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Pain in any part of the leg is a common symptom of trauma or disease.
There are many causes of leg pain.
Traumatic causes include sports injuries. Other causes can relate to the blood vessels, nerves, muscles, joints, soft tissues, or bones.
The course of treatment depends on the cause of the leg pain.
Leg pain can often be treated at home, but if pain is sudden, severe, or persistent, or if there are other symptoms, medical attention may be necessary.
This article will look at some common causes of leg pain and some home treatments.
Fast facts about leg pain
Here are some key points about leg pain. More information is in the main article.
- The causes of leg pain can be musculoskeletal, neurological, or vascular.
- Shin splints and stress fractures can result from repetitive sports, such as running.
- Leg pain can sometimes indicate a serious vascular problems. These can occasionally be fatal, and they require medical intervention.
- Many types of pain can be treated at home, but severe or persistent pain can indicate a more serious condition.
Pain occurs when nerves respond to stimuli such as high levels of pressure, high or low temperatures, and chemicals, which can be released by tissue damage.
Leg pain can be sharp, dull, numbing, tingling, burning, radiating, or aching.
It can also be acute, meaning sudden and short term, or it can also be chronic and persistent. Severity can be rated on a scale from 1 to 10, or from mild to severe.
Injury sustained during a sports game or in an accident is normally acute and traumatic. The person can often identify the cause.
Other causes, such as peripheral arterial disease (PAD), tend to build up over time, although the person may be able to pinpoint the onset of pain.
Some sports injuries build up over time, such as repetitive strain injuries and stress fractures. Traumatic injuries can also become long-term, or chronic, problems if the individual does not rest or seek treatment.
It is important to be aware of what was happening before and around the time that leg pain emerged, as this can help decide when to seek medical treatment.
Leg pain can mostly be classified as neurological, musculoskeletal, or vascular, or these can overlap.
Musculoskeletal pain: Examples are crepitus, recognized by a popping or cracking sound in the knee, or arthritis, an autoimmune disease that affects the joints in the hip, knee, or ankle. If a muscle, tendon, or ligament is strained, for example, during a fall, any pain will be musculoskeletal.
Night cramps, compartment syndrome, and stress fractures are also musculoskeletal problems.
Vascular pain: Causes include PAD, deep vein thrombosis (DVT), cellulitis, infections, varicose veins, and varicose eczema, where pain is accompanied by discoloration of the skin.
Neurological pain: Conditions include restless legs syndrome, in which the legs twitch uncontrollably, neuropathy, or nerve damage, and sciatic nerve pain. Neurological pain can be present even when resting.
Here we will look at some of these in more detail.
Different causes of leg pain can have similar symptoms. Getting a correct diagnosis increases the chances of receiving appropriate treatment, if necessary. Identifying the symptoms and their onset can help find an appropriate diagnosis.
Leg cramps, or Charley horses
Charley horses are transient episodes of pain that can last for several minutes. The muscle, usually the calf at the back of the lower leg, tightens and goes into spasm.
Cramps are more common at night and in older people. An estimated 1 in 3 people aged over 60 years experience night cramps, and 40 percent experience over 3 attacks per week.
PAD can cause pain in the leg due to poor circulation. Without treatment, it can be fatal. The key symptom is intermittent claudication.
Intermittent claudication causes the blood supply to the leg muscles to become restricted. The resulting lack of oxygen and nutrients causes pain.
- a cramp-like muscle pain during exercise or exertion
- pain in the buttocks, thighs, calves, and feet
- pain when walking or climbing stairs
The cramps consistently occur after the same walking distances, and they often ease on resting.
Share on PinterestDVT causes one type of leg pain and can become a blood clot on the lung if not quickly treated.
DVT refers to a blood clot in the deep veins of the leg. It can emerge after spending a long time sitting down, for example, on a long-distance flight.
Symptoms include swelling and a hot, painful sensation on one side of the leg. This may only occur when walking or standing up.
The clot may dissolve on its own, but if the person experiences dizziness and sudden shortness of breath, or if they cough up blood, emergency attention is needed.
These could be signs that DVT has developed into a pulmonary embolism, or a blood clot in the lung.
