Generality
Burning in the legs, intended as a burning sensation in the lower limbs, is a widespread symptom, among whose causes there are both conditions of little relevance, from the clinical point of view, and clinically very important conditions.
An example of a cause of burning in the legs that is not clinically relevant is intense physical exercise, while an example of clinically important cause of burning in the legs is diabetic neuropathy.
Burning in the legs can occur in isolation or in association with other symptoms; in this second case, the accompanying symptomatology depends on the factor of origin of the symptom in question.
Finding out, through an accurate diagnostic investigation, what triggers a burning in the legs is essential for planning the most appropriate therapy.
What is Leg Burning?
Burning in the legs, understood as burning in the lower limbs, is a very common symptom, which can depend on many different causes, some decidedly more serious than others.
The burning in the legs is not always the same, but it can vary, from patient to patient, in terms of duration of sensation, intensity of sensation, speed of appearance, associated symptoms and so on.
Legs in anatomy and common language: a brief clarification
In human anatomy, the term leg indicates the portion of the lower limb between the knee and ankle. Outside the anatomical area, however, it is often used as a synonym for the lower limb, so it also includes the overlying portion, which corresponds to the name of the thigh.
Causes
As anticipated, the causes of burning in the legs are numerous; these triggers include physical causes and actual diseases .
Physical causes of burning in the legs
They can be classified as physical causes of burning in the legs:
- Burns / burns, including those due to excessive sun exposure, affecting the lower limbs;
- Excessive exposure to cold in lower limbs;
- Exposure to toxic / poisonous substances in the lower limbs;
- Intense physical exercise for the lower limbs;
- Injuries (eg: abrasions, cuts, scratches, etc.) on the thighs or legs;
- The mechanical-physical compression (ex: a too narrow belt) of a nerve that runs along the lower limbs.
Diseases that cause burning in the legs
The list of diseases that can cause burning in the legs is extensive and includes:
- Alcoholic neuropathy . It is a suffering of peripheral nerves due to excessive alcohol intake.
Excessive alcohol intake compromises the absorption of food and causes recurring episodes of diarrhea and vomiting; the bad absorption of food and the continuous episodes of diarrhea and vomiting mean that the person concerned does not take in nutrients such as vitamins, which are fundamental to the good health of the peripheral nervous system.
- Diabetic neuropathy . It is a suffering of peripheral nerves due to diabetes mellitus.
The high levels of glucose that characterize diabetes mellitus are a source of damage to various organs in the human body, including the blood vessels responsible for keeping peripheral nerves alive. Lacking the right blood supply, peripheral nerves lose their normal function at first, after which they undergo necrosis. Diabetic neuropathy begins with peripheral nerve necrosis.
- Guillain-Barré syndrome . It is an autoimmune disease that affects the peripheral nervous system. In autoimmune diseases, the immune system functions incorrectly and attacks the organism it is supposed to defend, sometimes causing devastating effects, such as in the case of Guillain-Barré syndrome (where the peripheral nerves suffer aggression from the immune system) ).
- Paraesthetic meralgia . It is a neuropathy (thus a disease of the nerves), which affects the lateral cutaneous nerve of the thigh, a peripheral nerve of the sensory type.
To favor the appearance of paresthesic meralgia can be: obesity, pregnancy, diabetes, the habit of wearing clothes that are too tight at the waist level, the presence of a pelvic / abdominal tumor etc.
- Multiple sclerosis . It is a chronic and debilitating disease that occurs due to the progressive degradation of myelin belonging to the neurons of the central nervous system.
- Peripheral arteriopathy . It is an affection of the arteries that lead the blood to the limbs (especially the lower ones). Mainly due to atherosclerosis, peripheral arterial disease reduces blood flow through the arterial vessels involved and consequently the tissue supply which the aforementioned arterial vessels should provide to oxygenate; all this, therefore, translates into suffering for the limbs involved.
- Rheumatoid arthritis . It is an autoimmune disease, in which the immune system attacks the joints and causes their degeneration, with logical repercussions on joint function.
- Vitamin deficiencies . As stated under "alcoholic neuropathy", vitamins are indispensable for the survival of peripheral nerves.
Vitamin deficiencies due to a state of malnutrition very often lead to a neuropathy of the lower limbs.
- Systemic lupus erythematosus . It is a chronic inflammatory disease of the autoimmune and multisystem nature; "multisystem" means that it affects different organs and tissues of the body.
- Post-herpetic neuralgia . It is a possible complication of herpes zoster (or shingles) viral infections.
This condition is established when the Herpes zoster virus is able to reach the cells of the nervous system and damage them progressively.
- Spinal stenosis . It is the narrowing of the spinal canal, that is the channel resulting from the stacking of the vertebrae of the spinal column and inside which the spinal cord takes place.
The presence of a spinal stenosis can cause the compression of the aforementioned spinal cord or the compression of the roots of the peripheral nerves that depart from the spinal cord.
- Discopathies . Discopathy is the medical term for any disease of the intervertebral disc.
Among the various discopathies that can affect the human being, the most famous is undoubtedly the herniated disc.
Discopathies are responsible for a compression of the peripheral nerve roots, a compression on which a peripheral neuropathy depends.
- Stroke and transient ischemic attack (TIA) . They are two serious cerebrovascular conditions, in which there is a reduced blood supply to a more or less extended area of the brain.
While in TIA the reduced blood supply is temporary (so at some point a normal blood circulation is restored), in stroke the reduced blood supply is permanent and causes the death of the encephalic area concerned.
Striking the brain, which is the organ that directs the human nervous system, episodes of stroke and TIA can have more or less profound repercussions on the health of peripheral nerves.
