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Swollen Calf: Common Causes of Swelling

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Last updated March 15, 2022

Swollen calf quiz

Take a quiz to find out what's causing your swollen calf.

Swollen calf can be caused by three categories of conditions - natural, traumatic, and systemic issues. Most often, it’s the first two causes, which we will go further in detail below but if you just had a long plane ride or sat down for a long time, blood clots can cause a condition called deep vein thrombosis (DVT). More serious causes involve organ issues such as kidney failure or liver disease. Read below for more details and treatment options to reduce swelling. We also prepared a free digital checker to help you self-diagnose swollen calf.

Swollen calf quiz

Take a quiz to find out what's causing your swollen calf.

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Symptoms of swollen calf

Apparently, that flight from New York to London was not just a challenge for your mind and sleep habits, it took a toll on your body as well! If you feel as though your calf is larger than usual — you are experiencing a swollen calf.

A swollen calf, just like any ailment of the leg, can create a range of issues. The good news is that your swollen calf symptoms are not always a cause for panic and may be more of a nuisance than anything else.

Common characteristics of a swollen calf

If you're experiencing a swollen calf, it can likely be described by:

  • Discomfort while standing or walking
  • Enlarged calf
  • Swelling along a leg vein
  • Pain and/or leg tenderness: Particularly while standing or walking
  • Discolored/red skin
  • Swollen areas that are warm to the touch

The calf is located in the lower portion of the leg and consists of muscles and tendons that connect between the knee and ankle. Running, jumping, and other athletic movements are all made possible by the calf and its "fast twitch" muscle fibers. The calf is relatively large when compared to many other components of the body, but it is also one of the closest to the ground and furthest from the heart. These two factors lend the calf to swelling from a variety of causes.

Causes of swollen calf

Taking a hard look at the cause is a critical step toward determining if a basic home remedy will be sufficient or if a trip to the doctor is warranted. Typical causes of a swollen calf are:

Environmental causes

Environmental causes of calf swelling may be related to lifestyle habits or certain exposures.

  • Natural causes: The condition of the body can sometimes be enough to cause calf swelling. Swelling is often linked to the retention of water which is increased by being overweight, pregnant, or while menstruating. Remaining on your feet for long periods or, conversely, sitting for an extended duration may also lead to a swollen calf.
  • Medications: Taking certain medications, such as those to treat depression, hormone medications, and steroids are known to cause calf swelling.

Traumatic causes

Trauma to the calf can cause swelling, such as the following.

  • Strains: Overexertion during athletic activities can lead to muscle strains and swelling.
  • Breaks: Significant trauma to the shin can cause breaks and lead to a swollen calf.
  • Surgery: Swelling is a common by-product of surgical procedures on the calf.

Systemic disease swollen calf causes

Calf swelling may occur due to systemic diseases, such as the following.

  • Organ failure: A wide range of effects, including swelling in the calf, can occur when the organs such as the kidney, heart, and liver begin to fail.
  • Vascular: Swelling can occur when blood is ineffectively pumped throughout the body. Such a condition can lead to swelling through issues with veins and blood clots. Deep vein thrombosis (DVT) is more common after long airplane trips due to the cabin pressure, dehydration, as well as prolonged periods of immobilization. DVT or pulmonary embolus (PE) from a DVT that has dislodged to the lungs need immediate evaluation and treatment. For prevention, get up and walk around every hour or two on long flights and consider compression stockings if you have poor circulation.

Inflammatory swollen calf causes

Causes of a swollen calf due to inflammation may be related to the following.

  • Autoimmune: Disorders that cause the body to attack itself can cause conditions such as rheumatoid arthritis.
  • Infections: Swelling may result when the sections of the lower leg become infected.

This list does not constitute medical advice and may not accurately represent what you have.

Swollen calf quiz

Take a quiz to find out what's causing your swollen calf.

Take swollen calf quiz

Pulmonary embolism

An embolus is a blood clot that forms in the bloodstream, breaks loose, and is carried by the blood to become lodged elsewhere in the circulatory system. If this clot (embolus) blocks part of the bloodstream in the lungs (pulmonary system,) this condition is called pulmonary embolism.

It is most often caused by blood clots in the deep veins of the legs, which can form after long periods of inactivity or bedrest.

Other risk factors include smoking, obesity, and female hormone replacement therapy.

Symptoms include sudden difficulty breathing; chest pain; coughing, sometimes with blood; anxiety; lightheadedness; and fast, irregular heartbeat.

Pulmonary embolism is a life-threatening medical emergency, because it causes high blood pressure in the pulmonary arteries and lack of oxygen in the blood. Take the patient to the emergency room or call 9-1-1.

Diagnosis is made through patient history, physical examination, blood tests, and chest x-ray.

Treatment involves anticoagulants, or blood thinners; "clot-busting" medications; and surgery to implant a filter to help prevent clots from traveling through the bloodstream.

Deep vein thrombosis

A deep vein thrombosis (DVT) occurs when a blood clot forms in a vein deep in the body, usually in the lower leg or thigh. DVT can cause swelling, pain, and redness in the affected leg. Some of the risk factors for developing DVT include obesity, pregnancy, cancer, surgery, and previous history of blood clots.

You should consider calling your primary care or urgent care provider. Deep vein thrombosis can be evaluated with a review of your symptoms, a physical exam, and an ultrasound. A blood test may also be performed. Once diagnosed, DVT can be treated with blood-thinning medication, which is usually taken for three months.

