What Are the Common Causes of Leg Pain?

Leg pain may be intermittent or constant, develop gradually or suddenly and affect a localized area on your leg such as the knee or the shin or your entire leg. The pain can be sharp, dull, stabbing, tingling or aching. Some type of leg pain is just annoying but more severe type of pain may affect your ability to bear weight on the leg or to walk.

Common Leg Pain Causes

Neurological conditions, problems with blood circulation and infectious diseases all can affect the leg. However, majority of the leg pain occurs as a result of injury, overuse and wear or tear related to age of the bones, muscles, joints, ligaments and tendons of the legs. These problems are usually not serious and can be prevented and treated by using self-care and lifestyle measures.

Injury

Leg pain may occur due to injuries such as:

  • Stress fracture or hairline fracture
  • Charley horse (muscle cramp) usually due to overuse or dehydration
  • Strain, sprain or overuse injury (shin splint)
  • Traumatic injury (torn meniscus or rupture of Achilles tendon)

Inflammatory, Degenerative and Autoimmune Diseases

Leg pain may occur due to degeneration of the joints, autoimmune diseases and inflammatory diseases, such as:

  • Bursitis
  • Baker’s cyst
  • Fibromyalgia
  • Gout
  • Osteoarthritis
  • Intermittent claudication due to hardening of the arteries
  • Rheumatoid arthritis
  • Varicose veins
  • Tendinitis

Life-Threatening or Serious Conditions

In some situations, pain in leg may indicate a life-threatening or serious condition that requires emergency medical evaluation. Some of these leg pain causes are:

  • Deep venous thrombosis (formation of blood clot in the leg that may break and travel to other parts of the body, causing pulmonary embolism, stroke or heart attack)
  • Spinal stenosis (narrowing of the spinal canal, leading to compression of the spinal nerves and spinal cord)
  • Peripheral artery disease (Narrowing of the arteries of the extremities due to buildup of cholesterol and fat on the arterial walls, limiting blood flow to the extremities)

Other Rare Conditions

Leg pain may occur due to certain rare illnesses that do not become evident immediately. Some of these conditions are:

  • Tumor of the bone (benign or malignant)
  • Medicines such as allopurinol used for gout or corticosteroids
  • Osteomyelitis (infection of the bone)
  • Legg-Calve-Perthes disease (degenerative disease of hip bone, which is very rare)
  • Damage to sciatic nerve due to degenerative disc disease or spinal stenosis
  • Growth plate fracture
  • Cellulitis (infection of the skin)

When to Visit a Physician

Visit an emergency room or call for emergency medical help if:

  • You have an injury to the leg with an exposed tendon or bone or a deep cut.
  • You are not able to put weight on the leg or walk.
  • You have swelling, pain, warmth and redness in your calf region.
  • You hear a grinding or popping sound during leg injury.

Visit your physician as early as possible if you develop:

  • Signs of infection including warmth, redness or tenderness or high temperature greater than 37.8 °C
  • A swollen, unusually cool or pale leg
  • Calf pain, especially after sitting for a long time, such as on a plane ride or long car trip
  • Swelling of both legs with difficulty in breathing
  • Any serious symptoms of leg that appear for no obvious reason

Schedule a visit to a physician if:

  • You develop pain after or during walking.
  • You develop swelling of both legs.
  • Your leg pain becomes worse.
  • Your leg pain symptoms don’t get better after a couple of days of treatment at home.
  • You develop varicose veins that are painful.

How Is Leg Pain Diagnosed?

To evaluate the leg pain, the physician interviews the patient and does a physical examination so as to determine the potential leg pain causes. Whether diagnostic testing such as X-rays and blood tests is required or not depends upon the physician’s concern as to what is causing the leg pain. In some cases, X-rays and testing are not needed.

Blood Tests

Blood tests such as a WBC (white blood cell) count, an ESR (erythrocyte sedimentation rate) and a C-reactive protein (CRP) may help in the detection of an infection. The WBC count is usually elevated in an infection unless the immune system of the patient is compromised due to which it may appear falsely normal. If CRP and ESR are elevated, they require to be interpreted in regard to the specific condition that is being suspected.

Uric acid measurement may be done if gout is considered as the cause of leg pain. Certain other blood tests may be done depending upon the leg pain causes being considered.

Imaging

  • Ultrasound
  • X-rays
  • Arteriogram
  • Ankle-brachial index (ABI)
  • CT scan
  • Magnetic resonance imaging (MRI)
  • Joint aspiration
  • Nerve conduction studies
  • Compartment pressures

How to Deal with the Leg Pain

Treatment depends on the underlying causes. Home treatments may take care of minor leg pain. To relieve mild leg pain and swelling:

  • Don’t use your leg as much as you can.
  • Apply a bag or frozen peas or an ice pack to the affected leg for 15-20 minutes thrice daily.
  • Elevate the affected leg whenever you lie down or sit.
  • Try OTC pain killers such as naproxen sodium or ibuprofen.

In patients who have chronic medical illness, prevention is the key to treatment. Neuropathic pain in diabetics is very difficult to control; lifestyle measures to control blood sugar minimize the risk of neuropathy and development of other complications later in life.

Individualization of home care should be done for every patient. Your physician is the important resource for diagnosis and treatment of leg pain. If symptoms of acute leg pain occur along with swelling, loss of feeling and cold leg, medical care must be sought immediately.

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