What are the common causes of severe calf pain in both legs. How can severe calf pain be treated effectively. What preventive measures can be taken to avoid severe calf pain in both legs.

Understanding Claudication: The Painful Walking Syndrome

Claudication is a condition characterized by pain in the legs during exercise, primarily due to reduced circulation. This pain typically manifests as a cramp-like sensation in the calf muscles while walking, though it may also affect the thigh and buttock muscles. The underlying cause of claudication is atherosclerosis, a hardening of the arteries that restricts blood flow to the leg muscles.

During physical activity, leg muscles require increased oxygen supply. In individuals with claudication, the compromised blood flow fails to meet this heightened demand, resulting in muscle pain. Interestingly, the pain subsides after a brief rest period, allowing the person to resume walking. The distance one can walk on flat ground before experiencing pain serves as a rough indicator of the condition’s severity.

Diagnosing Claudication

Diagnosis of claudication often relies on the patient’s reported symptoms and a physical examination focusing on leg pulses. Weak or absent pulses can be indicative of the condition. For confirmation, doctors may employ additional tests:

• Doppler ultrasound to measure blood pressure in the legs
• Treadmill tests to assess pain onset during walking
• CT or MRI angiograms to visualize arterial blockages

Treatment Approaches for Claudication and Severe Calf Pain

The primary goal in treating claudication is to prevent further deterioration of the arteries. This approach not only addresses leg pain but also reduces the risk of heart attacks and strokes, as atherosclerosis can affect arteries throughout the body.

Lifestyle Modifications

Several lifestyle changes can significantly improve claudication symptoms:

1. Smoking cessation: Quitting smoking is crucial for arterial health
2. Weight management: Losing excess weight can improve walking distance
3. Regular exercise: Persistent walking, despite initial discomfort, can enhance muscle efficiency and blood flow over time
4. Medication: Daily low-dose aspirin (75mg) may be recommended to support arterial health

Medical Interventions

For persistent claudication, medical interventions may be necessary:

• Angioplasty: A balloon is used to stretch open narrowed arteries
• Stenting: A scaffold-like device is inserted to keep arteries open
• Bypass surgery: In severe cases, surgery may be performed to reroute blood flow around blocked arteries

Calf Strains: Another Common Cause of Severe Leg Pain

While claudication is a significant cause of calf pain, muscle strains can also lead to severe discomfort in the lower legs. The calf consists of two main muscles: the gastrocnemius and the soleus. These muscles converge at the Achilles tendon, which attaches to the heel bone. Overstretching or tearing either of these muscles results in a calf strain.

Symptoms of Calf Strain

How does a calf strain differ from claudication? Calf strains typically present with the following symptoms:

• Sudden, sharp pain in the calf muscle
• Swelling and tenderness in the affected area
• Difficulty walking or standing on tiptoes
• Possible bruising in severe cases

Cramps: A Common Yet Painful Calf Condition

Muscle cramps are another frequent cause of calf pain. These sudden, involuntary contractions can be intensely painful and may last from a few seconds to several minutes. But what triggers these uncomfortable spasms?

Common Causes of Calf Cramps

• Dehydration: Insufficient fluid intake can lead to electrolyte imbalances
• Mineral deficiencies: Low levels of calcium, magnesium, or potassium may contribute to cramping
• Overexertion: Pushing muscles beyond their limits, especially during new or intense exercises
• Poor blood circulation: Can be related to claudication or other vascular issues
• Certain medications: Some drugs may increase the likelihood of muscle cramps

Differential Diagnosis: When Calf Pain Signals Something More Serious

While many cases of calf pain are benign, it’s crucial to recognize when the symptoms might indicate a more severe condition. When should you be concerned about calf pain?

Red Flags for Serious Calf Pain

• Sudden, severe pain accompanied by swelling and redness
• Pain that doesn’t improve with rest or basic home treatments
• Calf pain associated with shortness of breath or chest pain
• Signs of infection, such as fever or warmth in the affected area

These symptoms could indicate conditions such as deep vein thrombosis (DVT), compartment syndrome, or even a ruptured Baker’s cyst. Prompt medical attention is essential in these cases to prevent potentially life-threatening complications.

