause brief discomfort, but that should pass quickly.

If you do experience increased pain during treatment, tell your doctor immediately. Their goal is to provide comfort and healing, not a worsening of symptoms.

What will recovery be like?

Recovery from chiropractic care is usually easy and uneventful. In most cases, you can receive treatment and go on about your daily life as usual. You may feel lingering muscle soreness, but that should ease quickly.

There are a few people for whom chiropractic care is not recommended. If you have severe osteoporosis or cancer of the spine, chiropractic care is not a good choice.

In some cases, herniated or bulging discs may be made worse by chiropractic care. If you experience tingling in the legs, loss of bowel or bladder control, or weakness in the lower extremities, head to your nearest emergency room for treatment. For people at risk of stroke, cervical (neck) adjustments are not recommended. These can increase the risk of stroke.

Overall, chiropractic care is generally recognized safe, with few side effects.

How many visits will I have to a chiropractor for sciatica?

In general, most patients find relief from symptoms within six to ten visits to the chiropractor. This is a generalization, though. You might find you need many more or far fewer. Your chiropractor can tell you what to expect at your first visit, including how many visits you might need and how often. They’ll also discuss the treatment plan during the acute phase of treatment and potential options as you move into maintenance, or ongoing, care.

Other sciatica treatments

Sciatica is a complicated condition that responds best to variety of treatments. In addition to using chiropractic exercises for sciatica, other sciatica treatments than can help include:

1. Physical therapy: Targeted exercise that builds muscular support for the spine
2. Deep tissue massage: Deep tissue massage can release muscle tension that causes pressure on the sciatic nerve
3. Acupuncture: This complementary treatment triggers endorphin production and can ease pain
4. Medications: Over-the-counter and prescription medication helps to ease inflammation and pain
5. Transcutaneous electrical stimulation (TENs): TENS machines replace painful nerve signals with a mild electrical buzz
6. Epidural steroid injections (ESI): Medications for pain and inflammation are injected directly to the affected nerves
7. Lysis of adhesions: Lysis of adhesions breaks up the scar tissue that is causing pressure and pain
8. Disc decompression: For opening up the intervertebral space and relieving pressure
9. Spinal cord stimulation (SCS): An implanted device that “mutes” pain signals
10. Intrathecal pump implants: These implants deliver regular, powerful pain relief
11. Percutaneous discectomy: Damaged disc material is removed to create space between the vertebrae

Sciatica can be challenging to treat, but you do have options.

If you’re in Arizona and are considering seeing a chiropractor for sciatica, Arizona Pain can help. We believe in creating comprehensive treatment plans tailored to each person in pain. Get in touch to schedule your appointment today!

Musculoskeletal leg pain involves pain that develops in any of the tendons, ligaments, and muscles in the lower extremities. Conditions ranging from tendinitis to arthritis may be the source of your discomfort. Although this type of pain most frequently develops in the lower back, pain in the leg, hip, knee, or ankle is also common. Musculoskeletal leg pain causes vary from patient to patient. They can range from serious physical disorders to more benign stresses from daily life. Here’s the most common causes, as well as ways to prevent musculoskeletal leg pain.

What do we mean by musculoskeletal leg pain?

Leg pain is a broad category of pain that can occur anywhere in the upper or lower leg. It can range in intensity from a dull ache to a sharp, stabbing pain. There are multiple causes of leg pain and some can be very serious. Others can be controlled or cured with rest and at-home care, especially proactive treatments that then help prevent leg pain in the future. Acute leg pain will go away after treatment but if pain does not stop after three months, it is considered chronic and may require different treatments to alleviate.

Leg pain usually originates in one of three systems in the human body: the musculoskeletal system, the nervous system, or the circulatory system.

Musculoskeletal leg pain occurs in the muscles, ligaments, tendons, and bones in the leg. Pain originating in the nervous system will usually cause sharp, radiating pain down the sciatic nerve resulting in a condition referred to as sciatica. Circulatory system pain in the leg can feel similar to a condition that affects the musculoskeletal system but is often more typically felt in only one side of the body.

