Difficulty Walking: Symptoms & Causes

Inflammatory walking difficulty causes

Walking difficulty may occur due to the following inflammatory conditions.

• Arthritis: Arthritis is a general term for multiple conditions that cause painful inflammation and stiffness of the bones and joints. Arthritis can affect the bones and fluid-filled areas of the knees, ankles and even hips resulting in significant difficulties with walking.
• Autoimmune: Many inflammatory diseases that result in the body attacking itself can also affect the nerves and muscles and cause injuries that result in gait abnormalities. Conditions such as multiple sclerosis and lupus are examples of such autoimmune diseases that can attack multiple components of the systems necessary for walking.

Injury

Walking difficulty may occur due to injuries you may have sustained.

• Traumatic: Trauma from motor vehicle accidents and other serious injuries can result in fractures and sprains of the bones and ligaments of the lower extremities (respectively). Such injuries can result in mechanical issues as noted above that result in walking abnormalities. Do not forget that falls can also be considered traumatic injuries, especially in the elderly.
• Overuse: The lower extremities are the most stressed part of the body, and as a result, with time and increasing age they become more susceptible to injury simply due to overuse.

This list does not constitute medical advice and may not accurately represent what you have.

Stroke or tia (transient ischemic attack)

Transient ischemic attack, or TIA, is sometimes called a "mini stroke" or a "warning stroke." Any stroke means that blood flow somewhere in the brain has been blocked by a clot.

Risk factors include smoking, obesity, and cardiovascular disease, though anyone can experience a TIA.

Symptoms are "transient," meaning they come and go within minutes because the clot dissolves or moves on its own. Stroke symptoms include weakness, numbness, and paralysis on one side of the face and/or body; slurred speech; abnormal vision; and sudden, severe headache.

A TIA does not cause permanent damage because it is over quickly. However, the patient must get treatment because a TIA is a warning that a more damaging stroke is likely to occur. Take the patient to the emergency room or call 9-1-1.

Diagnosis is made through patient history; physical examination; CT scan or MRI; and electrocardiogram.

Treatment includes anticoagulant medication to prevent further clots. Surgery to clear some of the arteries may also be recommended.

Rarity: Common

Top Symptoms: dizziness, leg numbness, arm numbness, new headache, stiff neck

Symptoms that never occur with stroke or tia (transient ischemic attack): bilateral weakness

Urgency: Emergency medical service

Spinal stenosis

The spine, or backbone, protects the spinal cord and allows people to stand and bend. Spinal stenosis causes narrowing in the spine. The narrowing puts pressure on nerves and the spinal cord and can cause pain.

Next steps including visiting a primary care physician. For this condition, a physician might suggest further investigation including imaging of the spine. Treatments may include medications, physical therapy, or braces. For severe cases, surgery is sometimes recommended.

Rarity: Common

Top Symptoms: lower back pain, back pain that shoots down the leg, back pain that shoots to the butt, difficulty walking, thigh pain

Urgency: Primary care doctor

Rheumatoid arthritis

Rheumatoid arthritis is a chronic inflammatory disorder that affects the lining of the joints, causing them to become thickened and painful. It can also affect other parts of the body such as the heart, lungs, eyes, and circulatory system.

Rheumatoid arthritis is an autoimmune disease, which means the body's immune system turns against itself for unknown reasons.

Most at risk are women from ages 30-60. Other risk factors are family history, smoking, and obesity.

Early symptom include warm, swollen, stiff, painful joints, especially the fingers and toes; fatigue; and fever. Usually, the same joints on both sides of the body are affected.

If untreated, irreversible joint damage and deformity can occur, with other complications. Early diagnosis can allow preventive treatment to begin as soon as possible.

Diagnosis is made through physical examination; blood tests; and x-ray, CT scan, or MRI.

There is no cure for rheumatoid arthritis, but the disease can be managed to improve quality of life. Treatment includes nonsteroidal anti-inflammatory drugs; steroids; anti-rheumatic drugs; physical therapy; and sometimes surgery to repair the joints.

Pinched nerve in the neck

A pinched nerve in the neck is also called cervical radiculopathy. It means that a nerve in the neck, at a point where it branches off from the spinal cord, is being compressed by the surrounding bones, muscles, or other tissues.

It can be caused by a traumatic injury, such as from sports or an automobile accident, especially if the injury results in a herniated disk. It may also arise from the normal wear and tear of aging.

Symptoms include sharp, burning pain with numbness and tingling from the neck to the shoulder, as well as weakness and numbness into the arm and hand.

Diagnosis is made through patient history, physical examination, and simple neurological tests to check the reflexes. Imaging such as x-ray, CT scan, or MRI may be done, as well as electromyography to measure nerve impulses in the muscles.

A pinched nerve in the neck often improves with simply a few days or weeks of rest. Physical therapy, nonsteroidal anti-inflammatory drugs, and steroid injections into the spine can all be very helpful.

Rarity: Common

Top Symptoms: pain in one shoulder, spontaneous shoulder pain, pain that radiates down arm, pain in the back of the neck, severe shoulder pain

Urgency: Primary care doctor

Peripheral arterial disease (PAD)

Peripheral artery disease (PAD) is a chronic condition that reduces blood flow in the arteries, usually arteries that lead to the legs. This reduced blood flow happens when clumps of fat (called plaques) build up inside these arteries, causing them to narrow. Symptoms include leg numbness, foot and thigh pain, cold feet, and muscle fatigue. These symptoms often occur when walking or exercising. The risk of developing PAD is higher in those who smoke or have diabetes. High blood pressure, high cholesterol, being overweight, and not getting much exercise also can put one at higher risk.

