Lower Leg Pain: Causes, Symptoms & Common Doctor Questions
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Lower leg pain symptoms
We need our legs for a lot of the activities of daily living and, for the most part, we take them for granted. It is not until you are having lower leg pain that you realize just how important your calves are for ambulation.
The lower leg consists of muscles, bones, tendons, ligaments, joints, blood vessels, and nerves. Damage or irritation to any of these structures can lead to lower leg pain. As pain is the body's way of telling you something is wrong and it needs to heal, it is wise to pay attention to this pain rather than "fight through it."
Common characteristics of lower leg pain
Lower leg pain may be associated with these common symptoms:
Lower leg pain causes
For the most part, lower leg pain is due to musculoskeletal injury any sort of strain, sprain, tear or other damage you may incur from sports or everyday living. Such injuries are inevitable as we use our legs any time we need to get around: to score a soccer goal, or to carry that heavy box down the street. While many of these wear-and-tear injuries are quite minor, other causes of lower leg pain can require urgent treatment.
Causes related to the musculoskeletal system may include the following.
- Strains and sprains: Overuse or acute injury can cause tears of lower leg muscles, tendons or ligaments. This will cause pain with use of the lower legs.
- Joint damage: Years of wear-and-tear or acute injury to the joints of the lower leg may cause inflammation of the joints called arthritis.
- Fracture: Acute trauma to the lower leg can cause the tibia, fibula, or other bones to break.
- Overuse: If you've been hitting the stair-climber too hard or suddenly increased the amount of running you do, your muscles may be sore, causing mild to moderate pain with use.
- Clot: Certain people are predisposed to forming blood clots in the lower legs (deep vein thrombosis or DVT), especially when they are stationary for long periods of time. These clots may cause pain and swelling of the affected leg.
- Vascular disease: If you experience pain or cramping with exercise or at night in your lower legs, you may have vascular disease. This is seen most commonly in smokers and diabetics.
Infection-related causes of lower leg pain may include the following.
- Tissue infection: Infection of the skin or soft tissues of the lower leg can cause localized pain, usually irritated by touch.
- Joint infection: Infections of the knee, ankle, or toe joints can cause pain in the lower leg which is usually aggravated by movement.
Certain autoimmune diseases attack the joints of the lower legs, such as multiple sclerosis, leading to damage, inflammation, and pain.
A peripheral nerve injury, such as oneimpacting the nerves that innervate the lower leg, can cause pain.
Metabolic-related causes may include the following.
- Electrolyte imbalance: Dehydration and resultant electrolyte imbalance may cause lower leg cramping and pain, especially if you are low in potassium.
- Hereditary: Some rare hereditary disorders can cause painful cramping of the muscles.
This list does not constitute medical advice and may not accurately represent what you have.
Shin splints (medial tibial stress syndrome)
Shin splints is when there is pain in the front part of the lower leg. The pain is from the swelling of the muscles, tendons, and bone tissue around your shin.
Top Symptoms: shin pain, dull, achy shin pain, pain in the inside of the shin, shin pain from overuse, irregular period
Symptoms that always occur with shin splints (medial tibial stress syndrome): shin pain
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
Restless leg syndrome (RLS) is a chronic condition characterized by uncomfortable sensations while lying down and a strong urge to move the legs. Leg movement relieves the unpleasant sensations temporarily, often resulting in poor quality sleep. RLS is co..
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
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
Chronic idiopathic peripheral neuropathy
Peripheral neuropathy refers to the feeling of numbness, tingling, and pins-and-needles sensation in the feet. Idiopathic means the cause is not known, and chronic means the condition is ongoing without getting better or worse.
The condition is most often found in people over age 60. Idiopathic neuropathy has no known cause.
Symptoms include uncomfortable numbness and tingling in the feet; difficulty standing or walking due to pain and lack of normal sensitivity; and weakness and cramping in the muscles of the feet and ankles.
Peripheral neuropathy can greatly interfere with quality of life, so a medical provider should be seen in order to treat the symptoms and reduce the discomfort.