1. Muscle overuse

Musculoskeletal leg pain typically doesn’t arise from a disorder or medical condition. About 33% of adults experience pain from overusing their muscles, according to the Cleveland Clinic.

In the case of overuse, acute musculoskeletal leg pain could develop from a particularly intense workout. Even carrying a golf bag has been shown to cause musculoskeletal distress in the ankle, according to a study published in the American Journal of Sports Medicine.

Frequently, musculoskeletal leg pain arises from muscle sprains or strains. A sprain occurs when a ligament stretches beyond its capacity or tears. Ligaments are the tissues that connect bones to one another. A strain, meanwhile, involves injury to the muscle or tendon. A tendon is tissue that connects muscle to bone.

While sprains more commonly occur during falls or sports injuries, strains are usually the result from overuse, according to the American Academy of Orthopaedic Surgeons (AAOS). However, strains can also result from overstretching. In the leg, the hamstring muscle is easily susceptible to strains, particularly for athletes. The hamstring is actually made up of three separate muscles that run from the bottom of the pelvis to below the knee. Hamstring tendons connect the muscle to the bone.

Potential hamstring injuries include strains in the muscle itself. Tendonitis—inflammation or irritation—can also develop in the connective tissues. Runners sometimes report high hamstring tendonitis in the portion closest to the pelvis.

2. Muscle underuse

Although leg musculoskeletal pain causes are often discussed in terms of overuse, some researchers advocate reframing the issue as underuse. In the British Journal of Sports Medicine, researchers argued that muscle use was not the problem. The problem was that the muscles had not been used prior to running, jumping, or participating in some other type of activity normally avoided in a person’s mostly sedentary lifestyle. They wrote:

“Articles are often written assessing “injuries” with the implication that they were the result of movement. This explanation, although sequentially accurate, neglects to focus on the fact that a lack of previous movement is more likely the true source.”

To drive the point home, researchers reviewed several studies and found adults who maintain robust exercises regimens typically experience less musculoskeletal pain—not more.

The researchers concluded that while pushing the body too hard may result in injury, not exercising at all increases the risk of injury when a person finally does exercise. Researchers wrote that:

“A review of the current science implicates that too little activity over time may in fact be the primary cause of a large percentage of musculoskeletal injuries…  People are more likely to exercise too little than too much.”

Sedentary people who begin vigorously exercising likely put themselves at risk for musculoskeletal injuries. To avoid injury, consider easing into exercise gradually and stay mindful of the body’s physical limits.

3. Shin splints

Shin splints are characterized by pain on the shin—the bone in the front part of the lower leg. Common in athletes and dancers, shin splints often develop from overuse or changes in exercise routines. This is an acute condition that can be eased through rest and icing the affected area.

Shin splints can re-occur, but wearing supportive shoes and easing up on the exercise can help stave off this type of musculoskeletal leg pain.

4. Arthritis

Arthritis is one of the most common musculoskeletal disorders affecting nearly 70% of people over age 65 and thousands of younger people in the U.S., according to the Arthritis Foundation.

The most common form of arthritis is osteoarthritis, a degenerative joint disease in which the cartilage in joints breaks down, causing inflammation and pain. Rheumatoid arthritis is a systemic, autoimmune disease, which means the body’s immune system fights the body as if it were a foreign virus. Either type of arthritis may result in musculoskeletal leg pain. Common areas this discomfort affects are the hip, knee, ankle, and foot.

Arthritis in the hip can lead to trouble walking and pain in nearby areas, such as the thigh or knee. Pain in the foot or ankle is especially common in people with rheumatoid arthritis, with more than 90% of patients reporting musculoskeletal pain in those areas, according to the AAOS.

5. Fibromyalgia

Widespread, musculoskeletal pain is fibromyalgia’s defining characteristic. Researchers aren’t sure how or why the condition develops, but it affects about 2% of the total population, according to the Centers for Disease Control and Prevention (CDC).

Women are at much higher risk of developing the disorder, with the CDC reporting a 7:1 ratio of women to men.

