what causes leg pain

Lower leg pain is common, but it can be tricky sorting out its many potential causes. While factors like what your pain feels like stabbing, burning, or cramping, and so on—can provide insight, oftentimes, a detailed physical examination and/or an imaging test are needed to clinch the diagnosis.

Here is a summary of the most common lower leg pain conditions, ranging from muscle and bone to blood vessel and nerve problems.

Muscle Strain

A strain is a common cause of leg pain and results from an overstretching of a muscle that sometimes leads to a tear. The gastrocnemius muscle of the calf is a common area for strains and tears.

Symptoms
While muscle strains usually cause mild soreness, you may also experience cramping or a sharp, tearing sensation, especially if the strain is sudden and/or severe. In addition to pain, swelling and bruising may also occur over the affected muscle.

Causes
Muscle strains may occur as a result of sudden trauma, like a fall or a blow to the muscle. Overuse injuries to the lower leg can also lead to muscle strains. More specifically, a sudden change in direction, like when playing tennis or basketball, may result in a calf muscle strain.

Diagnosis
While a medical history and physical examination are generally sufficient to diagnose a muscle strain in the lower leg, your doctor may order an X-ray to rule out a concomitant bone fracture.

Treatment
The R.I.C.E protocol is recommended for the treatment of a muscle strain. This includes resting the muscle, applying ice to the painful area several times a day, compressing the muscle with an elastic bandage, and elevating the lower leg above the heart (to reduce swelling).

In addition, your doctor may also recommend taking a nonsteroidal anti-inflammatory drug (NSAID) to soothe the acute inflammation. Physical therapy can help a person ease back into their exercise regimen after a muscle strain.¹Medial Gastrocnemius Strain Overview and Treatment

Shin Splints

Shin splints, also known as medial tibial stress syndrome, refers to inflammation of the muscles, tendons, and other tissues surrounding your shinbone (tibia).

Symptoms
The pain of shin splints may be sharp or dull and is felt along the inside (medial) and back (posterior) part of the tibia where the calf muscles attach to the bone. Usually, the pain is felt during and after physical activity.

Causes
Shin splints is a common exercise-related injury, often affecting runners and those involved in sprinting or jumping sports. In addition, shin splints may be aggravated or triggered by foot conditions such as overpronation or high-arched feet. Improper or worn-out footwear can also increase your chances of developing shin splints.

Diagnosis
A medical history and physical examination are sufficient to diagnose shin splints. However, your doctor may order imaging tests to rule out mimicking conditions like a stress fracture of the tibia, tendonitis (see below), or less commonly, chronic exertional compartment syndrome.

Treatment
While shin splints can be quite unpleasant, the good news is that simple measures can be used to treat them.²

These measures include:

• Stopping the activity that led to the shin splints (often for weeks). Try substituting the activity with a gentler exercise like swimming.
• Icing the area for 20 minutes several times a day. Be sure to place the ice in a towel or use a cold pack so there is no direct contact with the ice on your skin.
• Compressing the area with an elastic bandage. This is especially helpful if swelling is present.
• Stretching your lower leg muscles. This will help soothe your shin splints.

In addition, medications like NSAIDs may be recommended by your doctor to ease pain and reduce inflammation.What Determines How Long Your Shin Splints Last?

Tendonitis

Tendonitis is a common sports overuse injury but can strike anyone, regardless of activity levels. Tendonitis is inflammation surrounding a tendon, which is a strong, cord-like structure that anchors a muscle to bone.

Common types of tendonitis that would cause lower leg pain around the ankle area are Achilles tendonitis and posterior tibial tendonitis.³

Symptoms
Tendonitis causes pain that increases with activity or stretching of the affected tendon. Other signs and symptoms may include swelling that worsens with activity as the day progresses, thickening of the tendon, and morning stiffness.

A sudden pain and/or “pop” at the back of your calf or heel indicates a potential Achilles tendon tear or rupture. In this case, be sure to seek medical attention right away.

Causes
Trauma, such as from a fall, or sudden increases in the intensity or frequency of physical activity may lead to tiny tears in the fibers that make up a tendon. These tiny tears trigger swelling and irritation.

More specifically, in addition to trauma and overuse or repetitive motions, other factors that increase your chances for developing Achilles tendonitis include:

• Abnormalities in foot structure such as flat feet or high arches
• Tight calf muscles
• Leg length discrepancy
• Wearing improper or worn-out footwear
• Cold weather training

Diagnosis
Diagnosis of tendonitis usually involves a medical history and physical examination. Imaging tests, like a magnetic resonance imaging (MRI), may be ordered to confirm a diagnosis of tendonitis and/or to access the severity of the tendon tear.

Treatment
The R.I.C.E. protocol (rest, ice, compression, and elevation) is also recommended for this condition. Anti-inflammatory medications, physical therapy, and/or orthotics are also often helpful.

Muscle Cramps

A muscle cramp is a contraction of a muscle that is sudden and out of your control. The calf muscle is a common area for a cramp to occur (often referred to as a “charley horse.”)

Symptoms
Muscle cramps can be mild and feel like a tiny twitch or be severe and intensely sharp or stabbing. Keep in mind, while muscle cramps in the lower leg can last anywhere from a few seconds to several minutes, muscle soreness may continue for days.

Causes
It’s not totally clear why muscle cramps develop, although experts suspect that tight and fatigued muscles lead to abnormalities in the processes that normally control muscle contraction.

Additional factors that may increase your risk for developing muscle cramps, include:

• Dehydration
• Electrolyte depletion
• Exercising in extreme heat

There are also multiple conditions that may cause lower leg muscle cramps, including diabetes, thyroid or liver disease, fibromyalgia, and nerve or blood vessel disorders. Pregnancy is another common cause of muscle cramps in the lower leg.

Lastly, some medications, like statins (cholesterol-lowering medications), may cause muscle cramps.

Diagnosis
A medical history and physical examination, which may reveal a tender muscle or palpable knot, is generally sufficient to diagnose muscle cramps. However, if an underlying condition is suspected as a potential culprit behind the cramps, your doctor may order various blood and/or imaging tests.

Treatment
Treatment for leg cramps often entails gentle stretching and massage, hydration, and applying heat. Sometimes, oral magnesium and/or calcium are recommended. Treating any underlying condition is also key to easing your muscle cramps.Muscle cramp causes, prevention, and treatment

lower leg pain

A stress fracture, which refers to a tiny break in a bone, is a common occurrence in the lower leg.

Symptoms
The hallmark symptom of a stress fracture is localized sharp pain with activity that diminishes with rest.

Causes
Stress fractures are overuse injuries.⁴ Basically, the muscles surrounding bone become so fatigued from overuse that they eventually transfer the stress onto the bone, leading to a tiny break.

Stress fractures of the lower leg are most commonly seen in sports that place repetitive stress on the leg, such as running and jumping sports (e.g., gymnastics, basketball, and tennis).

Diagnosis
An X-ray is usually enough to diagnose a stress fracture in the lower leg. Sometimes, though, the fracture cannot be visualized well on an X-ray or will not show up on one for several weeks. In these cases, your doctor may order a computed tomography (CT) scan or and MRI.

Treatment
The main treatment for stress fractures is rest, usually for six to eight weeks. In addition, ice and medication, such as Tylenol (acetaminophen) or a low potency opioid, like Norco (hydrocodone/paracetamol), are used to control the acute pain of a stress fracture.