Prevention Strategies for Calf Pain and Related Conditions

Preventing calf pain involves a multifaceted approach that addresses various risk factors. By implementing these strategies, individuals can significantly reduce their likelihood of experiencing severe calf pain:

Lifestyle Modifications for Calf Health

1. Regular exercise: Engage in low-impact activities like swimming or cycling to improve circulation
2. Proper hydration: Maintain adequate fluid intake, especially during physical activity
3. Balanced diet: Ensure sufficient intake of minerals like potassium, magnesium, and calcium
4. Smoking cessation: Quit smoking to improve overall vascular health
5. Weight management: Maintain a healthy body weight to reduce strain on leg muscles and improve circulation

Exercise-Specific Prevention Techniques

• Warm-up and cool-down: Always include these in your exercise routine to prepare muscles for activity and promote recovery
• Gradual intensity increase: Slowly build up the intensity and duration of your workouts to prevent overexertion
• Proper footwear: Wear shoes that provide adequate support and cushioning for your specific activities
• Regular stretching: Incorporate calf stretches into your daily routine to maintain flexibility

Innovative Treatments and Future Directions in Calf Pain Management

As medical research progresses, new approaches to managing severe calf pain are emerging. These innovative treatments offer hope for individuals who have not found relief through conventional methods:

Cutting-Edge Therapies for Calf Pain

• Stem cell therapy: Shows promise in regenerating damaged muscle tissue
• Platelet-rich plasma (PRP) injections: May accelerate healing in muscle strains
• Gene therapy: Potential future treatment for improving circulation in claudication patients
• Neuromuscular electrical stimulation: Can help strengthen calf muscles and improve blood flow

While these treatments are still being studied, early results are encouraging. Patients with persistent calf pain may want to discuss these options with their healthcare providers to determine if they might be suitable candidates for clinical trials or emerging therapies.

Holistic Approaches to Calf Pain Management

In addition to conventional medical treatments, many individuals find relief from calf pain through holistic and complementary therapies. These approaches often focus on overall well-being and may offer benefits beyond just pain relief:

Alternative Therapies for Calf Pain

• Acupuncture: May help improve circulation and reduce muscle tension
• Massage therapy: Can alleviate muscle tightness and promote better blood flow
• Yoga and Pilates: Improve flexibility, strength, and body awareness
• Herbal remedies: Some herbs like ginger and turmeric have anti-inflammatory properties
• Mind-body techniques: Practices like meditation may help manage pain perception

While these holistic approaches should not replace medical treatment for severe calf pain, they can be valuable complementary strategies when used under professional guidance. Always consult with your healthcare provider before starting any new treatment regimen, especially if you have underlying health conditions.

By understanding the various causes of severe calf pain, exploring diverse treatment options, and implementing preventive strategies, individuals can take proactive steps towards maintaining healthy, pain-free legs. Remember, persistent or severe calf pain should always be evaluated by a medical professional to ensure proper diagnosis and treatment.

Claudication (Cramp when walking) – Vascular Society

Claudication is a common condition where pain occurs in the legs with exercise due to a reduction in the circulation. The cause is hardening of the arteries otherwise known as atherosclerosis.  The common symptom is of a cramp like pain developing in the calf muscles on walking. The thigh and buttock muscles may also be involved. After a brief rest the pain resolves and it is possible to walk on again. The distance walked along the flat (not up hills) before the pain starts is used as a rough guide to the severity of the condition.  During walking the leg muscles use more oxygen which is supplied by the circulating blood.  If the supply is reduced the oxygen is used up and the muscles become painful. After a rest the oxygen levels return to normal and it is possible to walk again.

With the above symptoms and an examination of the pulses in the leg (weak or absent) it is often possible to diagnose claudication without any tests.   The blood pressure in the legs can be measured with doppler, at rest and after walking on a treadmill, to confirm the diagnosis.

TREATMENT.

The most important part of the treatment is to make sure your arteries do not get any worse. Atherosclerosis not only affects the arteries in your leg, but also those to your heart causing heart attacks, and your brain causing strokes. If you smoke it is vital that you stop altogether. You will be tested for diabetes, high blood pressure and raised cholesterol. These may require you to go on a diet or start some medication if you are not already on treatment.  If you are overweight, losing weight will help your arteries and enable you to walk further. Lastly, it has been shown that taking a small dose of aspirin (75 mgs) once a day also helps the arteries.

Regular exercise is good for the legs.  Although walking can be frustrating because of the frequent stops when the legs are painful, it is important to persist and try to walk each day, increasing the distance as the legs improve. Do not try to “walk through the pain”. Over a period of  3 – 6 months the muscles in the legs will become more efficient enabling you to walk further on the limited blood supply. In addition the blood flow in the leg will increase as smaller undiseased arteries increase in size. It is uncommon for the legs to get worse. Many patients are worried they may lose their leg but with the above treatment this is extremely unlikely and not a cause for concern.

