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Leg pain

Pain - leg; Aches - leg; Cramps - leg

 

Leg pain is a common problem. It can be due to a cramp, injury, or other cause.

Causes

 

Leg pain can be due to a muscle cramp (also called a charley horse). Common causes of cramps include:

  • Dehydration or low amounts of potassium, sodium, calcium, or magnesium in the blood
  • Medicines (such as diuretics and statins)
  • Muscle fatigue or strain from overuse, too much exercise, or holding a muscle in the same position for a long time

An injury can also cause leg pain from:

  • A torn or overstretched muscle (strain)
  • Hairline crack in the bone (stress fracture)
  • Inflamed tendon (tendinitis)
  • Shin splints (pain in the front of the leg from overuse)

Other common causes of leg pain include:

  • Atherosclerosis that blocks blood flow in the arteries (this type of pain, called claudication, is generally felt when exercising or walking and is relieved by rest)
  • Blood clot (deep vein thrombosis) from long-term bed rest
  • Infection of the bone (osteomyelitis) or skin and soft tissue (cellulitis)
  • Inflammation of the leg joints caused by arthritis or gout
  • Nerve damage common to people with diabetes, smokers, and alcoholics
  • Varicose veins

Less common causes include:

  • Cancerous bone tumors (osteosarcoma, Ewing sarcoma)
  • Legg-Calve-Perthes disease: Poor blood flow to the hip that may stop or slow the normal growth of the leg
  • Noncancerous (benign) tumors or cysts of the femur or tibia (osteoid osteoma)
  • Sciatic nerve pain (radiating pain down the leg) caused by a slipped disk in the back
  • Slipped capital femoral epiphysis: Most often seen in boys and overweight children between ages 11 and 15

 

Home Care

 

If you have leg pain from cramps or overuse, take these steps first:

  • Rest as much as possible.
  • Elevate your leg.
  • Apply ice for up to 15 minutes. Do this 4 times per day, more often for the first few days.
  • Gently stretch and massage cramping muscles.
  • Take over-the-counter pain medicines like acetaminophen or ibuprofen.

Other homecare will depend on the cause of your leg pain.

 

When to Contact a Medical Professional

 

Call your health care provider if:

  • The painful leg is swollen or red.
  • You have a fever.
  • Your pain gets worse when you walk or exercise and improves with rest.
  • The leg is black and blue.
  • The leg is cold and pale.
  • You are taking medicines that may be causing leg pain. DO NOT stop taking or change any of your medicines without talking to your provider.
  • Self-care steps do not help.

 

What to Expect at Your Office Visit

 

Your provider will perform a physical exam and look at your legs, feet, thighs, hips, back, knees, and ankles.

Your provider may ask questions such as:

  • Where on the leg is the pain? Is the pain in one or both legs?
  • Is the pain dull and aching or sharp and stabbing? Is the pain severe? Is the pain worse at any time of day?
  • What makes the pain feel worse? Does anything make your pain feel better?
  • Do you have any other symptoms such as numbness, tingling, back pain, or fever?

Your provider may recommend physical therapy for some causes of leg pain.

 

 

References

Ginsberg J. Peripheral venous disease. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 81.

Marcussen B, Hogrefe C, Amendola A. Leg pain and exertional compartment syndromes. In: Miller MD, Thompson SR, eds. DeLee & Drez's Orthopaedic Sports Medicine. 4th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 112.

Shy ME. Peripheral neuropathies. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 420.

Silverstein JA, Moeller JL, Hutchinson MR. Common issues in orthopedics. In: Rakel RE, Rakel DP, eds. Textbook of Family Medicine. 9th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 30.

White CJ. Atherosclerotic peripheral arterial disease. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 79.

 
  • Lower leg muscles

    Lower leg muscles - illustration

    The muscular components of the lower leg include the gastrocnemius, soleus, peroneus longus, tibialis anterior, extensor digitorum longus, and the Achilles tendon.

    Lower leg muscles

    illustration

  • Leg pain (Osgood-Schlatter)

    Leg pain (Osgood-Schlatter) - illustration

    Leg pain in older children or young adolescents can occur for many reasons. An Osgood-Schlatter lesion results from continued trauma to the anterior tibial bone and causes a visible lump below the knee.

