Pain - leg; Leg pain; Cramps - leg
Leg pain can be due to a muscle cramp (also called a charley horse). Common causes of cramps include:
- Muscle fatigue or strain from overuse, excessive exercise, or holding a muscle in the same position for a long time.
- Dehydration or depletion of potassium, sodium, calcium, or magnesium.
- Medications like diuretics, which can cause you to lose too much fluid or minerals, and cholesterol-lowering drugs called statins.
An injury can also cause leg pain from:
- A torn or overstretched muscle (strain)
- Inflamed tendon (tendinitis)
- Shin splints - pain in the front of your leg related to overuse or repetitive pounding
- Hairline crack in the bone (stress fracture)
Other common causes of leg pain include:
- Blood clot (deep vein thrombosis) from prolonged bed rest.
- Atherosclerosis (plaque buildup) that blocks blood flow in the arteries. This type of pain, called claudication, is generally felt when exercising or walking and relieved by rest.
- Inflammation of the leg joints by arthritis or gout.
- Nerve damage - common in diabetics, smokers, and alcoholics. You may feel numbness, tingling, or a sensation of pins-and-needles.
- Infection of the bone (osteomyelitis) or skin and soft tissue (cellulitis).
- Varicose veins.
Less common causes include:
- Slipped capital femoral epiphysis - seen in boys and overweight children (usually between 11 and 15 years old), this refers to a separation of the ball of the hip joint from the thigh bone. It causes pain and growth abnormalities.
- Legg-Calve-Perthes disease - poor blood flow to the hip that can lead to shortening of the length of the leg. This condition usually affects boys between 4 and 10 years old.
- Benign tumors or cysts of the femur or tibia (osteoid ostioma).
- Malignant bone tumors (osteosarcoma, Ewing sarcoma).
- Drugs such as allopurinol and corticosteroids.
- Sciatic nerve pain (radiating pain down the leg) caused by a slipped disk in the back.
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 medications like acetaminophen or ibuprofen.
For leg pain caused by varicose veins, leg elevation and compression with elastic bandages or support hose can help.
For leg pain caused by nerve disorders or claudication, control Diabetes, eliminate alcohol and tobacco, and avoid ill-fitting shoes.
Call your health care provider if
Call your doctor if:
- The painful leg is swollen or red.
- You have a fever.
- Your pain worsens when walking or exercising and improves with rest.
- The leg is black and blue.
- The leg is cold and pale.
- You are on medications that may be causing leg pain. DO NOT stop or change any of your usual medications without talking to your doctor.
- Self-care steps do not help.
What to expect at your health care provider’s office
Your health care provider will perform a physical examination, with careful attention to your legs, feet, thighs, hips, back, knees, and ankles.
To help diagnose the cause of the problem, your doctor will ask medical history questions, such as:
- Where exactly is your pain?
- Do you have pain in one or both legs?
- How would you describe the pain? Dull and aching? Sharp and stabbing? Do you consider it to be severe?
- Is the pain worse at any particular time of day, like in the morning or at night?
- What makes the pain feel worse? For example, does exercise or long periods of standing worsen your pain?
- Does anything make your pain feel better like elevating your legs?
- Do you have any other symptoms like numbness or tingling? Back pain? A fever? Weakness?
The following diagnostic tests may be performed:
- Duplex Doppler/ultrasound exam to look for a blood clot
- X-ray of your back or legs
- MRI if a malignant tumor is suspected
- Bone biopsy if tumor is seen on MRI which may be malignant
- Bone scan
- Blood tests for specific diseases
- Arteriogram to check blood flow
Treatment depends on the cause. Medications may include pain medicines, anti-inflammatory drugs (NSAIDs), anticoagulants (blood thinners) such as Coumadin if there is a blood clot, and others. Cellulitis and osteomyelitis are each treated with antibiotics; osteomyelitis will require extended use of antibiotics.
For some causes of leg pain, physical therapy may be recommended by your doctor. If you have a blocked artery, inserting a balloon catheter into the artery to improve blood flow may be advised.
To prevent claudication and nerve damage:
- Don’t smoke or use tobacco.
- Limit how much alcohol you drink.
- Keep your blood sugars under good control if you have Diabetes.
- Reduce other heart disease risk factors, including High Cholesterol and High blood pressure.
To prevent overuse injuries, like shin splints, muscle cramps, and other causes of leg pain:
- Warm up before physical activity and cool down afterward. Be sure to stretch.
- Drink plenty of fluids throughout the day, especially before, during, and after exercise.
by Harutyun Medina, M.D.
All ArmMed Media material is provided for information only and is neither advice nor a substitute for proper medical care. Consult a qualified healthcare professional who understands your particular history for individual concerns.