From the Guidelines
The feeling of a pulse or twitch in your legs after walking is most likely caused by increased blood flow and muscle fatigue, which are normal and temporary sensations that resolve with rest. According to the 2024 ACC/AHA/AACVPR/APMA/ABC/SCAI/SVM/SVN/SVS/SIR/VESS guideline for the management of lower extremity peripheral artery disease 1, patients with peripheral artery disease (PAD) may experience exertional leg symptoms, including pain, aching, cramping, or tiredness, which can be relieved by rest. However, the guideline also notes that some patients with PAD may not experience typical claudication symptoms, and instead may report tingling, numbness, burning, throbbing, or shooting sensations in their legs.
When you walk, your leg muscles work harder and require more oxygen, causing blood vessels to dilate and blood flow to increase. This increased circulation can create a noticeable pulsing sensation. Additionally, the repetitive muscle contractions during walking can lead to temporary fatigue, causing small involuntary contractions or twitches as your muscles recover. These sensations are usually normal and temporary, typically resolving with rest.
Some key points to consider:
- Staying hydrated and ensuring adequate electrolyte levels (particularly potassium, calcium, and magnesium) can help minimize these sensations.
- Stretching before and after walking can also help reduce muscle fatigue and twitches.
- If the twitching is severe, persistent, or accompanied by pain, weakness, or swelling, it could indicate a more serious condition like peripheral artery disease, electrolyte imbalances, or nerve issues, which would warrant medical attention, as noted in the guideline 1.
- The guideline also highlights the importance of prompt medical attention for severe clinical subsets of PAD, such as chronic limb-threatening ischemia (CLTI) and acute limb ischemia (ALI), which can have serious consequences if left untreated 1.
From the Research
Possible Causes of Pulse or Twitch in Legs After a Walk
- Restless legs syndrome (RLS) is a common neurological disorder that can cause uncomfortable sensations in the legs, including a feeling of a pulse or twitch, especially after a walk 2.
- RLS can be triggered by various factors, including peripheral artery disease (PAD), which can cause calf deoxygenation and mobility issues 2.
- The feeling of a pulse or twitch in the legs after a walk can also be related to the body's response to exercise, particularly in individuals with RLS or other neurological conditions 2, 3.
Relationship Between Exercise and RLS Symptoms
- Low-intensity exercise, such as walking, can help alleviate RLS symptoms in some individuals, particularly those with PAD 2.
- Exercise can improve hemodynamics, mobility, and sleep quality, which can help reduce RLS symptoms and improve overall quality of life 2, 4.
- However, exercise can also trigger or worsen RLS symptoms in some individuals, particularly if they have underlying neurological or cardiovascular conditions 2, 3.
Treatment Options for RLS
- Pregabalin is a medication that has been shown to be effective in reducing RLS symptoms, including the feeling of a pulse or twitch in the legs 5, 3, 6.
- Other treatment options for RLS include dopamine agonists, such as pramipexole and ropinirole, as well as non-pharmacological approaches like pneumatic compression and vibrating pads 4.
- The choice of treatment depends on the individual's specific needs and medical history, and may involve a combination of medications and lifestyle modifications 4, 6.