Leg pain is a very common occurrence in people and can range from mild to very intense, depending on its cause.
Pain in the legs is classified as:
- Musculoskeletal
- Vascular and
- Neurological
Pain can occur in the bones, connective tissues, blood vessels, nerves, or skin. Severe or persistent leg pain can have a negative impact on the quality of life.
Leg pain sometimes can indicate a serious health problem that requires urgent medical intervention (vascular issues like deep vein thrombosis). Many types of leg pain can be treated at home, but severe or persistent pain may indicate a more serious condition. The first step in treating leg pain is to make an accurate diagnosis based on symptoms so that the GP can determine the best treatment options. Treatment includes medication, physical therapy, immobilization, and, if necessary, surgery.
What is leg pain?
Pain in the leg is described as any sensation of pain or discomfort in the area between the groin and the ankle. Depending on the cause, leg pain can range from mild to severe, and the symptoms can be continuous (without interruption) or intermittent (occurring at intervals). Leg pain can be acute, meaning it occurs suddenly and then goes away. It can also last for weeks or months, indicating chronic leg pain.
Different types of leg pain
Different types of leg pain are typically classified by doctors as neurological, musculoskeletal, or vascular, which may overlap in symptoms.
Neurological pain
This type of pain arises from certain conditions and disorders such as restless leg syndrome, neuropathy, or damage to the nerves, including sciatic nerve pain (the longest nerve in the body that runs through the entire length of the leg). Neurological pain can be present even at rest.
Musculoskeletal pain
Examples of musculoskeletal pain include the sound of crackling in the knee or arthritis, joint-related conditions. For instance, injuries to muscle tendons or ligaments from a fall can cause musculoskeletal pain, as well as muscle cramps and stress fractures.
Vascular pain
Vascular pain can be caused by peripheral arterial disease (PAD), deep vein thrombosis (DVT), vasculitis, and varicose veins.
Common symptoms of leg pain
Pain in the legs can only affect a small area of the leg, or it can cover a wide area or even the entire leg. It is important to observe whether both legs look the same, i.e., if there are any differences in size or color.
Symptoms that can occur with pain in the legs include:
- Swelling
- Varicose veins
- Wounds or ulcers
- Redness and heat
- Poor general condition in case of infection or fracture of the leg
- Changes in the color of the leg or foot
Most common causes of leg pain
Arthritis (gout, juvenile idiopathic arthritis, osteoarthritis, psoriatic arthritis, reactive arthritis rheumatoid arthritis)
Arthritis is a condition that causes inflammation or swelling in one or more joints. Specific symptoms vary depending on the type of arthritis, but they usually include joint pain and stiffness.
Back pain
Unpleasant pain that originates in the lower back and “travels” down the legs all the way to the feet is a recognizable sign of sciatica. The culprits for this pain can also be a herniated disc or spinal stenosis. These conditions cause a narrowing of the space around the spinal nerves, which can lead to nerve pain and irritation.
Bone cancer
Persistent bone pain that worsens over time and continues even during the night. Swelling and redness (inflammation) occur in the affected bone, which can impede movement, especially if the affected bone is near a joint.
Fracture
A fracture or a broken bone can cause swelling, deformity, bruising and loss of strength or mobility in the leg.
Stretching of muscles and tendons
Minor injuries can lead to slight stretching of muscles or tendons, while more severe injuries can involve partial or complete tearing of these tissues. Symptoms will vary depending on the severity of the injury and may include pain or tenderness, redness or bruising, limited range of motion, muscle spasms, swelling, muscle weakness.
Claudication
Claudication is pain, cramping, or a feeling of fatigue caused by insufficient blood flow to the muscles during exercise. It can be accompanied by a tingling sensation or a feeling of fatigue in the legs and buttocks while moving. Claudication is also a symptom of a disease, most commonly peripheral artery disease, which involves narrowing of the arteries in the limbs that restricts blood flow.
Deep vein thrombosis (DVT)
Deep vein thrombosis (DVT) occurs when a blood clot (thrombus) forms in one or more deep veins in the body, usually in the legs. Deep vein thrombosis can cause leg pain or swelling. Sometimes there may be no noticeable symptoms. If present, symptoms can include swelling (often warm to the touch) and a painful sensation. DVT can be a life-threatening condition if the clot dislodges and reaches the lungs.