If the claudication remains troublesome then you will need an ultrasound scan of the leg or an angiogram to see exactly where the narrowings or blockages in the arteries are.

ANGIOGRAM: this can be performed with a CT or MRI scan with some dye injected into the bloodstream, which allows the scan to highlight the arteries. If you are allergic to the dye or have reduced kidney function then this investigation may not be appropriate for you or special precautions may need to be taken.

Some narrowings and blockages in your arteries can be treated by using a balloon to stretch the artery open again.  This is called an angioplasty . In some arteries the results of angioplasty can be improved by also putting a stent inside the artery. This is like an internal sophisticated “scaffold” that holds the artery open. Medication can be attached to the stent to reduce the risk of the stent being narrowed by growth of new tissue into the artery.

If there is a long or very hard blockage in the artery, it may not be possible to get through an perform an angioplasty.  In these circumstances, if the claudication is bad, a bypass operation will be considered and discussed with you. In some cases the risks of surgery are to high and a longer period spent exercising, losing weight etc. . is needed.

Calf pain – causes, treatment and prevention

On this page

What is calf pain?

Pain in the calf (the back part of the lower leg) is usually caused by a cramp or muscle strain. However, sometimes calf pain can be a symptom of something more serious.

What causes calf pain?

Cramp

Calf pain is usually caused by cramp, when the muscles suddenly contract. This might happen if you have been doing new exercises, if you are dehydrated, or if you are deficient in some minerals. Cramps normally go away quite quickly by themselves.

Calf strain

The calf is made up of 2 muscles called the gastrocnemius and the soleus. They meet at the Achilles tendon which is attached to the heel bone.

Overstretching or tearing either of these 2 calf muscles is known as a calf strain. Normally there is a sudden pain in the calf, and you may feel a pop, snap or tear. A calf strain may also mean you experience the following symptoms:

• Sudden pain at the back of the leg.
• The calf is stiff and weak when you walk.
• You find it hard to rise up onto your toes.
• You may have bruising on your calf after 1 or 2 days.

Other possible causes of calf pain include:

• Achilles tendonitis in which the Achilles tendon becomes inflamed.
• sciatica — when you have problems with the sciatic nerve which controls your lower leg
• a bruise due to injury
• diabetic peripheral neuropathy — when you have nerve damage that affects your feet, legs, arms and hand
• deep vein thrombosis (DVT) — when a blood clot forms in the deep veins of the arm or leg. This is a medical emergency. See your doctor immediately if you think you might have DVT (see below)

compartment syndrome — a serious condition

When should I see my doctor?

See your doctor if:

• your calf is swollen
• your calf is unusually cool or pale
• your leg is tingly or numb
• your leg is weak
• you have fluid retention
• your calf is red, warm and tender
• both legs are swollen and you have breathing problems
• your calf is painful during or after walking
• the pain gets worse or doesn’t improve after a couple of days of being treated at home
• you have painful varicose veins

Seek medical attention straight away if you have the symptoms of DVT and you have recently been sitting for a long time, such as on a flight. These include if:

• your calf is swollen
• your leg is painful
• the skin of the calf is red
• your calf feels warm

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How is calf pain treated?

If you have a muscle cramp, gently stretch or massage the muscle.

If you have a calf strain or Achilles tendonitis, you should first of all use the ‘RICE’ method of treatment:

• Rest the area.
• Ice the area for 20 minutes, using a covered icepack or bag of frozen peas.
• Compress the area with a bandage (but if the pain gets worse, loosen the bandage).
• Elevate the lower leg by sitting or lying down (for example with pillows), so it is above the level of the heart.

You can take anti-inflammatory medicines to relieve pain and bring down the swelling. After 48 hours, start stretching and strengthening the muscle, for example by doing heel raises and calf stretches. Don’t return to full physical activity until you can move your ankle and knee properly, the pain and tenderness have gone, and the strength has fully returned to your calf.

Can calf pain be prevented?

Always stretch before and after you exercise to repair and strengthen the calf. Don’t over exercise, and build up gradually if you are starting something new.

Drink plenty of water to avoid cramps. Magnesium supplements have been shown to prevent cramps in some people, especially pregnant women, although the evidence is not conclusive.

If you have diabetes, keep your blood sugar levels under control to prevent diabetic neuropathy.

