These Leg Pain Symptoms Can Be an Urgent Problem

Written by Evan Starkman

• Painful, Swollen, and Warm
• Ongoing Leg Cramps and Fatigue
• ‘Electrical’ or Burning Pain
• Sudden Sharp Pain

We’ve all had leg pain at some point. Maybe you banged your shin against your favorite chair, or you had an intense cramp in your thigh or calf muscle. It hurt, but it got better fast.

Leg pain that seems severe, ongoing, or out of the ordinary is a different story. Sometimes it’s a sign of an urgent problem that could stick around — or get worse — without treatment.

Call your doctor if you have one of these types of leg pain.

If your lower leg or thigh feels this way, it could be due to a blood clot called deep vein thrombosis (DVT). Skin in the area may also be sensitive to touch and reddish in color. Sometimes a DVT has no symptoms.

Things that can make you more likely to get a deep-vein clot include if you:

• Have had DVT before
• Are pregnant
• Have had prolonged bed rest
• Are older than 65
• Have had major surgery
• Use birth control or hormone replacement therapy
• Have certain cancers
• Are taking certain cancer treatments

A DVT blood clot is dangerous because it can break loose, travel to your lungs, and get caught in an artery there. When that happens, it’s called a pulmonary embolism (PE).

You could have symptoms like:

• Chest pain
• Trouble breathing
• A cough that may bring up blood

A PE is an emergency, and it can be deadly without treatment.

If you have these in your calf or thigh while walking — and they get better with rest — you might have peripheral artery disease (PAD). That’s when plaque gradually builds up in the arteries that carry blood to your limbs. PAD usually affects your legs. It prevents them from getting enough blood.

You’re more likely to get PAD if you:

• Are 65 or older
• Smoke
• Are obese
• Have high cholesterol, high blood pressure, diabetes, or kidney failure

Without treatment, there’s a chance that PAD could eventually bring on problems like:

• Sores
• Serious infections
• Pain while you’re not moving

It could even lead to gangrene. That’s dying tissue that sometimes leads to amputation.

When pain like this starts in your lower back or hip and runs down the back of one leg, it may be due to a condition called sciatica. You might feel:

• More pain when you move, sneeze, or cough
• A bad, long-lasting leg cramp
• Weakness or tingling in your leg
• “Pins and needles” sensation

Your sciatic nerve is the longest and widest nerve in your body. It branches from your lower back down into your legs. If it gets pinched due to a herniated disk in your spine or something else, that can bring on the symptoms of sciatica, usually in only one of your legs.

Many people with sciatica make a full recovery, sometimes without treatment. But you still need to see your doctor if you have sciatica symptoms, because without treatment, it’s possible to have complications like:

• Loss of feeling in your leg
• Bowel or bladder problems
• Permanent nerve damage

It could be due to one of these serious injuries. See your doctor to make sure your leg heals properly.

Achilles tendon tear. Your Achilles is a tough band of tissue that connects your calf muscle to your heel bone. You use it when you walk, run, and jump. If you tear it partly or completely, you might feel sudden pain in the back of your leg above your heel. You may also hear a popping sound when it happens. Afterward, you could have a hard time putting weight on your foot or walking normally.

Many people tear their Achilles while playing a sport that involves jumping or abrupt starts and stops. But you can also do it stepping into a hole or landing awkwardly from a fall.

ACL tear. Your anterior cruciate ligament (ACL) is a short, diagonal band of tissue that helps hold your knee joint together and helps it remain stable. If you tear it partially or completely, you might hear a popping sound along with the pain. Your knee may give out on you and become unstable or wobbly. Hours later, it could swell.

Some things that can raise your risk for an ACL injury are:

• Sports with sudden stops and direction changes
• Firmly planting your foot
• Slowing down while you run
• Getting hit or tackled in the knee

Hamstring tear. A group of three muscles run along the back of your thigh. They’re called the hamstrings. If you tear one of them, or tear a tendon in the back of your thigh, it can bring on sharp pain. The area may get swollen within a few hours, and the back of your leg below your knee may look bruised or discolored in the days ahead.