Vascular problems can be serious. Both PAD and DVT can present without symptoms. People whose lifestyle or medical history leaves them prone to vascular problems in the leg should be aware of possible symptoms.
Engaging in intense exertion during sports can lead to different types of injury.
Jogging and running can create repetitive impact forces that overload muscles and tendons. Shin splints produce severe, localized tenderness in the muscles, and sometimes bone pain commonly felt around the shin bone.
The shin pain cannot be explained by an obvious cause such as a fracture.
Fractures and stress fractures
Heavy pressure, for example, from a fall, can lead to fractures. Some fractures are easily and immediately visible, with severe bruising, swelling, and deformation. These normally receive urgent medical attention.
Stress fractures are small fractures that can result from repetitive stresses sustained during sports, often when the intensity of activity increases too quickly.
There is no single injury, and the fractures are small. The pain may start at an earlier stage during each exercise session, and eventually become present all the time.
This produces knee pain during downhill running. It is caused by inflammation of the popliteus tendon, which is important for knee stability.
Acute trauma can lead to sprains and strains. A sprain refers to a stretching or tearing. A strain is an injury to the muscles or tendons.
Often associated with running, a hamstring strain can lead to acute pain in the rear of the thigh muscle, usually due to a partial tear.
Sprains and strains usually develop because of inadequate flexibility training, overstretching, or not warming up before an activity. Continuing to exercise while injured increases the risk.
When an injury to the leg results in swelling, dangerous levels of pressure in the muscles can lead to acute or chronic compartment syndrome.
This could be due to a fracture or severe bruising.
The swelling causes pressure to build up until the blood supply to muscle tissue is cut off, depleting the muscles of oxygen and nourishment. The pain may be unexpectedly severe, considering the injury.
In severe cases, early pain may be followed by numbness and paralysis. Permanent muscle damage can result.
Sciatic nerve pain
Sciatica happens when pressure is put on a nerve, often in the spine, leading to pains that run down the leg from the hip to the foot.
It can happen when a nerve is “pinched” in a muscle spasm or by a herniated disk.
Long-term effects include strain on other parts of the body as the gait changes to compensate for the pain.
Ovarian cancer can lead to pain and swelling in the legs.
Many cases of leg pain can be resolved at home, without medical intervention.
Self-help for muscle cramps
Share on PinterestCramps, or Charley horses, can be alleviated by stretching and massaging the leg.
If serious causes of cramps have been ruled out, self-help measures can be appropriate.
Painkillers will not improve leg cramps, because they start suddenly, but stretching and massaging the muscle may help.
To relieve the pain when cramps occur:
- Hold the toe and pull it up towards the body, while straightening the leg.
- Walk around on heels until the cramp eases off.
To prevent cramps:
- Always stretch and warm up before and after exercising.
- Avoid dehydration by drinking 8 to 12 glasses of water a day.
- Regularly stretch and massage the legs.
Sports injury treatment
Minor sports injuries, such as leg sprains and strains can be treated with RICE:
- Rest: to prevent further injury and allows healing time to reduce swelling.
- Ice: to reduces swelling, inflammation, and pain. Applied for up 20 minutes wrapped in a cloth, not directly on the skin.
- Compression: use an elastic bandage, firmly but not tightly wrapped, to reduce swelling and pain.
- Elevation: lift the leg above the level of the heart so that gravity assists with draining, to reduce swelling and pain.
Drugs such as acetaminophen or non-steroidal anti-inflammatory drugs can help with some pain, but if pain persists for more than 72 hours, specialist medical advice should be sought.
A return to activity should be graduated in its intensity, to build up flexibility, strength, and endurance safely.
There is an excellent selection online with thousands of customer reviews if you want to buy ice packs or elastic bandages.
Medical attention is needed for claudication and other symptoms of vascular disease, because of the risk of heart attack or stroke.
To reduce cardiovascular risk factors, people are advised to:
- avoid or quit smoking
- do moderate exercise, as recommended by a doctor
- manage levels of blood sugar levels, cholesterol, and lipids
- control blood pressure
- adhere to antiplatelet therapy to reduce blood clots, if appropriate
- Exercise and a healthful diet are beneficial. Those who have a treatment plan for a cardiovascular or other condition should follow it carefully.
