Types and causes of leg pain
There are many causes of leg pain.
Traumatic causes include sports injuries. Other causes can relate to the blood vessels, nerves, muscles, joints, soft tissues, or bones.
The course of treatment depends on the cause of the leg pain.
Leg pain can often be treated at home, but if pain is sudden, severe, or persistent, or if there are other symptoms, medical attention may be necessary.
This article will look at some common causes of leg pain and some home treatments.
Here are some key points about leg pain. More information is in the main article.
- The causes of leg pain can be musculoskeletal, neurological, or vascular.
- Shin splints and stress fractures can result from repetitive sports, such as running.
- Leg pain can sometimes indicate a serious vascular problems. These can occasionally be fatal, and they require medical intervention.
- Many types of pain can be treated at home, but severe or persistent pain can indicate a more serious condition.
What is leg pain?
Leg pain has many different causes and can be managed at home.
Pain occurs when nerves respond to stimuli such as high levels of pressure, high or low temperatures, and chemicals, which can be released by tissue damage.
Leg pain can be sharp, dull, numbing, tingling, burning, radiating, or aching.
It can also be acute, meaning sudden and short term, or it can also be chronic and persistent. Severity can be rated on a scale from 1 to 10, or from mild to severe.
Injury sustained during a sports game or in an accident is normally acute and traumatic. The person can often identify the cause.
Other causes, such as peripheral arterial disease (PAD), tend to build up over time, although the person may be able to pinpoint the onset of pain.
Some sports injuries build up over time, such as repetitive strain injuries and stress fractures. Traumatic injuries can also become long-term, or chronic, problems if the individual does not rest or seek treatment.
It is important to be aware of what was happening before and around the time that leg pain emerged, as this can help decide when to seek medical treatment.
Leg pain can mostly be classified as neurological, musculoskeletal, or vascular, or these can overlap.
Musculoskeletal pain: Examples are crepitus, recognized by a popping or cracking sound in the knee, or arthritis, an autoimmune disease that affects the joints in the hip, knee, or ankle. If a muscle, tendon, or ligament is strained, for example, during a fall, any pain will be musculoskeletal.
Night cramps, compartment syndrome, and stress fractures are also musculoskeletal problems.
Neurological pain: Conditions include restless legs syndrome, in which the legs twitch uncontrollably, neuropathy, or nerve damage, and sciatic nerve pain. Neurological pain can be present even when resting.
Here we will look at some of these in more detail.
Different causes of leg pain can have similar symptoms. Getting a correct diagnosis increases the chances of receiving appropriate treatment, if necessary. Identifying the symptoms and their onset can help find an appropriate diagnosis.
Leg cramps, or Charley horses
Charley horses are transient episodes of pain that can last for several minutes. The muscle, usually the calf at the back of the lower leg, tightens and goes into spasm.
Cramps are more common at night and in older people. An estimated 1 in 3 people aged over 60 years experience night cramps, and 40 percent experience over 3 attacks per week.
Intermittent claudication causes the blood supply to the leg muscles to become restricted. The resulting lack of oxygen and nutrients causes pain.
- a cramp-like muscle pain during exercise or exertion
- pain in the buttocks, thighs, calves, and feet
- pain when walking or climbing stairs
The cramps consistently occur after the same walking distances, and they often ease on resting.
DVT causes one type of leg pain and can become a blood clot on the lung if not quickly treated.
DVT refers to a blood clot in the deep veins of the leg. It can emerge after spending a long time sitting down, for example, on a long-distance flight.
Symptoms include swelling and a hot, painful sensation on one side of the leg. This may only occur when walking or standing up.
The clot may dissolve on its own, but if the person experiences dizziness and sudden shortness of breath, or if they cough up blood, emergency attention is needed.
These could be signs that DVT has developed into a pulmonary embolism, or a blood clot in the lung.
Vascular problems can be serious. Both PAD and DVT can present without symptoms. People whose lifestyle or medical history leaves them prone to vascular problems in the leg should be aware of possible symptoms.
