Calf pain is often caused by muscle cramps or strains. More serious conditions such as blood clots & diabetic neuropathy can also cause upper & lower calf pain.
Calf pain symptoms
Call it a Charley Horse or, more likely, yelp in pain that you have a Charley Horse. Many of us suffer from leg cramps or experience calf pain from time to time. Calf pain can be caused by a number of conditions from electrolyte deficiency and dehydration, to over-exercising, to edema.
Common accompanying symptoms of calf pain
The symptoms that are often associated with calf pain include:
- Cramps in the calf area
- Feeling of a muscle strain in the calf
- Swelling of the calf
- Tightness in the back of the leg
- Unusual heat/unusual cold in the back of the leg
- Tingling in the calf muscle area
- Sharp pain
- Weakness in the leg
- Fluid retention
- Loss of balance or coordination
Calf pain usually presents with a sharp pain or even a dull aching pain with some tightness at the back of the leg, in the calf muscle area. Most times, calf pain is not a sign of a serious condition; however, it could be a sign of an underlying condition that causes swelling, tingling, and pain in that area of the leg including diabetes or sciatica.
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Calf pain causes
To understand calf pain, it helps to understand how the muscles are constructed here. The calf is actually comprised of two muscles of the leg: the gastrocnemius and the soleus.
Both muscles meet at the Achilles tendon, which attaches these muscles to the heel. Every time you move your leg or foot, you must use all of these muscles. Therefore, any strain to any one of these muscles when walking, jogging, lifting weights, or performing any type of exercise could contribute to calf pain.
Structural causes of calf pain
Issues among the structures that allow for normal calf functioning may result in calf pain.
- Muscle cramps: Muscle cramps are often a sign of dehydration or an electrolyte deficiency of magnesium or potassium. Getting more of these nutrients often helps alleviate leg cramps as well as drinking more water.
- Muscle strains: Muscle strains are often caused by fatigue, injuring a muscle, overtraining, or overuse of the calf muscles. Lifting more weight than usual with your legs, moving heavy furniture, carrying large, heavy loads, starting a new job with lots of standing involved, all of these can cause muscle strains.
- Achilles tendonitis: Achilles tendonitis is caused by strain to the Achilles tendon, which causes pain, swelling, and inflammation in the Achilles tendon. This can also cause pain in the connected calf muscles as well.
- Sciatica: The sciatic nerve runs all the way down the lower leg and to the back of the knee. Any issues with this nerve will cause pain in the calf muscle area, which is typically accompanied by numbness and tingling all along that area. In some cases, pain is so severe that surgery is required to alleviate it.
A bruise is typically a result of a fall, bump, scratch, or sudden trauma to an area. If the calf is bruised, this could cause a lot of calf pain. Any bruises that have no causes or explanation should be examined by a doctor. Unexplained bruising could be a sign of a serious underlying disorder.
Other medical conditions, often serious, can result in calf pain.
- Diabetic neuropathy: Diabetes, in its late stages, begins to affect the nerves and blood vessels of the leg. Diabetic neuropathy is a type of nerve damage that affects the feet, legs, and hands. This condition is a common complication of diabetes resulting from overexposure to high blood sugar, genetic factors, or nerve inflammation.
- Deep vein thrombosis: Deep vein thrombosis (DVT) is a blood clot that forms, typically in the arm or leg, and most often in the calf and thigh. Other symptoms include edema-like swelling of the limb, warmth in the limb affected, and skin discolorations in the limb affected. DVT is serious, as blood clots could move and travel to other parts of the body, most commonly the lungs (pulmonary embolism) — a potentially life-threatening condition.
This list does not constitute medical advice and may not accurately represent what you have.
A strain, commonly called a "pulled muscle," is when a muscle becomes overstretched, and microscopic tears occur. A calf strain happens when one of the muscles on the back of the lower leg is pulled.