Symptoms and Complications
Several other symptoms as well as some signs may accompany the burning sensation in the legs. These symptoms and signs vary depending on the triggering condition; this means, for example, that a burning in the legs due to diabetes will be associated with disorders other than those that accompany the burning in the legs due to a burn.
Going into more detail, among the symptoms and signs that most commonly combine with the presence of a burning in the legs, there are:
- Blood loss . This sign occurs when the legs have suffered a physical trauma, such as a scratch, a cut, a burn, etc.
- Blisters . Generally, these signs enrich the symptoms of burning in the legs due to excessive sun exposure.
- Sense of numbness along the lower limbs . This is a typical symptom of conditions that cause peripheral neuropathy of the lower limbs (eg, alcoholic neuropathy, diabetic neuropathy, etc.).
- Pain . There are two types of pain related to burning in the legs: nociceptive pain and neuropathic pain.
Nociceptive pain is the classic painful sensation that an individual experiences following a cut, a wound, a burn, etc. (physical causes of burning in the legs); neuropathic pain, on the other hand, is the chronic painful sensation that is established following damage or malfunction of peripheral nerves or structures of the central nervous system (diabetic, alcoholic, etc.).
- Redness, heat and swelling . Characterize the burning in the legs due to: sunburn, cold or injuries to the lower limbs.
- Tingling . It is a symptom that classically accompanies burning in the legs due to neuropathy.
Other symptoms associated with burning in the legs
Although less rarely than the previous disorders, the following symptoms and signs can also be associated with burning in the legs:
- Difficulty walking;
- Muscle weakness;
- Coordination problems;
- Joint pain ( arthralgia ) in the ankles and feet;
- Altered sensitivity of the skin;
- Foot ulcers (they are typical of a disease such as diabetes and the diabetic neuropathy that can result).
When the burning in the legs is due to conditions such as stroke or TIA - ie medical emergencies - the patient may experience very specific disorders such as: lethargy, difficulty speaking, fainting, altered consciousness, lack of attention, vision problems, severe headache, confusion, delirium and hallucinations.
When should I go to the doctor?
Burning in the legs is a symptom that must worry and lead the person concerned to consult a doctor, when it is prolonged over time and / or associated with symptoms or conditions of a certain clinical relevance.
To understand, a trivial burning in the legs, which affects a healthy individual after strenuous exercise, is certainly less worrying than a burning in the legs combined with tingling and numbness in the lower limbs, which affects a person with diabetes or alcoholic.
Complications
Possible complications that can affect the subject with a burning in the legs depend not on the latter (the burning in the legs is, as already said, only a symptom), but from the event / triggering condition.
Among the causes of burning in the legs, there are both events / conditions that can lead to serious complications and events / conditions for which there is no serious consequence to their presence.
Diagnosis
When the burning sensation in the legs causes concern and / or its origin is not clear, it is necessary to investigate the precise cause, to understand the seriousness of the problem in progress and the possible therapy to be adopted.
The diagnosis of the causes of a burning in the legs always starts from a careful medical history; therefore, based on what emerges from the latter, it can continue with:
- Blood tests;
- Electromyography;
- A neurology visit;
- X-rays, magnetic resonance imaging and / or CT scan of the spine.
history
For a person who complains of burning in the legs, the medical history consists of some typical questions, which are:
- How long has the burning sensation in your legs been in place? Do you remember a particular event that preceded the appearance of the symptom in question?
- Where is the burning pain in the legs located?
- In addition to burning in the legs, do you experience other symptoms?
- Are you taking any particular medicine?
- What is your daily diet? Do you drink alcohol and, if so, how much?
If accurate, the anamnesis can be of considerable help and, sometimes, it can be sufficient to understand what is the cause triggering the burning in the legs.
Why is it important to find out the causes?
The knowledge of the causes of burning in the legs is very important, because it allows to plan the therapy through which it is possible to obtain healing (or, at least, an improvement in the symptoms).
Without knowing what caused the burning in the legs, there is little hope of establishing the most appropriate treatment.
Therapy
In the presence of burning in the legs, the therapy adopted varies in relation to the triggering cause.
This means that the individual with a burning leg due to a diabetic neuropathy needs a different treatment from the individual with a burning in the legs due to an alcoholic neuropathy or a vitamin deficiency.
It should be pointed out that when the burning in the legs is not linked to particularly relevant clinical conditions (eg: intense physical effort), there is no need to resort to any particular therapy, but it is sufficient to stay at rest, waiting for the spontaneous resolution of the problem.
Examples of treatment for burning in the legs
- If the burning in the legs is due to diabetic neuropathy, the patient will benefit from all those treatments indicated in the case of diabetes mellitus (proper diet, exercise, reduction in body weight, etc.);
- If the burning in the legs is due to alcoholic neuropathy, the patient needs a radical change in lifestyle, abolishing the consumption of alcohol immediately and taking the nutrients the human body needs to be healthy;
- If the burning in the legs is due to excessive physical effort, the patient can choose between: resting for a day or two (rest is meant to be limited to daily activities) or to reduce the intensity of sports for a few days;
- If the burning in the legs depends on conditions such as Guillain-Barré's disease, multiple sclerosis, systemic lupus erythematosus, etc., the patient must undergo the treatment provided in each of the above-mentioned circumstances.
Prognosis
The prognosis in case of burning of the legs depends on the severity of the triggering cause: a burning in the legs due to a condition that is irrelevant from the clinical point of view is resolved without problems and in a short time, while a burning in the legs linked to a serious state of health it can last a long time, sometimes without ever completely healing.
