Stroke or tia (transient ischemic attack)
Transient ischemic attack, or TIA, is sometimes called a "mini stroke" or a "warning stroke." Any stroke means that blood flow somewhere in the brain has been blocked by a clot.
Risk factors include smoking, obesity, and cardiovascular disease, though anyone can experience a TIA.
Symptoms are "transient," meaning they come and go within minutes because the clot dissolves or moves on its own. Stroke symptoms include weakness, numbness, and paralysis on one side of the face and/or body; slurred speech; abnormal vision; and sudden, severe headache.
A TIA does not cause permanent damage because it is over quickly. However, the patient must get treatment because a TIA is a warning that a more damaging stroke is likely to occur. Take the patient to the emergency room or call 9-1-1.
Diagnosis is made through patient history; physical examination; CT scan or MRI; and electrocardiogram.
Treatment includes anticoagulant medication to prevent further clots. Surgery to clear some of the arteries may also be recommended.
Rarity: Common
Top Symptoms: dizziness, leg numbness, arm numbness, new headache, stiff neck
Symptoms that never occur with stroke or tia (transient ischemic attack): bilateral weakness
Urgency: Emergency medical service
Restless legs syndrome (RLS)
Restless Legs Syndrome, also called RLS or Willis-Ekbom Disease, is a neurologic and sensory disorder. It causes uncomfortable sensations in the legs that are only relieved by walking or by moving the legs.
The cause is not in the legs but in the brain. One theory is low levels of iron in the brain.
RLS may be hereditary. It is more common in women than in men, especially in middle age. It may get more severe as the person gets older.
Symptoms may happen only a few times a week and are usually worse at night.
There will be an irresistible urge to move the legs in order to relieve the uncomfortable sensations; difficulty sleeping, with daytime exhaustion and inability to concentrate; and sometimes depression and anxiety due to the effect on quality of life.
Diagnosis is made through patient history and physical examination. Blood tests and sleep studies may be done.
Treatment involves first addressing any underlying medical condition, such as iron deficiency. In some cases, anti-seizure medications can be helpful.
Peripheral arterial disease (PAD)
Peripheral artery disease (PAD) is a chronic condition that reduces blood flow in the arteries, usually arteries that lead to the legs. This reduced blood flow happens when clumps of fat (called plaques) build up inside these arteries, causing them to narrow. Symptoms include leg numbness, foot and thigh pain, cold feet, and muscle fatigue. These symptoms often occur when walking or exercising. The risk of developing PAD is higher in those who smoke or have diabetes. High blood pressure, high cholesterol, being overweight, and not getting much exercise also can put one at higher risk.
You should consider visiting a healthcare provider in the next two weeks to discuss your symptoms. Your provider can evaluate PAD with a review of your symptoms and a physical exam. An MRI may be performed as well. Once diagnosed, treatment involves medication, surgery, or procedures to open or bypass blocked arteries. Lifestyle changes regarding diet, exercise, and smoking cessation may also help.
Rarity: Common
Top Symptoms: leg numbness, spontaneous foot pain, decreased exercise tolerance, cold feet, thigh pain
Symptoms that never occur with peripheral arterial disease (pad): calf pain from an injury, thigh pain from an injury
Urgency: Primary care doctor
Multiple sclerosis (MS)
Multiple sclerosis, or MS, is a disease of the central nervous system. The body's immune system attacks nerve fibers and their myelin covering. This causes irreversible scarring called "sclerosis," which interferes with the transmission of signals between the brain and the body.
The cause is unknown. It may be connected to a genetic predisposition. The disease usually appears between ages 20 to 50 and is far more common in women than in men. Other risk factors include family history; viral infections such as Epstein-Barr; having other autoimmune diseases; and smoking.
Symptoms include numbness or weakness in arms, legs, or body; partial or total loss of vision in one or both eyes; tingling or shock-like sensation, especially in the neck; tremor; and loss of coordination.
Diagnosis is made through patient history, neurological examination, blood tests, MRI, and sometimes a spinal tap.
There is no cure for MS, but treatment with corticosteroids and plasma exchange (plasmapheresis) can slow the course of the disease and manage symptoms for better quality of life.