The disorder sometimes develops after a physical trauma, infection, surgery, or significant episode of stress. Other times, the onset seems random and cannot be attributed to any sort of physical or mental trigger. The condition is believed to run in families, and may have a genetic component.

Whatever the cause, fibromyalgia is believed to induce widespread musculoskeletal leg pain by interfering with the way the brain processes pain. Neurotransmitters that signal pain elevate to abnormally high levels. Meanwhile, receptors in the brain become more sensitive to pain signals, overreacting to the brain’s efforts to communicate distress.

Fibromyalgia’s musculoskeletal pain often manifests as a dull ache as opposed to a shooting or stabbing sensation. Fibromyalgia patients also experience pain above the waist. Other symptoms include:

• Fatigue
• Sleep apnea
• Cognitive difficulties such as trouble concentrating or focusing
• Depression
• Headaches
• Abdominal cramping

Preventing the most common musculoskeletal leg pain causes 

There are several things you can do to prevent musculoskeletal leg pain in your life. They include the following.

Eat right

Balanced nutrition is essential to maintain healthy body systems throughout our lives. Particularly, doctors recommend foods that maintain a good balance of potassium for healthy legs. Both high and low levels of potassium can be dangerous.

Also, the correct amount of calcium and magnesium can help prevent leg pain and degenerative conditions that affect the hips and knees, such as osteoarthritis or osteoporosis. However, always talk to your doctor or a nutritionist before changing your diet too drastically.

Stretch

Many sports injuries such as strains and sprains can be prevented with the correct pre-game or workout stretching routine. Add some easy leg stretching routines before you exercise every day to prevent leg pain.

Stretching can not only help prevent injury but it can also help rehabilitate your legs after you’ve suffered from a sports injury. Standing quadriceps flexes, hips flexor stretches, and calf stretches can help before any exercise routine.

Walk more

Another key to prevent leg pain is to keep your activity low impact. In fact, the aerobics craze of the 1980s actually led to permanent, lifelong injuries for some of the individuals who embraced the culture.

The good news is that low-impact exercise is easy to do and most of the time doesn’t require any additional accessories, except for the proper footwear. Walking is the easiest way to start a low-impact exercise routine. If you’ve not exercised much before, start slowly with an easy walk around your block and add time and distance as you begin to build more stamina and get more comfortable with the activity.

Stay hydrated

Most people don’t realize how dehydration can affect our systems. By the time you feel thirsty your body is already experiencing dehydration. Lack of hydration can lead to muscle cramps.

Individuals can forget to stay hydrated while engaging in physical activity. It may be easy to remember your water bottle when you’re hiking, but do you think about it when you’re working in your yard?

Get a massage

While frequent massages may seem self-indulgent they can really help keep your body balanced and restored. A massage greatly helps sore muscles, increases circulation, and makes you feel more relaxed.

A trained massage therapist can work with you to pay certain attention to parts of your legs where you may be experiencing minor discomfort. It can also be a great way to treat yourself once in a while.

Practice yoga

This Eastern meditative practice has become very popular in the United States. Yoga can help you maintain mind and body balance. It’s also a great low-impact stretching workout for the muscles in your legs.

Poses such as chair, warrior pose, warrior II pose, and the standing forward bend are all great for leg strength. As a bonus, you can also use yoga poses for your pre-exercise stretching routine.

Take a hike

Does a daily walk around your neighborhood sound boring and repetitive to you? Hiking can be a great way to add more scenic walking to your routine.

Depending on where you live, you can hike in river valleys, mountains, or the woods. You could even join a hiking group to make it a more social activity. Always remember to stay safe on the trail, bring plenty of water, and wear appropriate hiking boots that fit well.

Enjoy golf

Another low-impact activity that can help prevent leg pain and provide a little more excitement than a regular walk is golf.

By skipping the motorized golf cart you get your walking exercise in as you go from hole to hole and the correct swing technique also stretches the muscles in your legs. Like hiking, golf is also a great group activity.