Varicose veins
Pain can be aching, throbbing, or accompanied by a burning sensation. The legs become heavy, and there may be swelling around the ankles, muscle cramps, and restless leg syndrome. The skin over the veins may appear darker, and there can be itchy rashes.
Gout
Gout is a common and complex form of arthritis characterized by sudden, intense attacks of pain, swelling, redness, and tenderness in one or more joints, often in the big toe.
Growing pains
Growing pains are often described as pain or throbbing in the front of the thighs, calves, or behind the knees. Growing pains typically affect both legs and occur at night, and they may even wake a child from sleep.
Hamstring injury
Injury to the hamstring muscles most commonly manifests as a sudden, sharp pain in the back of the thigh. The pain is often accompanied by a feeling of cracking or tearing of the muscles.
Herniated disc
It occurs when a disc in the lower back shifts out of the intervertebral space, leading to compression of a nerve root. Symptoms depend on the location of the disc and whether it is pressing on a nerve. Herniated discs usually affect one side of the body. If the herniated disc is in the lower back, in addition to back pain, there may be pain in the buttocks, thigh, calf, and even part of the foot.
Ligament injury
Damage to the ligaments of the knee and ankle often occurs due to sports-related injuries. A torn ligament severely restricts movement, and there may be swelling and bruising.
Muscle cramps
Pain is usually felt in the calves and in most cases, it disappears quickly.
Osteomyelitis (bone infection)
Occurs when pathogens infect the bone or surrounding tissues. Symptoms of osteomyelitis are high fever, swelling, pain, heat and redness at the site of infection.
Peripheral arterial disease (PAD)
In peripheral arterial disease (PAD), there is poor blood circulation in the legs, which can cause leg pain during walking (claudication) and other symptoms such as muscle pain, cramps, and cold feet. Peripheral arterial disease is often a sign of fatty deposits accumulating in the arteries (atherosclerosis).
Peripheral neuropathy
Peripheral neuropathy is the result of damage to the peripheral nerves (located outside the brain and spinal cord). It often causes weakness, numbness and pain, usually in the hands and feet.
Sciatica
It occurs due to inflammation of the sciatic nerve, leading to pain that radiates down the leg from the hip to the foot.
Tibial stress syndrome (shin splints)
Chronic strain syndrome is a condition of muscles and nerves caused by exercise that causes pain, swelling and sometimes disability in the affected leg muscles, usually the lower leg (or arm). It is more common in young adult runners and athletes who participate in activities that involve repeating certain movements and actions.
Dislocation
Dislocation is the separation of two bones where they meet in the joint. Dislocation most commonly occurs in the shoulder, knee, and hip. The joint is visibly deformed or out of place, may be swollen, and accompanied by tingling and severe pain.
Meniscus injuries
The menisci are cartilaginous structures located in the knee joint between the articular surfaces of the thigh and shin bones. Injuries are accompanied by knee pain or tenderness, stiffness, or swelling. Difficulties with bending, straightening, or moving the knee are common, along with a sensation of clicking or popping when moving the joint.
Overview of available treatments for leg pain
Treatment of leg pain usually begins with painkillers taken according to the instructions.
Treatment options may also include:
- Local analgesics (creams, gels)
- Steroid injections
- Spinal cord stimulation (electrical)
- Nerve blocks
- Physical therapy (may include exercise, thermotherapy, cryotherapy, electrical nerve stimulation…)
- Alternative treatments such as acupuncture, chiropractic and/or massage
- Putting casts at fractures
- Depending on the cause of leg pain and symptoms, surgical interventions may be considered.
Treatment of leg pain caused by injuries and fractures
To reduce the load on the bones until they heal, there will be an indispensable cast and the use of crutches will be necessary. In some cases, surgery may be required to ensure the complete healing of certain types of fractures. Surgery may also be an option to help in the treatment of athletes who want to return to their sport more quickly.
Commonly prescribed medications for leg pain
There are many ways to alleviate leg pain, with medication being an important approach. The most common medications used are nonsteroidal anti-inflammatory drugs (NSAIDs), analgesics, and neurologic pain relievers.
Nonsteroidal anti-inflammatory drugs and analgesics are available at the pharmacy without a prescription, but they should only be used as directed by a doctor. Painkillers are also used in combination with other treatments, such as physical therapy and exercises.
Medicines used to treat neurological pain, such as low-dose antidepressants or antiepileptic drugs, work differently from other painkillers, and the type and dosage are determined exclusively by the doctor.