Engaging in intense exertion during sports can lead to different types of injury.
Jogging and running can create repetitive impact forces that overload muscles and tendons. Shin splints produce severe, localized tenderness in the muscles, and sometimes bone pain commonly felt around the shin bone.
The shin pain cannot be explained by an obvious cause such as a fracture.
Fractures and stress fractures
Heavy pressure, for example, from a fall, can lead to fractures. Some fractures are easily and immediately visible, with severe bruising, swelling, and deformation. These normally receive urgent medical attention.
Stress fractures are small fractures that can result from repetitive stresses sustained during sports, often when the intensity of activity increases too quickly.
There is no single injury, and the fractures are small. The pain may start at an earlier stage during each exercise session, and eventually become present all the time.
This produces knee pain during downhill running. It is caused by inflammation of the popliteus tendon, which is important for knee stability.
Acute trauma can lead to sprains and strains. A sprain refers to a stretching or tearing. A strain is an injury to the muscles or tendons.
Often associated with running, a hamstring strain can lead to acute pain in the rear of the thigh muscle, usually due to a partial tear.
Sprains and strains usually develop because of inadequate flexibility training, overstretching, or not warming up before an activity. Continuing to exercise while injured increases the risk.
When an injury to the leg results in swelling, dangerous levels of pressure in the muscles can lead to acute or chronic compartment syndrome.
This could be due to a fracture or severe bruising.
The swelling causes pressure to build up until the blood supply to muscle tissue is cut off, depleting the muscles of oxygen and nourishment. The pain may be unexpectedly severe, considering the injury.
In severe cases, early pain may be followed by numbness and paralysis. Permanent muscle damage can result.
Sciatic nerve pain
Sciatica happens when pressure is put on a nerve, often in the spine, leading to pains that run down the leg from the hip to the foot.
It can happen when a nerve is "pinched" in a muscle spasm or by a herniated disk.
Long-term effects include strain on other parts of the body as the gait changes to compensate for the pain.
Ovarian cancer can lead to pain and swelling in the legs.
Many cases of leg pain can be resolved at home, without medical intervention.
Self-help for muscle cramps
Cramps, or Charley horses, can be alleviated by stretching and massaging the leg.
If serious causes of cramps have been ruled out, self-help measures can be appropriate.
Painkillers will not improve leg cramps, because they start suddenly, but stretching and massaging the muscle may help.
To relieve the pain when cramps occur:
- Hold the toe and pull it up towards the body, while straightening the leg.
- Walk around on heels until the cramp eases off.
To prevent cramps:
- Always stretch and warm up before and after exercising.
- Avoid dehydration by drinking 8 to 12 glasses of water a day.
- Regularly stretch and massage the legs.
Sports injury treatment
Minor sports injuries, such as leg sprains and strains can be treated with RICE:
- Rest: to prevent further injury and allows healing time to reduce swelling.
- Ice: to reduces swelling, inflammation, and pain. Applied for up 20 minutes wrapped in a cloth, not directly on the skin.
- Compression: use an elastic bandage, firmly but not tightly wrapped, to reduce swelling and pain.
- Elevation: lift the leg above the level of the heart so that gravity assists with draining, to reduce swelling and pain.
A return to activity should be graduated in its intensity, to build up flexibility, strength, and endurance safely.
To reduce cardiovascular risk factors, people are advised to:
- avoid or quit smoking
- do moderate exercise, as recommended by a doctor
- manage levels of blood sugar levels, cholesterol, and lipids
- control blood pressure
- adhere to antiplatelet therapy to reduce blood clots, if appropriate
- Exercise and a healthful diet are beneficial. Those who have a treatment plan for a cardiovascular or other condition should follow it carefully.
Leg pain has many different causes, and the symptoms often overlap. If they persist, worsen, or make life difficult, the individual should see a doctor.
A differential diagnosis strategy can help rule out inappropriate causes, narrow down the possibilities, and provide timely intervention.