Rarity: Rare
Top Symptoms: severe fatigue, constipation, numbness, decreased sex drive, signs of optic neuritis
Urgency: Primary care doctor
Herniated (slipped) disk in the lower back
A herniated, ruptured, or "slipped" disc means that a vertebral disc – one of the soft pads of tissue that sit between each of the vertebral bones – has becomes squeezed out of shape. Its cushioning material has been forced against, and possibly through, the ring of fibrous tissue that normally contains it. This causes pain, numbness, and weakness in the legs.
The normal aging process causes the discs lose moisture and become thinner, making them more vulnerable to "slipping."
Most susceptible are men from ages 30 to 50. Smoking, obesity, lack of exercise, and improper lifting are also risk factors.
Symptoms include pain, weakness, numbness, and tingling in the back, leg, and foot.
Diagnosis is made through patient history, neurological examination, and MRI scan.
Treatment begins with rest, nonsteroidal anti-inflammatory drugs, physical therapy, and sometimes epidural steroid injections into the back to ease pain and inflammation.
Surgery to remove the herniated part of the disc – the part that was squeezed out of place – can also be helpful.
Rarity: Common
Top Symptoms: lower back pain, moderate back pain, back pain that shoots down the leg, back pain that gets worse when sitting, leg weakness
Urgency: Primary care doctor
Fibular nerve injury
The fibular nerves are also known as the peroneal nerves. Fibular nerves run from the lower spine all the way down the back of the leg, ending at the heel. If the are damaged or compressed, this can result in a condition known as foot drop.
The fibular nerves can be damaged through surgery, especially hip replacement or total knee replacement; any injury to the knee or low back; or neurologic diseases such as multiple sclerosis or Parkinson's disease.
Foot drop means that the person is unable to flex the foot upward from the ankle, because the fibular nerves that control this voluntary movement have been damaged. There may also be pain, numbness and weakness in the foot, and difficulty walking.
Diagnosis is made through physical examination, nerve conduction studies, and imaging such as x-ray or MRI.
Treatment involves using orthotics, which are specially made shoes, supports, and braces for the foot; physical therapy; and sometimes surgery to decompress or otherwise help repair the nerve.
Rarity: Uncommon
Top Symptoms: pain in the distribution of fibular nerve, numbness in fibular nerve distribution, difficulty walking or weakness with foot dorsiflexion
Urgency: Wait and watch
Fibromyalgia
Fibromyalgia is a set of chronic symptoms that include ongoing fatigue, diffuse tenderness to touch, musculoskeletal pain, and usually some degree of depression.
The cause is not known. When fibromyalgia appears, it is usually after a stressful physical or emotional event such as an automobile accident or a divorce. It may include a genetic component where the person experiences normal sensation as pain.
Almost 90% of fibromyalgia sufferers are women. Anyone with rheumatic disease, such as rheumatoid arthritis or lupus, may be more prone to fibromyalgia.
Poor sleep is often a symptom, along with foggy thinking, headaches, painful menstrual periods, and increased sensitivity to heat, cold, bright lights, and loud noises.
There is no standard test for fibromyalgia. The diagnosis is usually made when the above symptoms go on for three months or more with no apparent cause.
Fibromyalgia does not go away on its own but does not get worse, either.
Treatment involves easing symptoms and improving the patient's quality of life through pain medications, exercise, improved diet, and help with managing stressful situations.
Rarity: Common
Top Symptoms: fatigue, arthralgias or myalgias, anxiety, depressed mood, headache
Symptoms that always occur with fibromyalgia: arthralgias or myalgias
Urgency: Primary care doctor
Diabetic neuropathy
Diabetic peripheral neuropathy is the damage done to nerve fibers in the extremities by abnormally high blood sugar. Anyone with diabetes is at risk for peripheral neuropathy, especially if the person is overweight and/or a smoker.
Symptom include pain, numbness, and burning in the hands, arms, feet, and legs; muscle weakness; loss of balance and coordination; and infections, deformities, and pain in the bones and joints of the feet.
Peripheral neuropathy can develop very serious complications, since the high blood glucose prevents any infection or damage from healing as it should. This can lead to ulcerated sores, gangrene, and amputation. For this reason, signs of peripheral neuropathy are considered a medical emergency and the person should see a medical provider as soon as possible.
Diagnosis is made through sensitivity tests and nerve conduction studies.
There is no cure for diabetic neuropathy, but the symptoms can be managed in order to slow the disease and help restore function. Treatment will include lifestyle improvements and the use of pain medication.