Tips for preventing leg pain
Exercise for 30 minutes daily, five days a week. Increase physical activity gradually and avoid overdoing it too quickly. Replace worn-out footwear and wear appropriate footwear for your activity. Avoid slippery surfaces or running on bumps.
Always take time to stretch your muscles after exercising to prevent leg pain from physical activity.
Monitor and control cholesterol and blood pressure levels with the help of medical treatment and doctor’s advice.
Limit alcohol consumption to one or two drinks per day.
Discuss with your doctor other ways to prevent specific causes of leg pain.
It is also useful to eat foods rich in potassium, vitamins, and minerals to maintain muscle and bone health.
Overview of diagnostic procedures for leg pain
During a physical examination, doctors will gather detailed information about the patient’s medical history and ask questions about the type of leg pain, symptoms experienced, past bone fractures, vitamin D intake, physical condition, and medications used.
Diagnostic imaging techniques are also necessary to assess the condition and injuries:
- X-ray
- CT scanner
- Magnetic resonance imaging (MRI)
Prognosis and outcome
Some types of leg pain, especially those caused by muscle strains or other minor injuries, typically resolve within a few weeks with home care and do not require complex treatment. However, leg pain resulting from more serious injuries or nerve and tissue damage may require ongoing treatment or surgery.
What to do if you feel pain in your leg?
-First aid for mild pain and swelling: Elevate your leg above hip level whenever you sit or lie down.
-Apply an ice pack to the painful area for 15 to 20 minutes, three times a day.
-If needed, take over-the-counter pain medication. Use creams, patches, and gels that help relieve pain.
– Wear compression socks for pain caused by varicose veins
-Take a warm bath and gently stretch the muscles.
-If you have pain in the lower part of your leg, try flexing your toes while sitting or standing. If you have pain in the upper part of your leg, try bending forward and touching your toes. You can do this while sitting on the floor or standing.
– Facilitate each stretch, holding each position for five to ten seconds. Stop stretching if the pain worsens.
When to visit a doctor for leg pain?
Schedule an appointment and visit a doctor If you do not experience improvement despite taking medication and following treatment recommendations. Reasons for a visit also include pain during or after walking, leg swelling, worsening pain, or if you have painful varicose veins.
When to urgently visit a doctor?
Immediately call for emergency medical assistance or go to the hospital in the following cases:
- There are signs of infection, such as redness, heat or sensitivity, or a temperature higher than 37.8 C.
- The leg is swollen, paler or colder than usual.
- Pain in the leaves, especially after a long sitting.
- Swelling in both legs along with breathing difficulties.
- You have a leg injury with a deep incision, or you can see bone or tendon.
- You are unable to walk or put weight on your leg.
- You have pain, swelling, redness or heat in the calf.
- You can hear cracking or grinding at the time of the leg injury.
Living with leg pain
Depending on the cause of the leg pain, it is important to follow the doctor’s advice and recovery recommendations.
-If it’s due to a medical condition or a chronic condition, it’s necessary to adhere to the prescribed therapy, dietary changes, and adopt a healthy lifestyle to alleviate or eliminate the pain.
–Healing from a fracture, for example, may take weeks (sometimes even months). Therefore, rest and pain medications are crucial.
–Apply ice packs to the injured or swollen area as needed.
-Gradually resume activities. Once approved by your doctor, slowly progress from non-weight-bearing activities like swimming to your regular activities.
-Continue running or engaging in other activities gradually, slowly increasing the time and distance.
-If you experience muscle cramps, gentle stretching can be beneficial. This applies to many other types of leg pain as well.
The importance of monitoring the condition with a doctor
It is crucial for the treatment of leg pain to be under the supervision of a doctor. By addressing the underlying cause, it is possible to completely eliminate or alleviate leg pain. The application of appropriate physical therapy along with medications provides a good prognosis for recovery in many conditions (injuries).
How to take care of yourself after leg pain
If the leg pain subsides, it is necessary to take preventive measures to avoid the recurrence of symptoms. General self-care, which includes getting enough sleep, staying hydrated, regular exercise, quitting smoking, maintaining a healthy weight, and consuming a diet rich in minerals and vitamins, can help prevent leg pain.
Leg pain can have various causes, and the symptoms often overlap. Many types of leg pain can be relieved with over-the-counter medications and home treatments. If the pain does not stop, worsens, or significantly affects daily life, the person should consult a doctor. This is particularly crucial for leg pain symptoms that may indicate a serious vascular issue (such as a blood clot).
