Are you experiencing shooting pain in leg ? Does this pain make you uncomfortable? Shooting pain in leg can be caused by various reasons like by herniated disc, Stenosis, osteoarthritis ,Spondylolisthesis, trauma, nerve damage, Osteochondritis dissecans, AVN of femoral head, stress fracture of tibia, Radiculopathy, cauda equina syndrome, peroneal nerve tumours etc.Keep reading this article you will find everything related to it in this article.
Shooting pain in leg also known as sciatica starts in the lower back, radiates back into the buttock and down to the back of one leg. The pain is usually caused by pressure on the sciatic nerve due to herniated disc, bone spurs or a muscle strain. Person himself plays an important role in the prevention, treatment, and recovery of this leg pain. It mostly improves with rest, physical therapy, and many other self-care measures. Chronic pain can be helped with surgery sometimes.
What are types of shooting pain in leg?
Sciatic nerve is derived from spinal nerves L4 to S3. Each sciatic nerve travels through the pelvis and down the back of each leg. Each divides into a peroneal and tibial nerve to give feeling and muscle control of legs and feet. Leg pain can range from mild to severe Or it can be acute or chronic:
- Acute sciatic pain happens suddenly and typically heals within several days to weeks. The severity depends directly to amount of injury. The source of pain can be in spinal joints, discs, nerves, or it can be in muscles and ligaments.
- On the other side chronic sciatic pain persists for more than 3 months and its source is usually hard to determine. Chronic pain can either be felt all the time or it may worsen with certain activities. Contributing factors to this pain may include nerve damage, tissue scarring, arthritis, or mental effects . Mostly people with chronic symptoms may be referred to a pain specialist for pain management.
What are symptoms of shooting pain in leg?
Usually classic sciatic pain starts in the lower back and buttocks then radiates. It affects only one leg traveling down then to the back of the thigh, past the knee, and sometimes to the calf and foot. The pain feels most worse in the leg than in back. It can range from a mild ache to a severe burning or a shooting pain. Numbness or tingling that us pins-and-needles like feeling can occur in leg and foot. This usually is not a concern unless one has weakness of leg muscles or foot drop.
Sitting mostly causes the highest pain because of the weight this position puts onto the discs. Few activities, such as bending or twisting may worsen the pain, whereas lying down tends to bring a lot of relief. For some running or walking may actually feel better than sitting or standing for long time.
Immediate medical help should be opted if one has extreme leg weakness, numbness in the genital area, loss of bladder or bowel function, Because these are signs of a serious condition called cauda equina syndrome.
What are the causes of shooting pain in leg?
Shooting pain in leg can be caused by a various number of reasons that irritate or compress the sciatic nerve:
- Osteochondritis dissecans: is a condition in which bone underneath the cartilage of a joint dies because of lack of blood flow. This bone and cartilage can break loose, and lead to pain and possibly hindering joint motion. Osteochondritis dissecans seen mostly in children and adolescents. The occurs mostly in knee, but can also occur in elbows, ankles and other joints of the body.
- Stress fracture : also called a hairline fracture, is a small crack that doesn’t go all the way through your bone. Stress fractures commonly occur in the tibia, the largest of the two bones that make up your shin of lower extremity. This injury is very common among athletes, and is usually caused by overuse of body and can significantly interfere with exercise schedule and sports activity.
- Piriformis syndrome: Sudden tightening or spasm of the piriformis muscle can compress the nerve and lead to sudden shooting pain .
- Peroneal nerve tumours: Schwannomas, or neurilemmomas, are the most common benign peripheral nerve sheath tumours but reports of schwannomas arising from the common peroneal nerve are rare. While they are usually clinically silent, but sometimes they can become symptomatic due to mechanical compression and may present with severe pain, swelling or even a lump. A physical examination and prompt investigation may help to make a timely diagnosis and initiate appropriate treatment. Schwannomas should always be included in the differential diagnosis of lumps found in the vicinity of nerves .
- Sciatica: The pain that courses along the sciatic nerve in the buttocks and radiates down the legs. Mostly caused by compression of the 5th lumbar spinal nerve i.e. L5.
- AVN : Avascular necrosis of the femoral head is a pathologic condition that results from interruption of blood flow to the bone. AVN of the hip is not understood well, yet this process is the final common pathway of traumatic or nontraumatic factors which compromise the already precarious circulation of head of femor. Femoral head ischemia turns in the death of marrow and osteocytes and most often results in the collapse of the necrotic segment
- Trauma: Any sports injury or fall from a height can fracture the spine or tear a muscle and damage nerves which will lead to shooting pain in leg.
- Herniated disc: The gel-like centre of a spinal disc which acts as a cushion between two vertebrae can bulge or rupture through a weak area in the disc wall and lead to nerve compression which can cause severe pain.
