Pain in different parts of the body can be connected if it’s a symptom of the same source of disease or deficiency. However, the connection isn’t always clear, like with hemorrhoids and nerve pain in the legs.
This article will explore the potential link between these two conditions.
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Hemorrhoids are swollen blood vessels (veins) located in the lower rectal and anal areas. They often cause pain, discomfort, and anal bleeding.¹
They form when repetitive or prolonged straining puts stress on the vascular hemorrhoidal cushion, creating inflamed, elongated, and enlarged hemorrhoidal tissue.
Hemorrhoids are typically classified as either internal or external. Internal hemorrhoids occur inside the rectum, while external hemorrhoids form beneath the skin around the anus.
Internal hemorrhoids are usually painless, but external hemorrhoids are often painful and can become thrombosed, meaning blood clots have formed inside the hemorrhoids.
External hemorrhoids typically hurt more because tissues in the lower part of the anal canal have pain receptors similar to skin. Thrombosed hemorrhoids can be particularly painful.²
Hemorrhoids typically occur due to increased pressure on the veins in the lower rectal and anal areas.
Risk factors include the following:³ ⁴
Straining during bowel movements
Lifting heavy items
Prolonged periods of time spent sitting on the toilet
Weakening of the anal and rectal issue with advanced age
Insufficient fiber intake
Understanding what causes hemorrhoids can help you make lifestyle changes to reduce your risk of developing them.
The idea that hemorrhoid pain radiates down the leg is still under debate. There is no conclusive evidence that hemorrhoids cause nerve pain in the legs, so why do some people believe this is possible?
A study explored the association between hemorrhoids and lower chronic venous insufficiency (CVI) and uncovered some interesting findings.⁵
Veins facilitate blood flow from the body back to the heart. The flow can be interrupted by venous obstruction, insufficient contraction of muscles around veins, or when the valves in the veins stop working properly. This can cause blood to pool in your legs, causing CVI.⁶ ⁷
Among other symptoms, including swelling in the lower legs, ankles, or feet and itchy skin around the lower legs, CVI can cause varicose veins and pain.⁸
The study was carried out with two groups: a study group of 100 people who had received surgery for hemorrhoids and a control group of 100 volunteers who had not undergone surgery to treat hemorrhoids. The study group was found to have a significantly higher incidence of chronic constipation and varicose veins compared to the control group.
Correlation is not causation. It’s important to keep in mind that while hemorrhoids and some types of leg pain may seem connected, it does not mean that hemorrhoids cause radiating nerve pain in the leg.⁹
However, CVI and hemorrhoids do seem to share numerous risk factors, including prolonged sitting and pregnancy/higher parity (high number of births).
Furthermore, constipation, one of the major risk factors for hemorrhoids, has been shown to increase CVI risk. In this context, CVI and hemorrhoidal disease are thought to stem from similar pathophysiological mechanisms via increased intra-abdominal pressure.¹⁰
Intra-abdominal pressure is the pressure within the abdominal cavity, which can increase for various reasons. These include constipation, straining during bowel movements, prolonged sitting, a sedentary lifestyle, or obesity. It causes increased venous pressure leading to “venous” disease either in the anal area (causing hemorrhoids) or the veins in the legs. This explains the shared mechanisms behind hemorrhoids and CVI.¹¹ ¹²
There’s no credible evidence proving that hemorrhoids can cause hip pain directly. Without severe prolapse or strenuous stool passage, hemorrhoidal pain is usually restricted to the rectal area.
Radiating pain in the legs may instead be caused by other conditions like sciatica. Sciatica, which can cause pain, weakness, numbness, or tingling in the leg, is not a medical condition on its own but a symptom of a medical problem.
For example, perianal abscesses, which can be mistaken for hemorrhoids, may cause sciatica that causes radiating pain in the leg.¹³ ¹⁴
Therefore, anyone experiencing radiating pain from the rectum should immediately contact a doctor for diagnosis and treatment. A proper diagnosis is essential for managing symptoms and preventing further damage.
Hemorrhoids and nerve pain in the legs are uncomfortable conditions that can negatively impact a person’s quality of life. But there’s no direct connection between the two.
It’s important to note that leg pain may be a symptom of other conditions, such as sciatica or pudendal neuropathy. Therefore, you should seek medical attention to determine the underlying cause of your leg pain.
In summary, hemorrhoids and leg pain are separate conditions requiring different diagnoses and treatment approaches. Understanding this enables you to seek proper care and management for your symptoms and improve your overall well-being.
Hemorrhoids and what to do about them | Harvard Medical School
Symptoms & Causes of Hemorrhoids | National Institute of Diabetes and Digestive and Kidney Diseases
Venous Insufficiency (2022)