Leg pain has many different causes, and the symptoms often overlap. If they persist, worsen, or make life difficult, the individual should see a doctor.
A differential diagnosis strategy can help rule out inappropriate causes, narrow down the possibilities, and provide timely intervention.
Herniated disc facts
Picture of herniated disc between L4 and L5
- The discs are pads that serve as “cushions” between the vertebral bodies, which minimize the impact of movement on the spinal column.
- Each disc is designed like a jelly donut with a central softer component (nucleus pulposus).
- Abnormal rupture of the central portion of the disc is referred to as a disc herniation.
- The most common location for a herniated disc to occur is in the disc at the level between the fourth and fifth lumbar vertebrae in the low back.
- If the disc herniation is large enough, the disc tissue can press on the adjacent spinal nerves that exit the spine at the level of the disc herniation.
- The physical examination, imaging tests, and electrical tests can aid in the diagnosis of a herniated disc.
- Depending on the severity of symptoms, treatments for a herniated disc include physical therapy, muscle-relaxant medications, pain medication, anti-inflammation medications, local injection of cortisone (epidural injections), and surgical operations.
How are the spine and its discs designed?
The vertebrae are the bony building blocks of the spine. Between each of the largest parts (bodies) of the vertebrae are the discs. Ligaments are situated around the spine and discs. The spine has seven vertebrae in the neck (cervical vertebrae), 12 vertebrae in the mid-back (thoracic vertebrae), and five vertebrae in the low back (lumbar vertebrae). In addition, in the mid-buttock, beneath the fifth lumbar vertebra, is the sacrum, followed by the tailbone (coccyx).
The bony spine is designed so that vertebrae “stacked” together can provide a movable support structure while also protecting the spinal cord (nervous tissue that extends down the spinal column from the brain) from injury. Each vertebra has a spinous process, which is a bony prominence behind the spinal cord that shields the cord’s nerve tissue. The vertebrae also have a strong bony “body” in front of the spinal cord to provide a platform suitable for weight-bearing.
The discs are pads that serve as “cushions” between the vertebral bodies that serve to minimize the impact of movement on the spinal column. Each disc is designed like a jelly donut with a central softer component (nucleus pulposus). Ligaments are strong fibrous soft tissues that firmly attach bones to bones. Ligaments attach each of the vertebrae and surround each of the discs. When ligaments are injured as the disc degenerates, localized pain in the area affected can result.
Herniated Disc Treatment
Epidural Cortisone Injections for Sciatica and Herniated Disc…Beneficial?
A majority of patients with sciatica from disc herniation have resolution of their pain with various conservative measures, including antiinflammatory and muscle-relaxant medications, exercises, physical therapy, and time. However, some 10%-15% of affected patients require surgical procedures to relieve the pain.
Learn if a cortisone injection can reduce the need for surgery »
What is a herniated disc? What causes a herniated disc?
Cross-section picture of herniated disc between L4 and L5
As described above, each disc of the spine is designed much like a jelly donut. As the disc degenerates from age or injury, the softer central portion can rupture (herniate) through the surrounding outer ring (annulus fibrosus). This abnormal rupture of the central portion of the disc is referred to as a disc herniation. This is commonly referred to as a “slipped disc.”
The most common location for a herniated disc to occur is in the disc at the level between the fourth and fifth lumbar vertebrae in the low back. This area is constantly absorbing the impact of bearing the weight of the upper body. This is especially important when we are standing or sitting. The lower back is also critically involved in our body’s movements throughout the day, as we twist the torso in rotating side to side and as we hinge the back in flexion and extension while bending or lifting.
Herniated Disc See a medical illustration of the sciatica plus our entire medical gallery of human anatomy and physiology See Images
What are risk factors for a herniated disc?
Risk factors for a herniated disc include degeneration of the spine and heavy lifting or bending of the spine.
What are symptoms of a herniated disc?
The symptoms of a herniated disc depend on the exact level of the spine where the disc herniation occurs and whether or not nerve tissue is being irritated. A disc herniation may not cause any symptoms. However, disc herniation can cause local pain at the level of the spine affected.
