Dear Ask The Doctor: My husband has been suffering for a very long time muscle/possible nerve weekness in his right leg. He says if feels like it does not want to work right, does not always want to come move forward when walking or do what it's supposed to do. He has some numbness in his foot, under his foot and has also had some cold feelings in part of his leg. He knee also gives him problems on the same leg, it feels like it is out of place most of the time. But I do believe that he has further problems than just his knee. When you watch him walk, he has weekness in it which has gotten worse in the last couple of months, his leg has locked up on him this last summer when driving. He has balance issues because of this, he says he really does not have any pain, his main issue is it just does not want to work the way it should, it is getting harder harder for him to do everyday things. We have been to see a doctor in our local community, we are waiting for a MRI, but that will still take another 3 months, we would just like some idea as to what we may be dealing with, if you could give us any information that would be great. There are times when his right hand and are do not always work as it should but his main problem is his leg, it's like he has to work really hard to make it come with him. He is 48 years of age and does smoke.
Dear Patient: One of the most common causes of weakness and numbness in the legs is the narrowing of the spinal canal that can cause nerve compression; this can be diagnosed by performing a MRI.
Another important cause of pain and weakness in the legs may be due to peripheral artery disease (PAD), a decrease in arterial blood supply due to narrowing of blood vessels to the leg. Often the pain and weakness comes with activity - since walking requires more oxygen for the muscles and if the arteries are narrow and can't supply that need - the muscles begin to hurt. Depending upon the level of narrowing and the particular muscles involved, the areas of perceived pain may be different.
Other causes include: vitamin deficiencies (Vitamin B) and nerve inflammation not associated with the spinal cord.
The assessment of leg pain, weakness or numbness always begins with the health care practitioner interviewing the patient and performing a physical examination to help determine what types of further testing might be needed. Usually blood test along with imaging tests as MRI, CT scans and other studies as nerve conduction may be considered, to rule out other causes.