Hamstring tears tend to happen while you’re:

• Running
• Dancing
• Playing sports with lots of stop-and-start motions

Teenage athletes who are still growing have higher odds of getting this injury.

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Leg pain Information | Mount Sinai

Pain – leg; Aches – leg; Cramps – leg

Leg pain is a common problem. It can be due to a cramp, injury, or other cause.

The muscular components of the lower leg include the gastrocnemius, soleus, peroneus longus, tibialis anterior, extensor digitorum longus, and the Achilles tendon.

Leg pain in older children or young adolescents can occur for many reasons. An Osgood-Schlatter lesion results from continued trauma to the anterior tibial bone and causes a visible lump below the knee.

Shin splints is the common name for the medical condition called medial tibial stress syndrome in which pain occurs along the tibia (shin bone) in the front of the lower leg. The pain is a result of small tears in the area the lower leg muscles attachment to the tibia. Shin splints are typically caused from intense or vigorous athletic activity and can be resolved with adequate rest, stretching and modifying your exercise routine.

Varicose veins are enlarged, twisted, painful superficial veins resulting from poorly functioning valves. Varicose veins usually occur in the veins of the legs, although it may occur elsewhere. It is a common condition, affecting mostly women.

Retrocalcaneal bursitis is an inflammation of the bursa at the back of the heel bone. A bursa is a fluid-filled sac that acts as a cushion and a lubricant between tendons and muscles sliding over bone. Repetitive or over use of the ankle, by doing excessive walking, running, or jumping, can cause this bursa to become irritated and inflamed. Symptoms of bursitis include pain in the heel, especially with walking, running or when the area is touched.

The muscles in the lower leg are divided into several compartments. The muscles in the anterior compartment include the tibialis anterior, extensor halluscis longus, extensor digitorum longus, and peroneous tertius. This group of muscle primarily extends the toes and dorsiflexes the ankle. When there is inflammation in the anterior compartment a painful condition called shinsplints can occur.

Causes

Leg pain can be due to a muscle cramp (also called a charley horse). Common causes of cramps include:

• Dehydration or low amounts of potassium, sodium, calcium, or magnesium in the blood
• Medicines (such as diuretics and statins)
• Muscle fatigue or strain from overuse, too much exercise, or holding a muscle in the same position for a long time

An injury can also cause leg pain from:

• A torn or overstretched muscle (strain)
• Hairline crack in the bone (stress fracture)
• Inflamed tendon (tendinitis)
• Shin splints (pain in the front of the leg from overuse)

Other common causes of leg pain include:

• Peripheral artery disease (PAD), which causes a problem with blood flow in the legs (this type of pain, called claudication, is generally felt when exercising or walking and is relieved by rest)
• Blood clot (deep vein thrombosis) from long-term bed rest
• Infection of the bone (osteomyelitis) or skin and soft tissue (cellulitis)
• Inflammation of the leg joints caused by arthritis or gout
• Nerve damage common to people with diabetes, smokers, and alcoholics
• Varicose veins

Less common causes include:

• Cancerous bone tumors (osteosarcoma, Ewing sarcoma)
• Legg-Calve-Perthes disease — poor blood flow to the hip that may stop or slow the normal growth of the leg
• Noncancerous (benign) tumors or cysts of the femur or tibia (osteoid osteoma)
• Sciatic nerve pain (radiating pain down the leg) caused by a slipped disk in the back
• Slipped capital femoral epiphysis — most often seen in boys and overweight children between ages 11 and 15

Home Care

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 medicines such as acetaminophen or ibuprofen.

Other homecare will depend on the cause of your leg pain.

When to Contact a Medical Professional

Contact your health care provider if:

• The painful leg is swollen or red.
• You have a fever.
• Your pain gets worse when you walk or exercise and improves with rest.
• The leg is black and blue.
• The leg is cold and pale.
• You are taking medicines that may be causing leg pain. DO NOT stop taking or change any of your medicines without talking to your provider.
• Self-care steps do not help.

What to Expect at Your Office Visit

Your provider will perform a physical exam and look at your legs, feet, thighs, hips, back, knees, and ankles.

