Leg pain has been one of my symptoms off and on since I was diagnosed with PMR in 2021. My primary doctor initially dismissed my complaints of upper body pain and said my problems were all spine-related. I have had MRI's over the years documenting low back nerve impingement but I have led an active life and managed pain without drugs or surgery. My upper body symptoms got worse and I was finally diagnosed with PMR and referred to rheumatology. The rheumatologist also thought my leg pain was spine-related. At one point I complained of problems sitting due to tenderness in a small area of my upper low back and also burning pain in my thighs. I had never had this pain before. He referred me to a pain management specialist who was very helpful. He analyzed an older MRI compared to recent and gave me a cortisone shot in my upper low back. It took away the pain in my spine and improved the leg pain 70%. I feel that the spine pain may have been caused by interspinous bursitis, which can be caused by PMR. The pain management doctor thought the cause was prednisone deteriorating the soft tissue covering my spine. At any rate, the shot largely fixed the problems. Earlier this year I started having leg pain at night. It was burning pain and pins-and-needles that would move around. Either I couldn't get to sleep in the first place or would wake up at 2 AM and not get back to sleep due to pain. This was part of a disease flare-up after I needed to stop Kevzara due to cost. Symptoms calmed down when I took it easy for a few weeks. I've now been on Actemra for 2 months and the leg pain is completely gone. I feel that the leg pain may have been vascular caused by giant cell arteritis which has recently been added as a diagnosis. No matter what the cause for the leg pain, a cortisone shot and now Actemra have been very helpful. I have a back problem and it may be worse when I get off the drugs but I think doctors tend to jump to conclusions that a spine problem is causing any pain a patient may have. My primary doctor said that her medical school professor in New York told the class not to look for a zebra in Central Park, to look at the simplest and most obvious causes for a disease first. A few weeks later I saw a story in the New York Times about some zebras that had gotten loose in the New York suburbs! As far as your case goes, I would ask your doctor about a low back MRI or referrals to specialists in neurology or pain management.