Lower Leg Pain: Causes and Treatments

Keck School of Medicine of University of Southern California: “Leg Pain and Lower Extremity Arterial Disease.”

What Causes Leg Pain and How to Treat It

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Your legs can hurt from minor injuries or overuse, but this can also indicate a serious medical condition. Home remedies may help, but seek medical advice if the pain persists.

Leg pain can be dull or sharp. See your doctor if you’re experiencing severe or persistent leg pain. Getting a prompt diagnosis and treatment for any underlying conditions may prevent the pain from getting worse and improve your long-term outlook.

Preventable medical errors kill about 22,000 patients a year, according to research from the Yale School of Medicine. That’s much less than a previously reported number of 250,000 deaths a year where medical error is to blame.

Some of the more common causes of leg pain are minor or temporary conditions that your doctor can treat effectively.

A primary cause of leg pain is a muscle cramp or spasm that’s often known as “a charley horse.” A cramp usually triggers sudden, sharp pain as the leg muscles contract. The tightening muscles often form a visible, hard lump beneath the skin. There may be some redness and swelling in the surrounding area.

Muscle fatigue and dehydration may lead to leg cramps, especially in the calf. Certain medications, including diuretics and statins, may also cause leg cramps in some people.

Leg pain is also frequently a sign of injury, such as the following:

Muscle strain is a common injury that happens when the muscle fibers tear as a result of overstretching. It often occurs in the larger muscles, such as the hamstrings, calves, or quadriceps.
Tendinitis is inflammation of a tendon. Tendons are thick cords that join the muscles to bone. When they become inflamed, it can be difficult to move the affected joint. Tendinitis often affects tendons in the hamstrings or near the heel bone.
Knee bursitis happens when the fluid-filled sacs, or bursa, surrounding the knee joint become inflamed.
Shin splints cause pain along the inner edge of the shinbone, or tibia. The injury can occur when the muscles around the shinbone tear as a result of overuse.
Stress fractures are tiny breaks in the leg bones, particularly those in the shinbone.

Certain medical conditions commonly lead to leg pain. These include:

Atherosclerosis is the narrowing and hardening of the arteries due to a buildup of fat and cholesterol. Arteries are the blood vessels that carry oxygen-rich blood throughout your body. When there’s a blockage, it reduces blood flow to various parts of your body. If the tissues in the leg don’t receive enough oxygen, it can result in leg pain, particularly in the calves.
Deep vein thrombosis (DVT) occurs when a blood clot forms in a vein located deep inside the body. A blood clot is a clump of blood that’s in a solid state. DVTs typically form in the lower leg after long periods of bed rest, causing swelling and cramping pain.
Arthritis is an inflammation of the joints. The condition may cause swelling, pain, and redness in the affected area. It often affects joints in the knees and hips.
Gout is a form of arthritis that can occur when too much uric acid builds up in the body. It usually causes pain, swelling, and redness in the feet and lower part of the legs.
Varicose veins are knotted and enlarged veins that form when the veins overfill with blood due to incompetent valves. They usually appear swollen or raised and can be painful. They most often occur in the calves and ankles.
Infection in the bone or tissues of the leg can cause swelling, redness, or pain in the affected area.
Nerve damage in the leg may cause numbness, pain, or tingling. It often occurs in the feet and lower part of the legs as a result of diabetes.

The following conditions and injuries can also lead to leg pain, but they’re less common causes:

A slipped (herniated) disk occurs when one of the rubbery disks in between the vertebrate slips out of place. The disk can compress nerves in the spine. This may trigger pain that travels from your spine to your arms and legs.
Osgood-Schlatter disease occurs when the tendon that connects the kneecap to the shinbone becomes strained. It pulls on the cartilage of tibia where it attaches to the bone. It causes a painful lump to form below the knee, resulting in tenderness and swelling around the knee. It primarily occurs in adolescents experiencing growth spurts during puberty.
Legg-Calve-Perthes disease occurs due to an interruption of the blood supply to the ball of the hip joint. The lack of blood supply severely damages the bone and can deform it permanently. These abnormalities often result in pain, especially around the hip, thigh, or knee. This primarily occurs during adolescence.
Slipped capital femoral epiphysis is a separation of the ball of the hip joint from the thighbone, causing hip pain. The condition only occurs in children, particularly those who are overweight.
Noncancerous, or benign, tumors can also develop in the thighbone or shinbone.
Malignant, or cancerous, bone tumors may form in the larger leg bones, such as the thighbone or shinbone.