You should consider visiting a healthcare provider in the next two weeks to discuss your symptoms. Your provider can evaluate PAD with a review of your symptoms and a physical exam. An MRI may be performed as well. Once diagnosed, treatment involves medication, surgery, or procedures to open or bypass blocked arteries. Lifestyle changes regarding diet, exercise, and smoking cessation may also help.

Rarity: Common

Top Symptoms: leg numbness, spontaneous foot pain, decreased exercise tolerance, cold feet, thigh pain

Symptoms that never occur with peripheral arterial disease (pad): calf pain from an injury, thigh pain from an injury

Urgency: Primary care doctor

Multiple sclerosis (MS)

Multiple sclerosis, or MS, is a disease of the central nervous system. The body's immune system attacks nerve fibers and their myelin covering. This causes irreversible scarring called "sclerosis," which interferes with the transmission of signals between the brain and the body.

The cause is unknown. It may be connected to a genetic predisposition. The disease usually appears between ages 20 to 50 and is far more common in women than in men. Other risk factors include family history; viral infections such as Epstein-Barr; having other autoimmune diseases; and smoking.

Symptoms include numbness or weakness in arms, legs, or body; partial or total loss of vision in one or both eyes; tingling or shock-like sensation, especially in the neck; tremor; and loss of coordination.

Diagnosis is made through patient history, neurological examination, blood tests, MRI, and sometimes a spinal tap.

There is no cure for MS, but treatment with corticosteroids and plasma exchange (plasmapheresis) can slow the course of the disease and manage symptoms for better quality of life.

Rarity: Rare

Top Symptoms: severe fatigue, constipation, numbness, decreased sex drive, signs of optic neuritis

Urgency: Primary care doctor

Greater trochanteric pain syndrome

Greater trochanteric pain syndrome, also called trochanteric bursitis or GTPS, is an inflammation of the bursa of the greater trochanter.

Bursae are the small "cushions" between tendons, bones, and muscles. The greater trochanter is the larger of two bony knobs at the top of the thigh bone. Overuse, trauma, or infection can cause inflamed and irritated bursae around the greater trochanter.

Most susceptible are individuals with low back pain, osteoarthritis, and obesity.

Symptoms include chronic, persistent pain on the outside of the hip that radiates down the outside of the leg, sometimes to the knee.

The symptoms are similar to other conditions such as degenerative joint disease, and so a medical provider should be seen for an accurate diagnosis.

Diagnosis is made through physical examination and observation of simple movements.

Treatment largely involves managing the symptoms through weight loss, physical therapy, and over-the-counter nonsteroidal anti-inflammatory drugs. In some cases, corticosteroid injections into the hip work well to relieve pain, and surgery can sometimes help.

Foot weakness

Any foot weakness is a sign of nerve damage, which is very worrisome and requires you to go see a doctor immediately!

Rarity: Uncommon

Top Symptoms: foot weakness, lower leg weakness, severe pelvis pain, hearing voices or seeing things that aren't there, arm weakness

Urgency: Hospital emergency room

B12 deficiency

Vitamin B12 deficiency means a shortage of cobalamin, which is one of the complex of B vitamins.

Cobalamin, or B12, is needed to make DNA, nerves, and red blood cells, but the human body cannot make its own B12. It must be consumed in food or as a vitamin supplement.

B12 deficiency is most often seen among vegetarians, since this vitamin is mainly found in animal protein foods. Conditions that interfere with the body's ability to absorb vitamins from food can cause the deficiency, including Crohn's disease; taking proton pump inhibitors for heartburn; and any form of weight-loss surgery such as stomach stapling or gastric bypass.

Symptom include numbness and tingling in the hands; difficulty with coordination and walking; joint pain; jaundice (yellowed skin;) and shortness of breath.

If not treated, B12 deficiency can progressively worsen into memory problems, severe depression, and even paranoia or hallucinations.

Diagnosis is made through physical examination and blood test.

Treatment simply involves supplementing vitamin B12, either with food choices, vitamin tablets, or B12 injections.

Amyotrophic lateral sclerosis (ALS)

Amyotrophic lateral sclerosis is also called ALS or Lou Gehrig's Disease. It is a degenerative disease that destroys nerve cells, which eventually leads to loss of control over muscle function.

The cause of ALS is not known. It may be inherited and/or due to a chemical imbalance, faulty autoimmune response, or exposure to toxic environmental agents.

Symptoms include weakness; difficulty with speaking, swallowing, walking, or using the hands; and muscle cramps. The muscles of the arms, hands, legs, and feet are most involved at first. It does not affect the senses or a person's mental ability.

ALS is progressive, meaning it worsens over time. There is no cure, but supportive care can keep the patient comfortable and improve quality of life.

Diagnosis is made through several tests including blood tests; urine tests; MRI; electromyography (EMG) to measure muscle activity; nerve conduction studies; and sometimes muscle biopsy or spinal tap (lumbar puncture.)

Treatment involves medications to both slow the progression of the disease and ease the symptoms; respiratory therapy; physical therapy; occupational therapy; and psychological support.

Questions your doctor may ask about difficulty walking

• How would you describe your walk?
• Have you been experiencing dizziness?
• Did you just suffer from a high impact injury (e.g., a fall, collision, accident or sports trauma)?
• Do your symptoms get worse when you exercise?

Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.