Why does walking make my legs ache?

Dr Martin Scurr has been treating patients for more than 30 years and is one of the country's leading GPs. Here he tackles pain in the legs after walking and the dangers of deep vein thrombosis...

I am 94 years old and in reasonable health, but suffer terrible pains in my legs - I can hardly walk.

My doctor says my back is the problem - I have spondylitis  - and the only treatment is painkillers.

Have you any other suggestions, as the pills cause me endless problems with sickness and side-effects? Albert Hazell, Wolverhampton

Charlie Chaplain had a funny walk

Charlie Chaplain had a funny walk

Dr Scurr says... What joy it is for myself and readers to hear from a man who is in reasonable health at the age of 94.

But I'm sorry to hear you are in such pain. My feeling is that the problem is not the spondylitis - more of that in a minute - but irritation of the nerves in your spinal canal.

Your spine is made up of bones called vertebrae - down the middle of these there is a space called the spinal canal.

Down the middle of the spinal canal runs the spinal cord - the nerve 'highway' - which connects from the brain all the way down your body.

The part of the spine we're interested in is the bit near your waist - here, the nerves fan out of the spinal cord into the cauda equina (or horse's tail).

They then pass between the bottom five vertebrae (the lumbar vertebrae, which run from your waist down to your botom) to both sides of the body, heading towards the legs.

Over the years, the lumbar vertebrae are subjected to huge amounts of wear and tear because they take so much of our weight.

The discs in between them, which were shock absorbers when you were young, will have shrivelled and thinned.

This is partly why we shrink in height and get stiffer as we age - and also why most of us suffer some degree of back pain.

While such changes have been taking place, a number of repair processes have been occurring, too.

New bone has formed on your vertebrae; unfortunately this reduces the space there is for the nerves to pass out between them.

In your case, I suspect that the nerves in the cauda equina are being crushed when you're upright or walking - these positions compress the spine just enough to cause pressure on the nerves.

This is because the space housing them has been narrowed by years of gradual wear and tear - and subsequent bone formation. The result is leg pain.

Your doctor has said you have spondylitis, wear and tear of the buttress joints between the vertebrae, which seems likely.

However, I suspect the main problem is the one I've outlined above. The medical term for it is spinal canal stenosis.

In order to confirm this diagnosis, you need a magnetic resonance scan (MRI scan) where all the nerves show up.

Painkillers will only relieve the symptoms. The problem, as you say, is those that work - at doses required - tend to produce side effects greater than the benefit.

This month alone, two of my patients have had surgery for this condition, including a man of 84.

But at 94, even though you are a well man, it is a different situation. The dangers of surgery are considerable - the anaesthetic could cause complications and you could have urinary or respiratory problems afterwards.

I am sorry not to put it more positively, but at the moment you have a painful, but non-life-threatening condition.

Although it could be helped by surgery, an operation would turn this condition into a potentially life-threatening one.

Equally, I appreciate that the possibility of being consigned to a wheelchair is tough.

Speak to your GP about getting referred to an anaesthetist specialising in pain clinic services.

A trial of lower spinal cortisone injections, which can relieve pain and inflammation, could ease your symptoms more than your current medication.

My husband has a blockage in an artery in his legs, but the blood gets through OK because the doctor can feel a pulse. However, he is thinking of taking a flight to Australia and I'm a bit worried about DVT, as the flight is 24 hours long. What are your thoughts on this? Mrs P. Oakshott, Ifield, Crawley

Let me reassure you that arterial blockage is not a risk factor for a deep vein thrombosis in the leg.

First of all, DVTs are formed in the veins, not the arteries (arteries carry oxygenated blood away from the heart towards the extremities; veins take the de-oxygenated blood back to the heart and lungs).

Also, the blood clots that cause DVT are formed differently from those in the arteries.

They occur as a result of problems with the wall of the vein (such as being squashed flat when you have your legs crossed for hours and hours) or if something is wrong with the blood (if it's too concentrated due to dehydration) or something wrong with the flow (sitting for long period with the legs hanging down vertically, or almost so).

So as it is the veins that suffer with a DVT, and your husband has a problem with his arteries, you should not worry.


Do you have a health question for Dr Scurr? He will answer a selection of readers' queries every week. Write to Dr Scurr, Good Health, Daily Mail, 2 Derry Street, London W8 5TT, or e-mail drmartin@dailymail.co.uk

Dr Scurr cannot enter into personal correspondence. Please include contact details. His replies cannot apply to individual cases and should be taken in a general context. Always consult your own GP with any health worries.

It is a completely separate condition and one will not exacerbate the other.

To protect against DVT, wear compression stockings. This puts pressure on the veins just under the skin, in turn forcing more blood through the deep vein which runs through the core of the leg. This extra blood flow lessens the chances of a clot.

It's important to drink water frequently during the flight (maybe half a pint or 300ml every couple of hours) which will enforce the third measure, to get out of the seat every two hours and make your way to the loo.

This uses the leg muscles and keeps the blood flowing in the deep veins. Walk up and down the aisle every couple of hours for five minutes or so anyway; and take a minute deliberately to flex and bend your ankles every hour or so as well.

Some of my patients take low dose aspirin before travelling. There is no evidence this works and my greater worry is that taking aspirin distracts from the other effective measures described above.

It also means there is the additional hazard of possible gastrointestinal bleeding.

Of course, if your husband has been prescribed aspirin because of his arterial disease - it prevents blood cells sticking to the fatty deposits in the arteries and forming clots - then he should continue that as well as any other usual pills that he is taking. 

By the way... Irrational prejudice is not healthy, so it's always gratifying to learn that what you think is a prejudice is, in fact, a properly valid opinion.

Although in my case, that knowledge is slightly worrying.

My particular prejudice is supplements. I've never seen the point of using them as a substitute for a nutritious diet - in other words, taking time, trouble and care about food.

But is this just bias? Regular readers will be aware of the huge emphasis I, like most doctors, place on proper evidence.

One of the most useful tools we have is the Cochrane Library, a world-renowned network of unpaid experts which collates data on whether treatments, tests or procedures work.

I decided to do a search of the Cochrane Library for guidance on supplements.

You can get all the vitamins you need from a balanced diet

You can get all the vitamins you need from a balanced diet

Unfortunately this only confirmed they are a complete waste of money, if not downright dangerous.

The research revealed that worthwhile trials - in other words, proper scientific studies - of antioxidant supplements (Vitamins A, C, E, and selenium) showed they offered no significant benefits.

The research also showed that Vitamin A and E may actually increase mortality.

Just to be clear - taking a supplement of Vitamin A or Vitamin E may increase your chances of dying sooner.

I believe that antioxidant vitamins should be evaluated further before they are sold to the public, and until then should be available only on prescription.

There may be a case for supplements for those with a poor diet because of illness or the frailty of very old age.

But if you're healthy, take them at your peril. If you're being given such supplements by an alternative therapist, a trichologist or any other such non-medical practitioner - walk away.

Recently I've come across patients who've had high doses of vitamins given to them intravenously; they've been totally conned into believing that it will be of benefit.

One word of advice: avoid.

No comments have so far been submitted. Why not be the first to send us your thoughts, or debate this issue live on our message boards.

We are no longer accepting comments on this article.

Who is this week's top commenter? Find out now