Chronic idiopathic peripheral neuropathy
Peripheral neuropathy refers to the feeling of numbness, tingling, and pins-and-needles sensation in the feet. Idiopathic means the cause is not known, and chronic means the condition is ongoing without getting better or worse.
The condition is most often found in people over age 60. Idiopathic neuropathy has no known cause.
Symptoms include uncomfortable numbness and tingling in the feet; difficulty standing or walking due to pain and lack of normal sensitivity; and weakness and cramping in the muscles of the feet and ankles.
Peripheral neuropathy can greatly interfere with quality of life, so a medical provider should be seen in order to treat the symptoms and reduce the discomfort.
Diagnosis is made through physical examination; blood tests to rule out other conditions; and neurologic and muscle studies such as electromyography.
Treatment involves over-the-counter pain relievers; prescription pain relievers to manage more severe pain; physical therapy and safety measures to compensate for loss of sensation in the feet; and therapeutic footwear to help with balance and walking.
Rarity: Rare
Top Symptoms: distal numbness, muscle aches, joint stiffness, numbness on both sides of body, loss of muscle mass
Urgency: Primary care doctor
Vertebral osteomyelitis
Vertebral osteomyelitis, or spinal osteomyelitis, is an infection in the bones of the spine. It usually affects the lumbar, or lower, back, and may be either acute or chronic.
The infection is caused by bacteria, most commonly Staphylococcus aureus and Pseudomonas aeruginosa, and by some types of fungi. These agents can travel through the bloodstream from an infected wound elsewhere in the body and reach the bones of the spine.
Most susceptible are those with weakened immune systems; poor circulation; recent injury; or undergoing hemodialysis. Osteomyelitis of the spine is the most common form of osteomyelitis in adults, though children can also be affected.
Symptoms include swelling, redness, and pain at the site of the infection, along with fever, chills, and fatigue.
A medical provider should be seen for these symptoms, as vertebral osteomyelitis can progress to abscess and cause further complications if not treated.
Diagnosis is made through blood tests, imaging of the spine, and sometimes biopsy.
Treatment involves several weeks of intravenous antibiotic or antifungal medication, which can be given as an outpatient.
Rarity: Rare
Top Symptoms: upper back pain, spontaneous neck or back pain, fever, foot numbness, upper leg numbness
Urgency: Hospital emergency room
Will the numbness in my lower leg affect my gait or walking?
Depending on what nerves in the leg are affected, your gait or walking may be affected. For example, if you have injury or disruption to the common peroneal nerve a nerve that provides both sensation and movement to the lower leg and foot you may find it difficult to lift the foot when walking and develop a "slapping" gait or dragging of the feet while walking.
Why am I only feeling numbness in one leg and not both?
You are only feeling numbness in one lower leg and not both because the nerve or nerves in that leg have been affected whereas the nerve in the other leg has not.
Will the numbness spread from my lower leg to other parts of my body?
Depending on the specific cause of your symptoms, you may experience numbness and other symptoms in other parts of your body. For example, if you suffer from diabetes you may have neuropathy that causes numbness in the hands as well.
How long will the lower leg numbness last?
The duration of your symptoms will depend on the specific cause. For example, mechanical causes of lower leg numbness can have a range of causes from benign to severe. A compressive cause such as too-tight clothing will have a much faster resolution than a fracture or compressive tumor. Discuss your specific prognosis with your physician to get more detailed information on the duration of your symptoms.
Is lower leg numbness life-threatening?
Usually, numbness in the lower leg is not life-threatening, especially if it is related to compressive etiologies of leg numbness. However, there are life- and/or limb-threatening conditions such as compartment syndrome a situation in which increased pressure within a confined space can lead to inadequate blood supply to an organ that can also present as numbness. Usually, these conditions are associated with severe trauma and symptoms such as paralysis, lack of pulse, and changes in the color of the extremities. Also, Guillain-Barre Syndrome can result in numbness and weakness spreading to other parts including the breathing muscles, and is an emergency needing immediate medical attention.
Questions your doctor may ask about lower leg numbness
- Are you sleepy during the day?
- Do you have trouble sleeping?
- Do your symptoms improve with activity (moving around and such)?
- Are your symptoms worse during the late afternoon or night?
Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.