You can usually treat leg pain at home if it’s due to cramps or a minor injury. Try the following home treatments when your leg pain is from muscle cramps, fatigue, or overuse:

Rest your leg as much as possible, and elevate your leg with pillows.
Take an over-the-counter pain reliever, such as aspirin or ibuprofen, to help ease discomfort as your leg heals.
Wear compression socks or stockings with support.

Apply ice

Apply ice to the affected area of your leg at least four times per day. You can do this even more frequently in the first few days after the pain appears. You can leave the ice on for as long as 15 minutes at a time.

Take a warm bath and stretch

Take a warm bath, and then gently stretch your muscles. If you have pain in the lower part of your leg, try pointing and straightening your toes when sitting or standing. If you have pain in the upper part of your leg, try to bend over and touch your toes.

You can do this while sitting on the ground or standing up. Ease into each stretch, holding each position for five to 10 seconds. Stop stretching if your pain gets worse.

It can sometimes be difficult to determine when leg pain warrants a trip to the doctor or the emergency room. Schedule a doctor’s appointment if you’re experiencing:

swelling in both legs
varicose veins that are causing discomfort
pain while walking
leg pain that continues to get worse or persists beyond a few days

Go to the hospital immediately if any of the follow occurs:

You have a fever.
You have a deep cut on your leg.
Your leg is red and warm to the touch.
Your leg is pale and feels cool to the touch.
You’re having difficulty breathing and you have swelling in both legs.
You’re unable to walk or put any weight on your leg.
You have a leg injury that occurred along with a pop or grinding noise.

Lower Leg Pain: Causes and Treatments

The lower parts of your legs take the brunt of your day-to-day life. You shouldn’t have to be in pain, though.

Medical treatments can help if your doctor says you have a condition like leg cramps, blood clots, or issues with the nerves. But you can do things at home that help, too.

Bones, Joints, and Muscles

Muscle cramp. It can strike in your sleep or in the middle of the day. This sudden, tight, intense lower leg pain is sometimes called a “charley horse.” When it takes a grip, it can get worse quickly. It happens when your muscles are tired or dehydrated. Drink more water if you’re prone to leg cramps.

It might help to gently stretch or massage the area where your muscle has tensed up. Stretch your legs properly before you exercise, too.

Shin splints. You can feel this pain right up the front of your calf. The muscles and flesh along the edge of the shin bone become inflamed, so it hurts to walk, run, or jump. Doing activity over and over on hard surfaces can bring this on. You may also be more likely to get shin splints if you have flat feet or your feet turn outward.

Rest your legs to feel better. Ice helps. So can anti-inflammatory meds such as aspirin, ibuprofen, and naproxen, if your doctor says these are safe for you. You can buy them over the counter.

You might want to see your doctor if the pain stays. Try not to do anything that makes your leg hurt more. Once it feels a little better, do some stretches. The next time out, wear comfortable, supportive shoes. And don’t run on hard surfaces if possible.

Tendinitis. One of the first warning signs you have an inflamed Achilles tendon is pain in your lower calf, near the back of your heel. It’s a common injury that makes the tendon swell, stretch, or tear. You can get it from overworking the calf muscle or climbing the stairs. It might stick around for a long time, too.

Apply ice to get some relief. Or take anti-inflammatories if your doctor says they’re okay for you. Avoid doing anything that causes pain. When it hurts less, stretch and strengthen your leg.

If your pain feels severe, your Achilles tendon may be torn. Another possible sign of a tear is having trouble pointing your toe downward. Your doctor may inject medicine into the inflamed area. You might need surgery to repair the damage.

