When walking makes your legs hurt

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We know about arthritis, but four other conditions can affect your legs and make walking painful.

Fitness experts used to stress the benefits of heavy-duty aerobic exercise - the kind that makes you breathe hard and gets your heart going.

But the message changed to moderation after a number of studies showed that physical activity that's far less taxing is associated with lower rates of heart disease, some cancers, and several other illnesses - if it's done regularly.

Plain old walking usually tops the moderate-intensity exercise list because it's easy, convenient, and free, and it requires minimal equipment - a comfortable pair of shoes.

The trouble is that walking isn't so easy for everyone. Indeed, it's agony for many. And forget the "brisk" pace of three to four miles per hour advised for health and fitness.

With age - and occasionally without it - a number of conditions can result in leg pain that makes walking difficult. Some are very familiar, such as arthritis that makes knees and hips creaky; others, such as peripheral artery disease, aren't.

This article looks at four nonarthritic conditions that cause leg pain and may affect walking, and some ways to treat and manage them - no need to limp and bear it!

We're discussing these conditions separately, but people may have two or more of them at the same time, which complicates diagnosis and treatment.

1. Peripheral artery disease

Peripheral artery disease is a form of atherosclerosis, the same condition that leads to most strokes and heart attacks. Fat- and cholesterol-filled plaque narrows arteries, and blood clots can collect on the plaque, narrowing them further.

In peripheral artery disease, the arteries affected by atherosclerosis tend to be the ones that supply the leg muscles. The risk factors are similar to those for heart disease and stroke: smoking, high cholesterol levels, high blood pressure, and especially diabetes.

The classic symptom is cramping, tight pain that's felt in muscles "downstream" from the narrowed artery. It can occur in the buttocks, thigh, calf, or foot, but occurs most often in the calf.

The pain tends to come on with walking, get worse until the person stops walking, and goes away with rest. Similar to angina, the pain caused by peripheral artery disease comes from working muscle cells that are "starved" for oxygen because of obstructed blood flow. The medical jargon for this kind of pain is intermittent claudication, from the Latin claudicatio for limping.

Many people with peripheral artery disease have other sorts of pain, though. Sometimes their legs are heavy, or they tire easily. And it's common for people to cut back on their activity level without realizing it, which can mask the problem.

Signs of peripheral artery disease include a diminished pulse below the narrowed artery, scratches and bruises in the lower leg that won't heal, and pale and cool skin.

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