If the disc herniation is large enough, the disc tissue can press on the adjacent spinal nerves that exit the spine at the level of the disc herniation. This can cause shooting pain in the distribution of that nerve and usually occurs on one side of the body and is referred to as sciatica. For example, a disc herniation at the level between the fourth and fifth lumbar vertebrae of the low back can cause a shooting pain down the buttock into the back of the thigh and down the leg. Sometimes this is associated with numbness, weakness, and tingling in the leg. The pain often is worsened upon standing and decreases with lying down. This is often referred to as a “pinched nerve.”
If the disc herniation occurs in the cervical spine, the pain may shoot down one arm and cause a stiff neck or muscle spasm in the neck.
If the disc herniation is extremely large, it can press on spinal nerves on both sides of the body. This can result in severe pain down one or both lower extremities. There can be marked muscle weakness of the lower extremities and even incontinence of bowel and bladder. This complication is medically referred to as cauda equina syndrome.
How do health care professionals diagnose a herniated disc?
The doctor will suspect a herniated disc when symptoms described above are present. The neurologic examination can reveal abnormal reflexes. Often pain can be elicited when the straight leg is raised when lying or sitting. This is referred to as a “positive straight leg raising test.” There can be abnormal sensation in the foot or leg.
A variety of blood tests are frequently done to determine if there are signs of inflammation or infection.
Plain film X-rays can indicate “wear and tear” (degeneration) of the spine. They do not, however, demonstrate the status of discs. In order to determine whether or not a disc is herniated, an MRI scan or CT scan is performed for diagnosis. Sometimes a CT myelogram is used to further define the structures affected by a herniated disc. A CT myelogram is a CT that is performed after contrast dye is injected into the spinal canal. This allows for better visualization of the discs in certain cases. An electromyogram (EMG) can be used to document precisely which nerves are being irritated by a disc herniation.
What is the treatment for a herniated disc?
Picture of the stapled incision after surgery
Occasionally, disc herniation is incidentally detected when a test such as an MRI is performed for other reasons. If no symptoms are present, no particular treatment is necessary.
Depending on the severity of symptoms, treatments for a herniated disc include physical therapy, muscle-relaxant medications, pain medications, anti-inflammation medications, local injection of cortisone (epidural injections), and surgical operations. In any case, all people with a disc herniation should rest and avoid reinjuring the disc. Sometimes, even people with relatively severe pain early on can respond to conservative measures, including physical therapy with an exercise regimen, epidural cortisone injection, and/or oral cortisone medication (such as methylprednisolone or prednisone), without the need for surgical intervention.
There are now a variety of surgical approaches to treat disc herniation. Each type of operation is customized to the individual situation and depends a great deal on the condition of the spine around the disc affected. Surgical options include microdiscectomy using small surgical instruments and open surgical repair (either from a posterior or anterior approach). The urgent operation can be necessary when cauda equina syndrome is present (reviewed above).
Lower Back Pain: Symptoms, Stretches, Exercise for Pain Relief See Slideshow
What are home remedies for a herniated disc?
Home remedies for disc herniation can be very effective in relieving the pain. These include over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin) and naproxen sodium (Aleve), as well as the application of heat and ice. Alternating heat and ice is very effective for pain relief for many people. Activity modification is also important, which includes avoidance of activities that aggravate pain and may worsen the nerve impingement. Bed rest and complete inactivity are unnecessary; they hinder recovery and are not advised.
What exercises and stretches can be done for a herniated disc?
Exercising is not advised for new symptoms of a herniated disc. On the other hand, building and maintaining strength in the back muscles and abdominal muscles is very important to prevent and treat chronic back problems. Exercises such as walking, physical therapy, and yoga have been proven to be very beneficial for those with chronic back pain.
Simple stretching can be very beneficial for symptoms of a herniated disc. Stretching should be started slowly and carefully. Stretching generally involves stretching the back in a backward bending position, called extension.
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What kind of health care professionals treat herniated discs?