Broken bones or sprains. Say you twist your ankle and get a mild sprain. Try the RICE treatment: rest, ice, compression, and elevation.

For a more severe sprain or a broken bone (fracture), apply ice and see your doctor right away. You may need a cast or brace. You may also need physical therapy.

It will take time, but gradually you’ll be able to walk comfortably, again. Go slow as you gradually increase your strength and put weight on the injured leg.

Veins and Clots

Blood clot. When your blood thickens in a vein and clumps together, it can turn into a clot. One that develops in a vein deep in the body is called deep vein thrombosis (DVT).

Most deep-vein blood clots happen in the lower leg or thigh. They’re more likely to happen if you’re inactive for long periods, like on a long flight or car ride. You’re also at risk if you’re overweight, or you smoke, or take certain medications.

There’s a chance a clot could break off into your bloodstream and travel to an artery in the lungs. If so, it could block blood flow. This is a serious condition called pulmonary embolism.

If you think you might have a blood clot, go to your doctor or emergency room right away.

Medications, support stockings, and weight loss are types of treatments to help you avoid getting clots.

Varicose veins. You might be familiar with these, because you can see them at the surface of the skin. They appear to be twisted, dark blue or purple veins, and are caused by weak valves and vein walls. They may cause a dull ache, especially after standing.

Try support stockings to relieve the pain. And throughout the day, switch between standing and sitting. See your doctor about other types of treatment if your varicose veins are very painful.

Lower-extremity peripheral arterial disease. This can happen when the arteries in your legs become damaged and hardened. When your arteries narrow or become blocked, your legs miss out on the blood flow they need. That can cause your lower leg to cramp and feel pain when you walk, climb stairs, or do other kinds of exercise, because muscles aren’t getting enough blood.

Resting helps. But if your arteries become severely narrowed or blocked, the pain may persist, even when you rest. Also, wounds may not heal well.

You’re more likely to get this condition if you have diabetes, high blood pressure, high cholesterol, or you smoke or are obese.

Fix it with a change of lifestyle:

If you smoke, quit.
Eat healthier.
Manage your weight.
Exercise.

Other treatments include medications to control cholesterol, diabetes, or high blood pressure. Some people need surgery to improve blood flow to the area.

Lower Leg Pain: Nerves

The source of some pain is problems with your nerves.

Narrowed spinal canal (stenosis) and sciatica. A common cause of a narrowed spinal canal is arthritis of the spine. Sometimes a herniated disc puts pressure on nearby nerve roots, which can lead to symptoms of sciatica, such as:

Burning, cramping leg pain when standing or sitting
Numbness
Tingling
Fatigue
Weakness

Pain may begin in your back and hip, then later extend down into your leg. Rest is often the cure for other pains of the leg, but not this one. It doesn’t help sciatica.

Treatment may involve resting for a few days, along with taking anti-inflammatories and pain medications. Cold and heat can help with some symptoms. Physical therapy and stretching exercises are often useful. Gradually increase movement over time. Your doctor may also recommend other treatments or surgery if your pain doesn’t get better.

Diabetic neuropathy is a common complication of diabetes. Nerves can be damaged from high blood sugar levels. It can cause pain in both of your legs along with numbness and less sensation in the lower legs.

Talk to your doctor about medications to control the pain and help manage your blood sugar levels.

Show Sources

AAOS: “Muscle Cramp.”

Merck Manuals Online Medical Library: “Lower Leg Injuries.”

American Academy of Family Physicians: “Leg Problems.”

NHLBI: “How Is Deep Vein Thrombosis Treated?”

Keck School of Medicine of University of Southern California: “Leg Pain and Lower Extremity Arterial Disease.”

American Heart Association: “Symptoms and Diagnosis of PAD.”

NYU Hospital for Joint Diseases Spine Center: “Lumbar Herniated Disc.”

National Diabetes Information Clearinghouse (NDIC): Diabetic Neuropathies: The Nerve Damage of Diabetes.”

Lower Leg Pain: Causes and Treatments

What Causes Leg Pain and How to Treat It