- Stenosis: The narrowing of the bony canals in spine can compress the spinal cord and nerves leading to shooting pain of leg as well.
- Osteoarthritis: As discs also age naturally they dry out and shrink. Small tears in the disc wall can be painful and even bone spurs can form at those places. The facet joints tend to enlarge and ligaments thicken , all these can lead to pain in the body
- cauda equina syndrome: It’s compression of the end of the spinal cord which is called cauda equina, causing low back pain, numbness in the groin area groin, severe leg weakness and pain, difficulty controlling bladder or bowel function; an emergency condition which if left untreated can cause paralysis.
- Spondylolisthesis: A weakness or stress fracture in the facet joints in the spine can allow a vertebra to slip out of position leading to pinch the nerves which in return can cause shooting pain of leg.
- Radiculopathy: This refers to any disease affecting the spinal nerve roots in spinal cord . Also used to describe the pain along the sciatic nerve that radiates down the leg known as sciatica.
Leg pain can also be caused by some joint problem in the hip or in sacroiliac joint. This type of referred pain is quite common these days but its not sciatica.
How to diagnose shooting pain in leg?
- A careful medical history and a very careful medical exam will attempt to determine the type and cause of your spine problem that can lead to shooting pain in leg and the treatment options available. A diagnostic evaluation includes mostly these two medical history and physical exam. Sometimes imaging scans like x-ray, CT, MRI and tests to check muscle strength and body reflexes are used to determine cause of pain .
- Electromyography (EMG) and nerve conduction velocity (NCV) are diagnostic tests that are conducted to measure the electrical activity of muscles and nerves. These tests can play an important part in checking the patients o spine patient’s work-up . Other then back pain or neck pain, some patients with a spine related issue like nerve injury report unexplained symptoms, numbness or tingling sensations, muscle cramping, or weakness in lower extremity like in legs. EMG and NCV join together to help get to the diagnosis of why those symptoms are occurring in the leg or anywhere else
What are the treatments available for shooting pain in leg?
Healing mostly begins with self-care plus nonsurgical strategies. The goal is to correct the problem, restore function of that specific nerve and to prevent re injury.
- Self care for shooting pain in leg :
Exercise, strengthening, stretching and even ideal weight loss are key elements for the treatment. Making these a part of life-long daily routine helps a lot.
Self care: Sciatica mostly resolves with some rest, ice packs or heat, massage, pain relievers, and with gentle stretches. Try reducing muscle inflammation and pain using an ice pack for 20 minutes few times a day during the first 48 to 72 hours. Thereafter, a warm shower or a heating pad on low setting can be added to relax the muscles. A short period of bed rest is helpful but more than that a couple of days does more harm than good. If the self-care treatments aren’t working within the first few days, doctor should be consulted.
Few over-the-counter nonsteroidal anti-inflammatory drugs, such as aspirin, ibuprofen or naproxen, can bring instant relief. Muscle relaxant can be prescribed for spasms. If pain is severe and unbearable an analgesic may be prescribed that can be taken with the NSAID or a muscle relaxant.
Steroids reduce the swelling and inflammation of the nerves leading to decrease in pain. They are taken orally given over a five-day period or by injection directly into the painful area like epidural or facet injections. Steroids can provide immediate pain relief just within 24 hours.
- Physical therapy:
Mostly for leg pain, nearly normal schedule from the onset is recommended. Physical therapy can help in returning the full activity as soon as possible and also prevent re-injury. Physical therapists show proper lifting and walking techniques, and exercises to strengthen and stretch the lower back, leg, and stomach muscles. Massage, ultrasound, diathermy, heat, and traction can be also recommended for short periods by therapist. Patients may also benefit from yoga meditation and chiropractic manipulation .
Surgery is rarely required unless patient has muscle weakness, a proven disc herniation, cauda equina syndrome, or severe pain that has not resolved after a reasonable course of nonsurgical treatment or by medication. Surgery for a herniated disc is called a discectomy, in which the portion of the disc is removed which is compressing the spinal nerve. People who suffer with stenosis may benefit from a decompression of the nerves.
What can one do for prevention of shooting pain in leg?
- A positive mental attitude, regular basic activity, and a good return to work are all very important elements of recovery. If regular job duties cannot be performed initially then modified i.e. light or restricted duty can be prescribed for a limited time.
- Proper lifting of things ; avoid sitting for long periods of time.
- Good posture during sitting is important,standing, moving, and sleeping in a good way.
- Regular exercise with light stretching and strengthening.
- Good and healthy nutrition, healthy weight and lean body mass are also helpful.
- Stress management and relaxation is way more important.
- No smoking and alcohol use also prevents nerve damage