Talk to your doctor

Your doctor can help you with any questions you have about your body. While we often turn to them only after there is a concern or a problem, doctors really do have a desire to proactively help prevent injuries and illnesses in their patients. If you want to know more about ways to prevent leg pain in your life, your doctor is a great resource. You can find a pain doctor in your area by using the tips here: https://paindoctor.com/pain-management-doctors/.

Leg pain doesn’t have to change your life. If you’re concerned about leg pain in your future, use some of these methods to begin preventing the condition now or help ease any pain you already feel.

Hip and leg pain is a broad category of conditions that can range from acute soreness due to a minor injury to long-term chronic pain that can be the result of a disease or disorder. Because of the varying causes of hip and leg pain, there are a number of possible treatments as well, all dependent on the cause and severity of the condition.

How many people suffer from hip and leg pain?

It is estimated that nearly two million people in the United States seek emergency room treatments for sports injuries each year. Sports injuries are most often associated to injuries to the legs.

Basketball injuries top the list, with over 90% of individuals seeking treatment after an injury in this sport being men. Bicycling, football, and baseball were the next three most common sports causing injuries on the list. Children between the ages of six and 19 made up 20% of all sports injury related emergency room visits.

However, not all sports injuries are treatable by emergency room visits and some more minor injuries can be treated with rest and at-home care. There are also other conditions that can lead to hip and leg pain. Many of these are related to the hip itself.

How does the hip work?

The hip joint is a ball and socket joint, where the femur connects to the pelvis. The top of the femur is a round ball, which fits into the socket (acetabulum) formed by the pelvic bone.

The ball is allowed to glide and rotate within the acetabulum because a group of ligaments and muscles support the joint and inhibit over extension or malrotation from occurring. Also, within the joint is a synovial lining, which provides lubricating fluid to decrease friction, produced when the joint is in motion.

Any condition that irritates or inflames this joint, like arthritis, can also lead to pain.

What are the major causes of hip and leg pain?

The hip joint is a large weight-bearing joint attaching the leg bone to the pelvis. It allows the body to walk, run, and sit. The most common causes of pain in the hip and leg include:

• Sports-related injuries
• Motor vehicle accidents (MVA)
• Falls in the elderly
• Arthritis

Leg pain from sports injuries

The most common hip and leg pain issues are caused by minor sports injuries for most of the population. This can lead to:

• Muscle cramps
• Sprains and strains
• Fractures
• Shin splints

Each of these conditions can be treated at home with rest and a few simple at-home remedies.

What are muscle cramps?

Muscle cramps are a common condition that can be persistent and painful. They are often referred to as a “Charley Horse” when felt in the calf muscles. Caused by an involuntary contraction of the muscle, the sensation of a muscle cramp is a muscle that will not relax. You may even feel spasms in the affected area. Muscle cramps can occur after a sports injury and they are often related to nutrition and hydration.

When exercising, running, or playing sports, it is important to stretch the muscles properly before beginning and stay hydrated throughout the activity. To relieve a muscle cramp as it is happening, you may want to stretch the muscle, apply heat, drink more water, or take an over-the-counter pain reliever.

Typically a muscle cramp will go away on its own, but if the pain persists, there may be some concern about nerve damage or another malfunction that is causing the muscle cramps. If the cramps reoccur frequently, you should talk with a doctor about them.

What are sprains and strains?

The diagnoses of sprains and strains are among the most common sports injuries, but what do these terms really mean?

A sprain is the stretching or tearing of the ligaments that connect our bones. It is generally caused by some trauma, directly or indirectly, that stretches or ruptures these ligaments. This can be the result of a fall, a blow to the body from another player, or overstretching the leg during the game. Sprains will usually heal with rest and self-care. This may include compression, ice, and elevation as well as the use of over-the-counter pain medications. If an injury is more severe, surgical correction may be necessary.

A strain is an injury of the muscle or the tendons that connect the muscles to bones. Strains are more commonly caused by a repetitive motion or overuse of the muscles in the leg. To prevent a strain, athletes and individuals exercising are advised to take the proper breaks. Strains can also be caused by falls and contact with other players. Strains are treated similarly to sprains with compression, ice, and elevation.

What are shin splints?