Your provider may ask questions such as:

• Where on the leg is the pain? Is the pain in one or both legs?
• Is the pain dull and aching or sharp and stabbing? Is the pain severe? Is the pain worse at any time of day?
• What makes the pain feel worse? Does anything make your pain feel better?
• Do you have any other symptoms such as numbness, tingling, back pain, or fever?

Your provider may recommend physical therapy for some causes of leg pain.

Anthony KK, Schanberg LE. Musculoskeletal pain syndromes. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 193.

Hogrefe C, Terry M. Leg pain and exertional compartment syndromes. In: Miller MD, Thompson SR. eds. DeLee, Drez, & Miller’s Orthopaedic Sports Medicine. 5th ed. Philadelphia, PA: Elsevier; 2020:chap 113.

Silverstein JA, Moeller JL, Hutchinson MR. Common issues in orthopedics. In: Rakel RE, Rakel DP, eds. Textbook of Family Medicine. 9th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 30.

Smith G, Shy ME. Peripheral neuropathies. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 392.

Weitz JI, Ginsberg JS. Venous thrombosis and embolism. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 74.

White CJ. Atherosclerotic peripheral arterial disease. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 71.

Last reviewed on: 7/19/2021

Reviewed by: Linda J. Vorvick, MD, Clinical Associate Professor, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

Backache: what to do and how to treat

Arthritis

Hernia

Arthrosis

Herniated spine

Protrusion

Herniated discs

Spinal osteochondrosis

Scoliosis

Back pain

Joint pain

Contents

Causes of back pain

Lower back pain and so-called backache is a common syndrome, especially familiar to people over 60 years of age. Unpleasant aching continuous sensations are most often localized in the lumbar region. They can be caused by various diseases, including conditions after injuries with damage to the disc, joint, sprain or muscle spasm.

There are several types of pain. Radiating pain is usually a dull pain in the lower back that radiates down the leg to the very foot or knee. The cause of the syndrome is a violation of blood flow in the region of the lumbar muscle groups and sciatic nerve, this usually manifests itself in osteochondrosis of the spine with herniated discs.

Pain may be referred. In this case, the pain is localized in a place different from the actual cause. For example, during a heart attack, pain is felt in the left arm, and pain from the internal organs in the lower back is predominantly deep and aching in nature, and its exact location is difficult to determine. This pain is independent of movement.

So, the possible causes of lower back pain:

• spinal fractures and other injuries,
• osteoarthritis,
• spasms of the deep muscles of the spine with hernias,
• hyperextension of the spinal muscles in spondylolisthesis,
• fibromyalgia,
• ankylosing spondylitis (inflammation of the spine and large joints),
• oncological diseases,
• and other pathologies.

What can and can not be done in case of back pain?

Lumbago (the scientific name for backache is acute discogenic lumbalgia) is sudden and sharp pain in the lower back. This symptom accompanies various pathologies of the spine, but it is not a disease in itself. The pain is caused by improper load on the back, weight lifting, sometimes sports.

Backache requires immediate action: you need to take a position lying on your back, raise your legs by 90 degrees – in this position, the muscles will relax and it will become easier. In some cases, you can lie on your stomach, be sure to put 2-3 high pillows under the patient or lie on a fitball, relaxing your back muscles. You can also get on all fours and perform arching and arching in the back with a soft exhalation, the “Cat” exercise. If the pain is unbearable, then apply an ice compress to the lumbar region for 5-10 seconds.

Consult a kinesitherapist, and under his supervision, continue further treatment, not only home exercises, but also special decompression exercises, selected individually.

When shootings occur, there is a great temptation to warm the back, apply a heating pad, because the heat relieves the pain. However, in no case should you warm this place, as this can aggravate the inflammatory process. Relief comes, but it is temporary and deceptive, because the blood stops moving quickly and gradually drains from the muscles, the muscles cease to be well supplied with oxygen. Because of this, even more inflammation and pain can occur – you will only hurt yourself.