Many different health care providers treat herniated discs. Usually patients will see their primary care provider initially, who may be a general practitioner or specialist in internal medicine or family practice. Other physicians who frequently see patients with herniated discs include emergency-medicine physicians, pain-management specialists, orthopedists, neurosurgeons, rheumatologists, and neurologists.
What is the prognosis (outlook) for a herniated disc?
The outlook for herniated disc depends on the severity and accompanying symptoms. While it is often possible to have full recovery with conservative treatment measures, sometimes surgical intervention is necessary because of persistent symptoms.
Is it possible to prevent a herniated disc?
A herniated disc can only be prevented by avoiding injury to the spine.
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Medically Reviewed on 9/2/2020
Kasper, D.L., et al., eds. Harrison’s Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.
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What is Sciatica?
Sciatica describes persistent pain felt along the sciatic nerve. This nerve runs from the lower back, down through the buttock and into the lower leg. It is the longest nerve in the body. Pain results when this nerve is compressed or injured. It most commonly results from inflammation, bony enlargement due to arthritis or a displaced (herniated) disk in the lower spine.
Sciatica causes pain that begins in the lower back and spreads through the buttock, leg, calf and, occasionally, the foot. The pain generally will feel dull, aching or burning. Sometimes, it starts gradually, worsens during the night, and is aggravated by motion. Sciatica also can cause tingling, numbness or muscle weakness in the affected leg.
Your doctor will review your symptoms and your medical history. He or she will want to know if you have low back pain that spreads to the leg and if you have muscle weakness in your leg or foot. Your doctor will also ask questions that might suggest a serious condition, such as a bone fracture or infection. He or she will want to know if you’ve had:
- any injury
- problems controlling your bowels or bladder,
- a history of cancer
- recent weight loss.
Your doctor will examine you, paying special attention to your spine and legs. To look for problems in your spinal column and related nerves, your doctor may ask you to perform a series of tests that will check your muscle strength, reflexes and flexibility.
Your doctor may send you for X-rays, a computed tomography (CT) scan or a magnetic resonance imaging (MRI) scan. These tests check for problems in the spinal vertebrae (backbones) or discs that may be irritating or compressing your sciatic nerve. These tests are most helpful to rule out other causes of symptoms or if surgical options might be considered.The diagnosis is based primarily on your symptoms. The physical examination is important to look for abnormalities in the neurologic examination such as weakness, abnormal reflexes or loss of sensation in the leg. The exam might indicate another explanation for the symptoms. However, a normal physical examination is common in people with sciatica. While testing may be important in some cases, the diagnosis can be made even when all test results are normal.
Sciatica usually goes away on its own after a period of rest and limited activities. Most people with sciatica feel better within 6 weeks. Pain that lasts longer than 6 to 12 weeks should prompt a follow up visit to your doctor. If symptoms are severe or prolonged, you may be referred to a doctor who specializes in treating back pain.
Once the pain of sciatica passes, there are exercises, stretches and other measures that may prevent it from returning. Your doctor may refer you to a physical therapist to develop a personalized program. Here are some steps you can take in the meantime:
- Practice good posture. Stand up straight with your ears aligned with your shoulders. Align your shoulders with your hips and your buttocks tucked in. Your knees should be bent slightly.
- Do abdominal crunches. These exercises strengthen the abdominal muscles that help to support your lower back. Lie with your back on the floor, hands behind your head and knees bent. Press your lower back to the floor. Lift your shoulders up about 10 inches off the floor and then lower them. Don’t go that high if it causes more pain. Repeat 10 to 20 times, once a day.
- Walk/swim. Walking and swimming can help to strengthen your lower back.
- Lift objects safely. Always lift from a squatting position, using your hips and legs to do the heavy work. Never bend over and lift with a straight back.
- Avoid sitting or standing for extended periods. If you sit at work, take regular breaks to stand and walk around. If you must be on your feet, prop one foot on a small block or footrest. Switch feet throughout the day.
- Use proper sleeping posture. Take pressure off your back by sleeping on your side or on your back. Put a pillow under your knees.
- Stretch. Sit in a chair and bend down toward the floor. Stop when you feel just slight discomfort, hold for 30 seconds, then release. Repeat 6 to 8 times.