Rarity: Uncommon

Top Symptoms: fever, thigh pain, upper leg swelling, calf pain, butt pain

Urgency: Hospital emergency room

Cushing syndrome

Cushing syndrome is a hormonal disorder that occurs when there is too much of the stress hormone cortisol in the body. It can be caused by taking steroid medications commonly prescribed for asthma or arthritis, or by problems with the glands in the body that are involved in creating cortisol. Symptoms can vary from person to person but often include easy bruising, a "hump" on the back, and stretch marks. Fatigue, large stomach, red round face, and high blood sugar may also occur.

You should consider visiting a medical professional in the next week or two to discuss your symptoms. Cushing syndrome can be evaluated with a review of your symptoms and medical history, as well as blood tests. Treatment depends on the cause of your condition. If caused by steroid medication, you may be instructed to lower the dosage slowly over time. If caused by issues with your glands, surgery, radiation, or medication may be an option.

Compartment syndrome

Acute compartment syndrome describes the damage done to certain muscle groups of the arms or legs after a traumatic injury.

All of the long muscles are bundled into sections – "compartments" – by the white sheets of strong, tough connective tissue called fascia. If something interferes with circulation so that blood flow is trapped within the compartment, pressure rises because the fascia cannot stretch. This causes serious damage to the muscles and other tissues within the compartment.

Acute compartment syndrome is caused by a broken bone; a crush injury; burns, due to scarred and tightened skin; and bandages or casts applied before an injury has stopped swelling.

Symptoms can rapidly intensify. They include severe pain and tightness in the muscle; tingling or burning sensation; and sometimes numbness and weakness.

Acute compartment syndrome is a medical emergency which can result in loss of the limb. Take the patient to the emergency room or call 9-1-1.

Diagnosis is made through patient history and physical examination.

Treatment involves hospitalization for emergency surgery and, in some cases, skin graft.

Rarity: Rare

Top Symptoms: arm numbness, hand numbness, foot numbness, pain in one leg, thigh numbness

Urgency: Hospital emergency room

Cellulitis

Cellulitis is a bacterial infection of the deep layers of the skin. It can appear anywhere on the body but is most common on the feet, lower legs, and face.

The condition can develop if Staphylococcus bacteria enter broken skin through a cut, scrape, or existing skin infection such as impetigo or eczema.

Most susceptible are those with a weakened immune system, as from corticosteroids or chemotherapy, or with impaired circulation from diabetes or any vascular disease.

Symptoms arise somewhat gradually and include sore, reddened skin.

If not treated, the infection can become severe, form pus, and destroy the tissue around it. In rare cases, the infection can cause blood poisoning or meningitis.

Symptom of severe pain, fever, cold sweats, and fast heartbeat should be seen immediately by a medical provider.

Diagnosis is made through physical examination.

Treatment consists of antibiotics, keeping the wound clean, and sometimes surgery to remove any dead tissue. Cellulitis often recurs, so it is important to treat any underlying conditions and improve the immune system with rest and good nutrition.

Calf strain

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.

You can safely treat this condition on your own. A muscle strain can be treated with rest, ice, compression, and pain medication.

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. Achilles tendon rupture occurs when the Achilles tendon stretches too far and ruptures.

Rarity: Rare

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

Swollen calf quiz

Take a quiz to find out what's causing your swollen calf.

Take swollen calf quiz

Swollen calf treatments and relief

As with all ailments, the ideal treatment is one that can be performed at home. Fortunately, the most common causes of a swollen calf lend themselves to such treatments.

At-home treatments

A swollen calf from a common strain or from being pregnant are ideal situations for relief from home remedies, such as the following.

  • Rest and ice: Giving the calf a chance to recuperate can sometimes be the best medicine. Rest the calf for an extended period. Place ice on the affected area in 15 to 20 minute intervals.
  • Elevation: Maintaining the calf at an elevation above the heart will help fluid leave the affected area and reduce swelling.
  • Compression: Keep the swollen calf wrapped tightly, but not so tight as to cut off circulation.
  • Over-the-counter medicines: Non-steroidal anti-inflammatory drugs (NSAIDs), like ibuprofen (Advil, Motrin), are commonly used to help reduce pain and limit inflammation.
  • Lifestyle: Maintaining a healthy diet and exercising regularly will promote blood flow throughout the body and improve circulation.

When to see a doctor

If at-home remedies are not enough, there are also far more significant causes that will require the involvement of a doctor. Prescription medications are a likely route. Certain medications called diuretics are designed to help the body eliminate water and reduce swelling. There are also medications for further encouraging blood flow by reducing blood clotting.

When it is an emergency

While normally there is little cause for concern, it is important to seek immediate medical attention if the following are experienced along with the swelling:

The calf is critical for both everyday movements like walking and almost more important for athletic activities such as jumping, climbing, and running. A swollen calf may be nothing more than a nuisance, but it could also be a sign of a more systemic problem. Either way, proper care through either home swollen calf remedies or from working with a doctor can help return the calf to normal.

Questions your doctor may ask about swollen calf

  • Have you ever been diagnosed with diabetes?
  • What is your body mass?
  • Do you have high blood pressure?
  • Do you currently smoke?

Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.

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Dr. Rothschild has been a faculty member at Brigham and Women’s Hospital where he is an Associate Professor of Medicine at Harvard Medical School. He currently practices as a hospitalist at Newton Wellesley Hospital. In 1978, Dr. Rothschild received his MD at the Medical College of Wisconsin and trained in internal medicine followed by a fellowship in critical care medicine. He also received an MP...
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References

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  4. End Stage Renal Disease (ESRD). Johns Hopkins Medicine Health Library. Johns Hopkins Medicine Link
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  6. Rheumatoid Arthritis of the Foot and Ankle. American Academy of Orthopedic Surgeons: OrthoInfo. Reviewed Sept. 2017. OrthoInfo Link
  7. Sepsis and Cellulitis. Sepsis Alliance. Updated Dec. 13, 2017. Sepsis Alliance Link