Diagnosis is made through physical examination; blood tests to rule out other conditions; and neurologic and muscle studies such as electromyography.
Treatment involves over-the-counter pain relievers; prescription pain relievers to manage more severe pain; physical therapy and safety measures to compensate for loss of sensation in the feet; and therapeutic footwear to help with balance and walking.
Top Symptoms: distal numbness, muscle aches, joint stiffness, numbness on both sides of body, loss of muscle mass
Urgency: Primary care doctor
Lower leg pain treatments and relief
Most causes of lower leg pain are just aches and pains caused by minor injuries to the muscles, tendons, and ligaments in the lower leg. These types of injuries can be managed at home quite easily. However, if you experience sudden-onset, moderate to severe pain with no obvious cause or find yourself with an acute injury so severe it is difficult to walk, you should seek medical attention promptly.
At-home treatments for lower leg pain
Several treatments can be tried at home to soothe lower leg pain. The first four methods can be remembered with the mnemonic RICE.
- Rest: Most minor injuries will improve with time and rest as the body heals itself.
- Ice: Cold packs can diminish inflammation of aggravated tissues, alleviating some pain.
- Compression: A moderately tight wrap around an injured joint can help diminish inflammation.
- Elevation: Elevating an injured ankle or lower leg can reduce swelling.
- Stretching: Light stretching of an injured extremity helps with the healing process and prevents the muscles from getting too tight.
- Rehydration: Drinking fluids with electrolytes can help leg pain caused by cramping when dehydrated.
- Acetaminophen or NSAIDs: Over-the-counter pain medications like ibuprofen (Advil, Motrin) and acetaminophen (Tylenol) reduce pain and inflammation.
Medical treatments for lower leg pain
Treatments that will need to be recommended by your medical provider may include the following below. It is important to seek consultation if your lower leg pain worsens or persists.
- Physical exam: A healthcare provider will examine the leg to help diagnose the cause of the pain.
- Imaging: Ultrasound, CT, or MRI scans may be required to diagnose the cause of the leg pain.
- Physical therapy: Oftentimes physical therapy is the most effective means to heal an injured extremity.
- Pain medication: Pain medications can help reduce pain acutely.
- Surgery: Some conditions causing lower leg pain may require surgery to repair.
- Anticoagulation: Lower leg pain caused by clots usually requires the use of blood-thinning medications to resolve.
When lower leg pain is an emergency
Seek immediate treatment or call 911 for the following:
- Inability or difficulty weight-bearing or walking on the affected extremity
- Moderate to severe lower leg pain after an injury
- Sudden-onset leg pain with no clear cause
- Swelling of one lower leg but not the other
- Discoloration or cool temperature in the affected leg
- Sudden-onset difficulty breathing and chest pain associated with lower leg pain
Questions your doctor may ask about lower leg pain
- Any fever today or during the last week?
- Have you ever been diagnosed with diabetes?
- Where on your lower leg are you experiencing pain?
- What is your body mass?
Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.
Jesse Passman is a PGY-1 surgery resident. He graduated from Rice University with a BS in Ecology and Evolutionary Biology and received his MD from the University of Pennsylvania Perelman School of Medicine. During medical school, Jesse performed work in public health and surgery, taking a year-out to pursue an MPH at the University of Pennsylvania and do research in global surgery and the public health implications and clinical outcomes of trauma. In his free time, Jesse likes to travel, hike, backpack, and cycle.
- Sprains, strains and other soft-tissue injuries. American Academy of Orthopaedic Surgeons: OrthoInfo. Updated July 2015. OrthoInfo Link
- Ebell MH. Osteoarthritis: Rapid evidence review. American Family Physician. 2018;97(8):523-6. AAFP Link
- Peripheral vascular disease. American Health Network. AHNI Link
- Understand your risk for excessive blood clotting. American Heart Association. AHA Link
- Mader JT, Calhoun J. Bone, Joint, and Necrotizing Soft Tissue Infections. Baron S, eds. In: Medical Microbiology. 4th ed. Galveston, TX: University of Texas Medical Branch at Galveston; 1996. NCBI Link