- Avoid wearing high heels. Shoes with heels that are more than 1 1/2 inches high shift your weight forward, throwing the body out of alignment.
Sciatica usually can be treated successfully by a brief period of resting and limiting activity. Avoid prolonged bedrest that can actually make sciatica worse. Start gentle exercises to improve mobility and strengthen the back as soon as you can. If you are not making any progress, notify your doctor. Physical therapy can be helpful.
To ease inflammation around the nerve, your doctor may recommend that you alternate using hot and cold compresses.
You also may need to take acetaminophen (Tylenol) for pain, or anti-inflammatory drugs, such as naproxen (Aleve, Anaprox), ibuprofen (Motrin, Advil and others) or aspirin for pain and inflammation. Medications used to treat nerve pain may be helpful. They include amitriptyline (Elavil, Endep) or gabapentin (Neurontin).
In severe cases, an injection of a long-acting anesthetic with a corticosteroid medication may provide relief. However, recent studies suggest that corticosteroid injections for back pain and sciatica do not relieve short or long term pain any better than injections that do not contain any steroid. These injections typically are done in centers specializing in pain management.
Other non-medication options, including chiropractic manipulation, acupuncture, massage and yoga can be helpful, though how well they compare to more conventional treatment is uncertain.
Surgery may be necessary if pain cannot be relieved with other therapies or leg weakness persists, especially if it is getting worse. Surgery is most effective when there is a clear disc herniation that is compressing the root of the involved sciatic nerve.
When To Call a Professional
Contact your doctor if sciatica pain grows worse over a few days, or if it begins to interfere significantly with your daily activities. Call your doctor immediately if you experience sudden, extreme weakness in a leg, numbness in the groin or rectum, or difficulty controlling bladder or bowel function. These symptoms may indicate that nerves leading to the pelvis are compressed. This condition can cause permanent damage if not treated promptly.
The vast majority of sciatica cases can be controlled with simple home care. For most people, basic preventive measures are enough to keep sciatica from coming back although it can be chronic or recurrent. Some people do require surgery for persistent pain or leg weakness.
Learn more about Sciatica
IBM Watson Micromedex
Mayo Clinic Reference
American Academy of Orthopaedic Surgeons (AAOS)
National Institute of Arthritis and Musculoskeletal and Skin Diseases
National Institute of Neurological Disorders and Stroke
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
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Pain in the legs can occur as a result of conditions that affect bones, joints, muscles, tendons, ligaments, blood vessels, nerves, or skin. Leg pain can occur in the foot, ankle, knee, behind the knee, thigh, down the back of the leg, or in any part of the leg. It can occur at night, while lying down, or while running or exercising, depending upon the cause. Depending on the cause, leg pain can occur in one leg only or in both legs. Typically, the leg pain is a result of tissue inflammation that is caused by injury or disease. Either injury or chronic disease can cause inflammation to any of the tissues of the leg and lead to leg pain. Since the leg contains a number of different structures and tissue types, a wide variety of conditions and injuries can cause leg pain.
Depending on the cause of the pain, other symptoms, like
- aching, or
- a tingling sensation, may accompany leg pain.
Diabetic neuropathy (nerve damage from diabetes) is a common cause of tingling, burning, and numbness in the legs that can at times be painful. For diagnostic and therapeutic purposes, it is important to differentiate the exact type and location of any pain in the legs. Peripheral artery disease can cause claudication, or pain that occurs in the legs usually when walking or exercising. Blood clots (deep vein thrombosis) can be another cause of leg pain. Pain in the knee and ankle joints of the leg is common with the arthritis conditions. The pain of sciatica (from disc disease of the spine) may radiate down the leg and is another common cause of leg pain.
Other causes of leg pain
- Bacterial Infections
- Electrolyte Imbalances
- Fungal Infections
- Legg-Calvé-Perthes Disease
- Nerve Damage From Any Source
- Rupture of Ligaments or Tendons
- Slipped Capital Femoral Epiphysis
- Tears in Cartilage
- Ulcerations of the Skin
- Viral Infections
The term arthritis refers to stiffness in the joints. See Answer