Top Symptoms: pain in one calf, moderate calf pain, calf pain, sports injury, soccer injury
Symptoms that always occur with calf strain: pain in one calf
Repetitive strain injury of the calf
Repetitive strain injury of the calf is caused by consistent repetitive use.
Top Symptoms: lower leg numbness, calf pain from overuse
Symptoms that always occur with repetitive strain injury of the calf: calf pain from overuse
Symptoms that never occur with repetitive strain injury of the calf: recent calf injury, severe calf pain
A bruise is the damage of the blood vessels that return blood to the heart (the capillaries and veins), which causes pooling of the blood. This explains the blue/purple color of most bruises. Bruises of the calf are common, given the location on the body.
Top Symptoms: pain in one calf, recent calf injury, calf pain from an injury, swollen calf, bruised calf
Symptoms that always occur with calf bruise: recent calf injury, calf pain from an injury
Deep vein thrombosis
Deep vein thrombosis (DVT) is a blood clot that forms in a vein deep in the body. Most deep vein clots occur in the lower leg or thigh.
Top Symptoms: fever, thigh pain, upper leg swelling, calf pain, butt pain
Urgency: Hospital emergency room
The Achilles tendon connects the back of the heel to the muscles of the calves. Achilles tendonitis can be an acute or chronic condition. The term tendonitis implies inflammatory cells in the region of the tendon. While this may be true in acute cases of tendon overuse or tendon ..
Diabetic neuropathy is nerve damage caused by longstanding or poorly controlled diabetes mellitus (DM). Other risk factors for developing diabetic neuropathy include obesity, smoking, cardiovascular disease, and abnormal lipid levels.
Diabetic neuropathy can present as a number ..
Achilles tendon rupture
The Achilles tendon connects the calf muscles to the heel bone. Together, they help push the heel off the ground and let a person go up on their toes. If the Achilles tendon stretches too far, it can tear or rupture.
Top Symptoms: achilles tendon pain, constant foot pain, sports injury, recent ankle injury, swollen achilles
Symptoms that always occur with achilles tendon rupture: achilles tendon pain
Urgency: Hospital emergency room
Peripheral arterial disease (pad)
Peripheral artery disease is also called PAD, intermittent claudication, or vascular disease. The large main artery from the heart is the aorta, and its smaller branches are the peripheral arteries.
In PAD these peripheral arteries are blocked with plaque, which is debris that builds up in the lining of these arteries and eventually cuts off the blood flow.
Risk factors for PAD include smoking, high blood pressure, and diabetes.
PAD usually involves arteries that lead to the legs, but can affect any artery. Symptoms include numbness and pain in the legs, especially with exercise when more circulation is needed but the flow is blocked.
It is important to seek treatment for these symptoms. PAD can lead to increased risk of heart attack, stroke, and infection as well as to gangrene, a life-threatening medical emergency.
Diagnosis is made through patient history, physical examination, blood tests, and sometimes a treadmill test, MRI, and arteriogram.
Treatment involves medication and surgery to open or bypass blocked arteries, and lifestyle changes regarding diet, exercise, and smoking cessation.
Top Symptoms: leg numbness, spontaneous foot pain, decreased exercise tolerance, cold feet, thigh pain
Symptoms that never occur with peripheral arterial disease (pad): calf pain from an injury, thigh pain from an injury
Urgency: Primary care doctor
Baker's cyst (popliteal cyst)
A Baker's cyst, also called as Popliteal cyst, is a fluid-filled mass that causes a bulge and a feeling of tightness behind the knee. The pain can get worse when the knee is fully flexed or extended.
Top Symptoms: calf pain, swollen knee, knee pain that gets worse when squatting, knee instability, dull, achy knee pain
Symptoms that always occur with baker's cyst (popliteal cyst): lump on the back of the knee, constant knee lump
Urgency: Primary care doctor
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Calf pain treatments and relief
At-home treatments for calf pain
Calf pain caused by trauma, a pull, or a moderate injury of some kind can typically be eased with the following methods.
