Q I have severe pain in my legs after I walk about 1/4 mile. The pain is 4 to 5 inches above my outer ankle. If I continue to walk, my feet go numb.

— T.S., Anderson

A Your letter states that you have been to numerous types of doctors without a diagnosis and that the doctors have ruled out intermittent claudication, which is associated with peripheral blood flow. A Web site called WrongDiagnosis lists 193 causes of leg pain. So the issue is whether your leg pain and foot numbness is the primary problem or whether the symptoms are related to another health problem.

I’m sure the doctors mentioned to you that being overweight may be a contributing factor. Since you can walk casually without pain, it’s obvious that walking is not the correct exercise program for you. Stationary bicycles are excellent for daily workouts and since that doesn’t cause you discomfort, I would continue that form of exercise. You might also consult with a nutritionist to manage any dietary changes indicated.

Since you have seen so many physicians, I assume they’ve ruled out ankle injury, arthritis or spinal injuries that may cause leg, ankle and foot pain. Were X-rays or scans done? Torn or overstretched muscles, stress fractures, tendinitis (inflamed tendon), shin splints and other injuries are associated with pain, as well.

Serious sprains that damage or tear ligaments or a strain that tears the muscle might be associated. Swelling, redness and heat are common symptoms.

Dr. Grant Cooper writes that several low back conditions, such as degenerative disc disease and herniated discs, are common causes of leg and foot pain. If there is any compression or pressure on the nerves in the lower back, then pain, numbness or weakness can occur along the different nerve pathways that travel to the leg and the foot.

You might also consider your current medications.

Sometimes common medications have side effects that can lead to weakness or muscle injury. Diuretics can lead to a loss of minerals and fluids that can then cause leg pain or muscle cramps. Statin medications used to lower cholesterol have been associated with muscle injury. If the pain occurs with exercise only, ensure that you are adequately hydrated. If your symptoms continue, you should go back to your doctors and discuss specific causes.

You might have your physician check your muscle enzymes (creatine phosphokinase (CPK) and aldolase) to see if they’re elevated. Levels are high when there is inflammatory muscle disease or muscle trauma that may cause pain.

Leg and foot pain can be associated with the shoes you wear, as well. Make sure your walking shoes fit properly and support your feet. If you haven’t been assessed for Morton’s neuromas between your toes, have your doctor check. They tend to be associated with foot pain, but you might also have leg pain when walking. If you feel discomfort, stop, relax and rest your feet and legs.

Send your health questions to Debbie Jackson, Ph.D., MN Clemson University, 302 Sikes Hall, Clemson, SC 29634-5155 or email dbj@clemson.edu.