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If not properly managed, lower extremity pain can be debilitating, causing a significant decrease in a patient’s quality of life. At the Augusta Pain Center, various conservative and minimally invasive options are available to manage lower extremity pain.

Lower extremity pain is caused by many different injuries and illnesses, including peripheral artery disease, diabetes, thromboembolism, cellulitis, meralgia paresthetica and radiculopathy arising from spinal stenosis, disc herniation, nerve decompression, nerve root injuries, peripheral neuropathy and scar tissue from previous spinal surgeries.

“Many different disease processes can contribute to lower extremity pain,” says Richard S. Epter, M.D., Medical Director of the Augusta Pain Center. “Many times, lower extremity pain originates in the spine and can be caused by stenosis or disc herniation. Orthopedic or musculoskeletal diseases cause pain in the hip, knees, ankle and toes, as well. Pain may also be referred from the facet joint or sacroiliac joint.”

Identifying the Underlying 
Pain Generator

To determine the source of pain, a complete medical history and medical evaluation are performed. Dr. Epter also offers a wide variety of diagnostic studies that may be necessary to obtain an accurate diagnosis, including sympathetic nerve blockades, intra articular joint injections, discography, facet nerve injections, sacroiliac joint injections and spinal nerve root blocks.

“As always, the first step taken to determine the ideology of pain is to perform a history and physical exam, as well as gather the appropriate diagnostic studies,” says Dr. Epter. “Identifying the cause of chronic lower extremity pain is the most important aspect of treatment, as it helps determine the most appropriate course of treatment and helps to rule out more serious underlying conditions, such as cellulitis or thromboembolism, that warrant immediate treatment.”

Services Provided

“Patients who present with a combination of low back and radicular pain should be considered for an appropriate pain evaluation because these problems can often be treated conservatively or with minimally invasive procedures,” says Dr. Epter. “The same can be said for nerve compression disorders, such as meralgia paresthetica. This disease — characterized by thigh pain that occurs secondary to compression of the lateral nerve — should not be overlooked, as it can often be easily treated and diagnosed.”

For patients with nonradicular, generalized pain with patterns such as aching, burning or throbbing leg pain, sympathetic nerve blockades may be indicated. Also utilized for diagnostic purposes, these interventional procedures are performed when the sympathetic nervous system is overactive, resulting in pain that is neuropathic in presentation. This type of pain is often caused by diabetes, peripheral artery disease or complex regional pain syndrome. Interventional procedures, including spinal cord stimulation and radiofrequency ablation of lesions of the sympathetic nervous system, may also be helpful in achieving long-term pain control.

Conservative therapies, such as physical therapy, aquatic therapy and medication management, are also available for resolution of both radicular and generalized lower extremity pain.

To learn more about the services available through the Augusta Pain Center for lower extremity pain,