The RICE (Rest, Ice, Compression, Elevation) method is advised by all healthcare practitioners and anyone working at a hospital when they send you home with a pulled calf, tendon, or even a broken bone in some areas of the body.
- Rest: First, rest the area — meaning don't add insult to injury. Try not to use the injured leg.
- Ice: Applying cold ice packs to the area can reduce inflammation and pain.
- Compression: Use a leg brace or compression sock to reduce swelling and prevent any risk of blood clots.
- Elevation: Elevating the calf above the level of your heart will get swelling and inflammation to decrease.
Further treatments for calf pain
If your calf pain worsens or persists, you should consult your physician who may recommend the following.
- Pain medications: Aspirin, ibuprofen (Advil, Motrin), or naproxen (Aleve) can help relieve pain and inflammation.
- Physical therapy: If the calf pain is caused by serious injury, such as the tearing of ligaments or tendons, your doctor may advise physical therapy.
Questions your doctor may ask about calf pain
- Did you injure your calf?
- Did you just suffer from a high impact injury (e.g., a fall, collision, accident or sports trauma)?
- Do you have any idea what caused your calf pain
- Have you ever been diagnosed with diabetes?
Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.
FAQs about calf pain
Can alcohol cause calf pain?
Yes, if alcohol is consumed over a long period of time it can cause an alcoholic neuropathy. This means the consumption of alcohol can damage the nerves within the body. This damage starts with the longest nerves in the body which tend to service the limbs, arms or legs. Alcohol in high concentrations can kill neurons and tends to damage the longer neurons, first affecting the limbs. It may manifest as burning, pain, or cramping sensations in the legs.
Do blood clots lead to calf pain?
Blood clots can lead to calf pain depending on where they occur, especially if they they completely block blood flow to the affected leg. In some cases, a large blood clot can be painful and create a tender area on the calf. A leg with a dangerous clot, called a deep vein thrombosis (DVT), may be warmer than usual with redness or tenderness to the touch. It may have pain tracking on the pathway of major veins in the setting of an infection as well. If you have swelling of one leg, warmth, a tendency to clot, especially after sitting for a long car or plane ride, you should seek medical evaluation.
Why do my calves ache at night?
Restless leg syndrome is a common cause of leg pain or itchiness or discomfort at night that is alleviated by movement of the legs. It is much more common at night and may lead to sleep disturbances that impair functions during the day. It may cause jerking movements of the legs during the night commonly known as periodic leg movements.
Why are my calf muscles so tight?
Calf muscles can be tight for many reasons. One of the most common reasons for increased calf tightness is increased exertion of calves during the day. Commonly, shoes with a lift (e.g. high heels, wedges, etc.) can cause tightness of the calf muscles, especially if on their feet throughout the day. Additionally, any activity that involves using the calf muscles to flex the foot downward, like standing on the toes or pressing the accelerator of a car, can lead to calf tightness.
Can dehydration cause calf pain?
Dehydration can increase the chance of cramping for any muscle that is vigorously exercised. This includes muscles that are commonly used like hamstrings, quadriceps, or calves. If you are engaging in physical activity that takes advantage of calf muscles and you have not hydrated properly, it is possible to develop cramps in your calf muscles.
- Causes of Calf Pain. Institute for Preventive Foot Health. IPFH Link
- Ma CB. Sciatica. U.S. National Library of Medicine: MedlinePlus. Updated November 13, 2018. MedlinePlus Link
- What is Diabetic Neuropathy? National Institute of Diabetes and Digestive and Kidney Diseases. Published February 2018. NIDDK Link
- Deep Vein Thrombosis. American Academy of Orthopaedic Surgeons: OrthoInfo. Updated June 2015. OrthoInfo Link
- Chopra K, Tiwari V. Alcoholic Neuropathy: Possible Mechanisms and Future Treatment Possibilities. British Journal of Clinical Pharmacology. 2012;73(3):348-362. NCBI Link