The primary sign of a shin splint is an aching or throbbing in the shin, the front area of the lower leg just above your foot. They can be caused by swollen and irritated muscles, a stress fracture, or flat feet. They are most common for runners or dancers.

In general, shin splints will heal on their own. You can treat them at home with:

• Rest
• Ice
• Non-steroidal anti-inflammatory medications (NSAIDs)
• Compression
• Arch supports for your shoes

If the pain persists, you may want to talk to a doctor and have them do a complete physical examination of the area to determine if there any additional underlying problems. They may also recommend physical therapy.

What about more serious injuries, like fractures? 

A leg breaks when a force great enough to break the bone is applied to the limb. It is a common sports injury, but can also occur due to a car accident or a fall. The treatment for a broken leg will depend entirely on the severity of the break.

A leg fracture can occur in the femur, located in the thigh, or the tibia and fibula which are the two bones that make up your leg from the knee to the foot.

There are several categories of fractures, including:

• Open or compound: The bone ruptures the surrounding muscles and skin
• Closed: The broken bone does not protrude
• Incomplete: The fracture does not break the entire bone
• Complete: Both bones in the lower leg are broken through
• Stress or hairline: A crack in the bone

Stress and hairline fractures will generally heal on their own without the use of a cast. For more severe breaks, medical intervention is required to set the bone and allow it to heal properly. Some broken legs will require surgery if the break is extreme.

How will my hip and leg pain be diagnosed?

Diagnosing patients with hip and leg pain is never straight forward and is often difficult, as many of the symptoms are similar to other conditions. The first step is taking a comprehensive history and physical exam.

Several aspects will be covered in the history and some of the most common questions your doctor will ask you are:

• Where is the pain located?
• How long has the pain been there?
• What were you doing when you first noticed the pain?
• Is there anything you can do that alleviates the pain?
• Are you currently taking any medications for the pain? Do they work?
• Is there any family history of arthritis or other autoimmune diseases?

After conducting a full history and physical exam your doctor may want additional studies, including radiological films and blood work. Imaging techniques are useful because your doctor is often able to see pathology inside the affected joint.

Diagnostic tools

Common imaging techniques to evaluate hip and leg pain include:

• X-rays: A diagnostic test using an electromagnetic energy ray to produce images of internal tissues.
• CT scans: A diagnostic test that combines X-rays with computer technology to produce cross sectional views of the body. This is helpful because it helps to visualize detailed images of the body, including the bones, muscles, and organs.
• MRI scans: A diagnostic image that uses large magnets and a computer to produce detailed images of the structures within the body. This is even more detailed than the CT scan or an X-ray.

Your physician may also request a blood test, and may need to evaluate the consistency of the fluid accumulation in the joint.

Treatments for hip and leg pain

Most of these leg injuries fall under the category of acute pain. These conditions will heal on their own without lingering, long-term effects. Acute pain can be treated at home, as discussed previously, or with medical intervention.

Once the injury heals, you can normally resume full activity. However, if any pain from an injury continues for longer than three months it has crossed classification from acute to chronic pain. Patients dealing with chronic leg pain after an injury may need to seek more advanced treatment to stop or alleviate the pain long-term.

If you have experienced a sports-related injury, such as a muscle strain or a shin splint, talk with your doctor about the best care for your situation. If home care and rest doesn’t improve the condition, discuss more advanced treatment plans.

Physical therapy 

The most common and recommended methods for treating arthritis are conservative alternative therapy provided by a pain specialist. Staying active and physical therapy have also proven to be beneficial.

Physical therapy has been noted to significantly improve postural stability in patients suffering from hip osteoarthritis.

Hip and leg injections

Intra-articular joint injections are also rapidly gaining popularity and use in the treatment for arthritis because of their success, minimally invasive nature, and long-acting effects.

Speak with your pain physician today to determine the best way to improve your hip and leg pain. After conducting a full history and physical exam your physician may want additional studies, including radiological films and blood work.

Have you experienced a leg injury that had led to acute or chronic leg pain? To learn more about how we treat hip and leg pain, contact one of our doctors today.