    Leg pain (Osgood-Schlatter)

    illustration

  • Shin splints

    Shin splints - illustration

    Shin splints is the common name for the medical condition called medial tibial stress syndrome in which pain occurs along the tibia (shin bone) in the front of the lower leg. The pain is a result of small tears in the area the lower leg muscles' attachment to the tibia. Shin splints are typically caused from intense or vigorous athletic activity and can be resolved with adequate rest, stretching and modifying your exercise routine.

    Shin splints

    illustration

  • Varicose veins

    Varicose veins - illustration

    Varicose veins are enlarged, twisted, painful superficial veins resulting from poorly functioning valves. Varicose veins usually occur in the veins of the legs, although it may occur elsewhere. It is a common condition, affecting mostly women.

    Varicose veins

    illustration

  • Retrocalcaneal bursitis

    Retrocalcaneal bursitis - illustration

    Retrocalcaneal bursitis is an inflammation of the bursa at the back of the heel bone. A bursa is a fluid-filled sac that acts as a cushion and a lubricant between tendons and muscles sliding over bone. Repetitive or over use of the ankle, by doing excessive walking, running, or jumping, can cause this bursa to become irritated and inflamed. Symptoms of bursitis include pain in the heel, especially with walking, running or when the area is touched.

    Retrocalcaneal bursitis

    illustration

  • Lower leg muscles

    Lower leg muscles - illustration

    The muscles in the lower leg are divided into several compartments. The muscles in the anterior compartment include the tibialis anterior, extensor halluscis longus, extensor digitorum longus, and peroneous tertius. This group of muscle primarily extends the toes and dorsiflexes the ankle. When there is inflammation in the anterior compartment a painful condition called shinsplints can occur.

    Lower leg muscles

    illustration

    • Lower leg muscles

      Lower leg muscles - illustration

      The muscular components of the lower leg include the gastrocnemius, soleus, peroneus longus, tibialis anterior, extensor digitorum longus, and the Achilles tendon.

      Lower leg muscles

      illustration

    • Leg pain (Osgood-Schlatter)

      Leg pain (Osgood-Schlatter) - illustration

      Leg pain in older children or young adolescents can occur for many reasons. An Osgood-Schlatter lesion results from continued trauma to the anterior tibial bone and causes a visible lump below the knee.

      Leg pain (Osgood-Schlatter)

      illustration

    • Shin splints

      Shin splints - illustration

      Shin splints is the common name for the medical condition called medial tibial stress syndrome in which pain occurs along the tibia (shin bone) in the front of the lower leg. The pain is a result of small tears in the area the lower leg muscles' attachment to the tibia. Shin splints are typically caused from intense or vigorous athletic activity and can be resolved with adequate rest, stretching and modifying your exercise routine.

      Shin splints

      illustration

    • Varicose veins

      Varicose veins - illustration

      Varicose veins are enlarged, twisted, painful superficial veins resulting from poorly functioning valves. Varicose veins usually occur in the veins of the legs, although it may occur elsewhere. It is a common condition, affecting mostly women.

      Varicose veins

      illustration

    • Retrocalcaneal bursitis

      Retrocalcaneal bursitis - illustration

      Retrocalcaneal bursitis is an inflammation of the bursa at the back of the heel bone. A bursa is a fluid-filled sac that acts as a cushion and a lubricant between tendons and muscles sliding over bone. Repetitive or over use of the ankle, by doing excessive walking, running, or jumping, can cause this bursa to become irritated and inflamed. Symptoms of bursitis include pain in the heel, especially with walking, running or when the area is touched.

      Retrocalcaneal bursitis

      illustration

    • Lower leg muscles

      Lower leg muscles - illustration

      The muscles in the lower leg are divided into several compartments. The muscles in the anterior compartment include the tibialis anterior, extensor halluscis longus, extensor digitorum longus, and peroneous tertius. This group of muscle primarily extends the toes and dorsiflexes the ankle. When there is inflammation in the anterior compartment a painful condition called shinsplints can occur.

      Lower leg muscles

      illustration

    A Closer Look

     

      Talking to your MD

       

        Self Care

         

        Tests for Leg pain

         

         

        Review Date: 8/14/2015

        Reviewed By: Linda J. Vorvick, MD, Medical Director and Director of Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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