Some Causes and Features of Limb Pain
Cause* | Common Features† | Tests |
|---|---|---|
Sudden, severe pain that develops within a few minutes | ||
Blockage of an artery in a limb, usually a leg, by a blood clot | Sudden, severe pain Coolness and paleness of the limb After several hours, signs of nerve malfunction, such as weakness, numbness, tingling, or cramping Weak or no pulse felt in the limb | Arteriography done immediately |
Sudden herniation of a disk in the spine | Pain and sometimes numbness that occurs in a line down the limb Pain that is often worsened by movement Often neck or back pain Sometimes weakness in part of the affected limb | Usually MRI |
Heart attack (myocardial infarction) | Pain in an arm, not a leg Sometimes pain or pressure in the chest or jaw Sometimes nausea, sweating, and shortness of breath Sometimes in people known to have heart disease | ECG Blood tests for substances that indicate heart damage (cardiac biomarkers) Sometimes angiography of the arteries of the heart |
Peripheral arterial disease, caused by fatty deposits in artery walls (atherosclerosis), which reduce blood flow, almost always in a leg | Intermittent episodes of leg pain that occur only when walking and are relieved by a few minutes of rest (intermittent claudication) | Ultrasound study Sometimes arteriography |
Pain that develops gradually (over hours to days) | ||
Bacterial infection of the skin (cellulitis) | An irregular area of redness or darkness, warmth, and tenderness Sometimes fever | A doctor's examination Sometimes blood cultures |
Deep vein thrombosis (a blood clot in a deep-lying vein in a leg [typically] or an arm) | Swelling of an entire part of a limb (for example, whole calf or calf and upper leg) Usually pain, redness or darkness, warmth, and/or tenderness in the affected area Sometimes in people with risk factors for blood clots, such as recent surgery, an injury, bed rest, a cast on a leg, use of hormone therapy, or cancer | Ultrasound study Sometimes a blood test to detect blood clots (D-dimer) |
Bacterial infection deep under the skin and/or in the muscle (myonecrosis) | Deep, constant pain Redness or darkness, warmth, tenderness, and swelling that feels tight Signs of severe illness (such as fever, confusion, and a rapid heart rate) Sometimes a foul discharge, blisters, or areas of blackened, dead skin | Blood and tissue cultures X-ray studies Sometimes MRI |
Bone infection (osteomyelitis) | Deep, constant pain that often occurs at night Bone tenderness and fever Often in people with risk factors (such as a weakened immune system, use of illicit injection drugs, or a known source for the infection) | X-ray studies and MRI and/or CT scans Sometimes bone culture |
Chronic pain (present for a week or more) | ||
A bone tumor (originating in the bone or spread to the bone from cancer elsewhere in the body) | Deep, constant pain that is often worse at night Bone tenderness Often in people known to have cancer | X-ray studies and MRI and/or CT scans |
Pressure on certain nerves, as occurs in
| Usually weakness and sometimes numbness or tingling along part of the limb | Sometimes only a doctor's examination Sometimes electromyography and nerve conduction studies Sometimes MRI |
Pressure on a spinal nerve root (the part of a spinal nerve next to the spinal cord), which may be caused by a herniated disk or bone spurs | Pain and sometimes numbness that occurs in a line down the limb Pain that is often worsened by movement Often neck or back pain Often weakness in part of the affected limb | Usually MRI |
Degeneration or inflammation of many nerves throughout the body (polyneuropathy) | Chronic numbness and burning pain, typically in both hands and/or both feet Often in people with a disorder that causes nerve damage, such as diabetes, alcohol use disorder, or vasculitis | Sometimes only a doctor's examination Sometimes blood tests or electromyography and nerve conduction tests |
Severe burning or aching pain Sometimes increased sensation and pain caused by something that would not ordinarily be considered painful Often skin that appears red, mottled, or ashen and increased or decreased sweating in the affected limb Typically in people who have had an injury (sometimes many years before) | Only a doctor's examination | |
Chronic venous insufficiency (causing blood to pool in the legs) | Swelling of the ankles or legs Chronic mild discomfort, aching, or cramps in the legs but no pain Sometimes reddish brown, leathery areas on the skin and shallow sores on the lower legs Often varicose veins | Only a doctor's examination |
*Arm or leg pain that is caused by injury is not included. | ||
† A doctor's examination is always done. Features include symptoms and the results of the doctor's examination. Features mentioned are typical but not always present. | ||
CT = computed tomography; ECG = electrocardiography; MRI = magnetic resonance imaging. | ||