Lumbago treatments

Do not ignore bouts of lumbago, thinking that “it will pass by itself.” The pain will be relieved, but sooner or later the attack will recur, and in order to avoid this, competent treatment is necessary. How to treat unpleasant lumbago? Be sure to consult a doctor for examination, diagnosis and treatment. As a rule, complex therapy is prescribed depending on the nature and cause of the pain. Typically, the treatment regimen includes:

• A set of analgesic exercises for the home.
• Ice compress on the area of ​​pain or cold shower 5 seconds.
• Stretching exercises for the muscles of the spine and legs.
• Decompression exercises selected by a kinesitherapist under the supervision of an instructor-methodologist.
• Therapeutic massage.
• Physiotherapy, often of the contrast type.

Exercises for back pain according to Bubnovsky

With a “lumbago”, the deep muscles of the spine spasm, as if a severe bruise had occurred. As a result, inflammation and stagnation of blood occurs, comparable to edema, and in order to cope with this faster, it is necessary to restore blood circulation in a sore spot. The best way to restore blood circulation is to straighten the muscles and relieve their spasm with special exercises.

Muscles working in decompression restore hemodynamics and relieve swelling, after which the pain decreases. The author’s multifunctional MTB simulator helps with this. It is very important to learn how to exhale correctly when performing therapeutic exercises. Diaphragmatic breathing is an important element of Dr. Bubnovsky’s rehabilitation system. Additionally, a visit to the sauna with a cold shower or bath after, various contrast and hydromassage baths, therapeutic massage, stretching and a set of pain-relieving exercises for the home can be prescribed.

What exercises does the author of the technique, Sergey Mikhailovich Bubnovsky, offer:

• In order to get out of bed in the morning with a pronounced pain syndrome, gently exhale through your mouth with the sound “HAA”, roll over onto your stomach and slide down to the floor.
• Then slowly, making a soft almost blowing exhalation “ХХАА!” during each movement, begin to move on all fours, stretching one arm forward and one leg back, as if stretching the muscles along the body, each time try to take longer steps.
• Next, lie on your back on the floor, bend your legs, put your feet on the floor, hands behind your head – lift your shoulder blades from the floor up as you exhale, stretch your elbows to your knees. With acute pain under the lower back, you can put an ice compress. At first, the movement may cause sharp pain, but it is safe and the pain will subside as the exercises are performed. When lowering your head, you can stretch your legs, and when bending, try to pull your knees to your elbows. Perform 15-20 times.
• The next exercise is also performed lying on your back on the floor, legs bent, feet on the floor, arms along the body. On the exhalation “HAA” try to tear the pelvis off the floor, the exercise “Half-bridge”. It can also be performed lying on a cryocompress if the pain is acute. Perform 15-20 repetitions.
• Next, you can do the exercise “Cat” and stretch the muscles of the back and legs.
• If the pain is not very pronounced, then you can pull your knees up to your stomach while exhaling, this is a good preventive exercise against backache.

Prophylaxis

Painful syndromes in the neck, back, shoulders, lower back most often occur due to an incorrect lifestyle, sedentary and inactive. What to do? First and foremost, be physically active. An expert in modern kinesitherapy is always ready to provide additional assistance. You can choose exercises for both home and gym.

Often a person does not have the motivation to engage in a permanent basis. In such cases, Dr. Bubnovsky’s books can help, in which the author gives real clinical examples and justifies the importance of a healthy lifestyle. It is important to find out the cause of lumbago in order to tailor the exercise program to work the back muscles. In the program of exercises on the upper floor of the body, the spine is constantly subjected to stress and relaxation to achieve the maximum healing effect. In addition to exercises on simulators, there are exercises with rubber expanders, yoga or swimming, which also positively affects the condition of the back muscles and does not overload them.

Exercises to strengthen the back muscles pay off in the long run and will be beneficial for those who have experienced lumbago in the past, as well as those who are approaching retirement age or experiencing back pain. Regular exercise can prevent the occurrence of a new attack of lumbago and, in general, reduce everyday stress and pain. Flexible, durable, functional body that enjoys movement – what could be better!

Be healthy!

Information verified by an expert

Bubnovskaya Lyudmila Sergeevna

Physiotherapist, specialist in modern kinesitherapy

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