What to do when you have type 2 diabetes and your leg hurts ?

by James
(Florida)

type 2 diabetes and leg hurts

type 2 diabetes and leg hurts




Quick Answer
Persistent leg pain in a person with type 2 diabetes should be examined. It may result from peripheral artery disease, diabetic neuropathy, a blood clot, infection, arthritis, muscle injury or a back problem. Being able to move and feel the leg does not prove that circulation is normal. Sudden severe pain with a cold, pale or blue foot, new numbness or weakness is an emergency. One-sided swelling, warmth and redness also need prompt assessment for a blood clot or infection.


Answer by Dr. Albana Greca, MD, MMedSc



Hi James,



Diabetes increases the risk of both nerve damage and narrowed leg arteries, but leg pain has many possible causes. The pattern, location and accompanying symptoms are needed before treatment can be recommended.



Could Poor Circulation Cause the Pain?



Yes. Peripheral artery disease, or PAD, reduces blood flow through narrowed arteries. The classic symptom is aching, cramping, burning, heaviness or fatigue in the calf, thigh or buttock while walking that improves after several minutes of rest.



Other clues include a cooler foot, weak pulses, slow-healing wounds, color changes or pain at rest. Movement and sensation may remain present despite reduced circulation.



See our guide to diabetes and foot complications.




Emergency circulation warning: Call emergency services for sudden severe leg or foot pain with a cold, pale or blue limb, a weak or absent pulse, rapidly increasing numbness, or new inability to move the foot. Acute loss of blood flow can threaten the limb.


Could It Be Diabetic Neuropathy?



Diabetic peripheral neuropathy may cause burning, electric-shock pain, tingling, extreme sensitivity, numbness or weakness. It often begins in both feet and may be worse at night.



A trapped nerve, vitamin B12 deficiency, kidney or thyroid disease, medicines and spinal problems can produce similar symptoms.



Read more about diabetic peripheral neuropathy.



Other Causes That Need Attention




  • Deep vein thrombosis: One-sided swelling, pain or tenderness, warmth and redness may indicate a blood clot.

  • Infection: Redness, warmth, swelling, drainage, fever or a foot wound requires prompt care.

  • Charcot foot: A hot, red and swollen foot may be serious even when pain is mild.

  • Back or nerve-root pain: Pain may travel from the lower back or buttock down the leg and may include tingling or weakness.

  • Muscle, joint or tendon problems: Injury, arthritis, poor footwear and overuse are also common.




Blood-clot warning: Seek same-day medical care for new one-sided leg swelling, warmth, redness or unexplained tenderness. Call emergency services if this occurs with shortness of breath, chest pain, coughing blood, fainting or a rapid heartbeat.


What Should You Do Now?



Arrange a medical appointment soon. Seek urgent care sooner if pain worsens, occurs at rest, affects walking, or comes with swelling, color or temperature change, or a wound.



Until assessed:




  • Inspect both feet and legs for blisters, cuts, redness, swelling and color changes.

  • Wear supportive, well-fitting shoes and do not walk barefoot.

  • Do not massage a newly swollen or tender leg.

  • Do not exercise through unexplained pain or a suspected circulation problem.

  • Do not apply heating pads or very hot water to a numb foot.

  • Record when the pain begins, where it occurs and what makes it better or worse.



What Will the Clinician Check?



The examination should include the skin, feet, pulses, temperature, sensation, strength and the location of tenderness or swelling.



If PAD is suspected, testing may include an ankle-brachial index, toe pressures or Doppler ultrasound. Suspected blood clots require urgent venous ultrasound.



A foot examination should include monofilament and another sensory test. Blood tests may be selected according to the symptoms.



Be Careful With Painkillers



Do not automatically start aspirin, ibuprofen, naproxen or diclofenac. These medicines may be unsuitable for people with kidney disease, heart disease, stomach ulcers, high blood pressure or blood-thinning treatment. NSAIDs can injure the kidneys and increase cardiovascular or bleeding risks.



Ask a doctor or pharmacist which pain medicine is safest. Neuropathy, reduced circulation, a clot or infection requires treatment of the cause.



How Is the Cause Treated?




  • PAD: Treatment may include risk-factor management, structured walking therapy and, when needed, restoring blood flow.

  • Neuropathy: Medicines such as gabapentinoids, duloxetine or other guideline-supported options may reduce nerve pain.

  • Blood clot: Anticoagulant treatment is usually required after confirmation.

  • Infection or ulcer: Prompt wound care, pressure relief and antibiotics when infection is present may be needed.

  • Musculoskeletal or spinal pain: Treatment may include physical therapy or other cause-specific care.



Our diabetic neuropathy treatment guide explains options for confirmed nerve pain.



My Advice



Do not assume that circulation is normal because you can move or feel the leg, and do not assume every leg pain is neuropathy. Arrange an examination focused on arteries, veins, nerves, joints, muscles and the feet.



Seek emergency help for sudden severe pain with a cold or discolored foot, new weakness or numbness, or symptoms of a clot traveling to the lungs. Otherwise, schedule a prompt appointment before treating the pain on your own.



Hope this helps.



Dr. Albana Greca



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References






Educational only — not personal medical advice. Persistent leg pain in diabetes requires clinical assessment. Sudden loss of circulation, severe infection or symptoms of a pulmonary embolism require emergency care.


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