Leg & Calf Pain – Symptoms, Causes & Treatment

As Chiropractors, Osteopaths and sports therapists, the ProBack team are responsible for more than just back pain but for the mechanical components of the whole body; how they align and interact is key to understanding how any pain evolves including pain in the leg and pain in the calf.

We see many patients whose leg and calf pain is a direct result of nerve compression within the back known as Sciatica, most commonly this involves shooting pain down the leg often extending into the calf, however sometimes the pain occurs as just calf pain without additional symptoms. Often this occurs as sudden calf pain or can be described as a shooting pain in the calf.

Alternative causes for pain in the leg or calf can be brought on by many different things, with symptoms ranging from mild to severe. Often leg and calf pain is caused by a certain activity or a result of a direct injury without obvious causes, yet there may be a more complicated problem related to a bio-mechanical issue as a result of stresses and strains on the body.

Causes of Leg & Calf Pain

Many causes of leg and calf pain are due to localised inflammation; unless a large and unusual force has been exerted on those tissues, then it is likely that it is a repetitive strain that has caused the issue. In these cases, there are likely to be one or more additional mechanical issues in the chain from lower back to the foot that are causing dysfunction in the muscle tissues. Causes of leg or calf pain can include:

Dropped or dysfunctional arches (flat feet) can happen as a result of the arches not forming properly or becoming stiff due to the overwhelming strain caused by walking on hard surfaces like concrete. Local inflammation of tissue in the foot is often known as plantar fasciitis – which we can treat by mobilising the joints in the feet and giving the correct advice on footwear and potentially orthotics.

Muscle strains very commonly affect the legs or calves, usually as a result of an excessive force damaging the tendons around joints. If you have a muscle strain you may have swelling or pain in and around the joint area where the muscles connect into the bones; you my experience stiffness in the leg when trying to move the area.

This condition is particularly common in athletes, as the ankle and knee absorb force constantly during strenuous activity. You may get ankle or knee tendinitis as a result of weaker muscles in the legs, for example the hamstrings or thigh muscles, as this puts greater stress and strain on the knee and ankle.

Baker’s Cysts commonly occur from arthritis in the knee or from a sports injury, it is a form of swelling behind the knee. While this can originally cause pain in the knee, if a Baker’s Cyst ruptures this causes swelling and a sharp pain in the calf.

This condition can affect ‘compartments’ in the body, for example the leg or arm, and usually happens because of a sudden trauma, like a road accident. Trauma can result in bleeding and swelling within the muscles and can cause symptoms such as severe pain, tenderness or tightness. While acute compartment syndrome may need surgical intervention, chronic compartment syndrome can cause cramping or swelling during exercise which can improve with rest.

Shin splints can, again, occur as a result of injury from exercise as a result of more intense weight bearing on the legs. Examples of intense weight bearing include; running on a hard surface, or rapidly increasing training distances over a short space of time. The pain can vary in severity from a dull ache to more severe pain during exercise and occurs over the shinbone.

• Lower back or neck misalignment

Lower back or neck misalignment can cause referred pain into the legs, this can be as a result of overcompensating with the legs during load bearing, or from a disc injury that may be causing symptoms such as sciatica. This can cause sensations such as pain down the back of one or both legs, weakness, tingling or pins and needles.

Leg Pain

Is this your child’s symptom?

• Pain in the legs (hip to foot)
• Includes hip, knee, ankle, foot and toe joints
• Includes minor muscle strain from overuse
• Muscle cramps are also covered
• The pain is not caused by an injury

Causes

• Main Causes. Muscle spasms (cramps) and strained muscles (overuse) account for most leg pain.
• Muscle Cramps. Brief pains (1 to 15 minutes) are often due to muscle spasms (cramps). Foot or calf muscles are especially prone to cramps that occur during sports. Foot or leg cramps may also awaken your child from sleep. Muscle cramps that occur during hard work or sports are called heat cramps. They often respond to extra fluids and salt.
• Muscle Overuse (Strained Muscles). Constant leg pains are often from hard work or sports. Examples are running or jumping too much. This type of pain can last several hours or up to 7 days. Muscle pain can also be from a forgotten injury that occurred the day before.
• Growing Pains. 10% of healthy children have harmless leg pains that come and go. These are often called growing pains (although they have nothing to do with growth). Growing pains usually occur in the calf or thigh muscles. They usually occur on both sides, not one side. They occur late in the day. Most likely, they are due to running or playing hard. They usually last 10 to 30 minutes.
• Low Calcium Level. Low calcium and vitamin D levels can cause minor bone pains. Pain is mainly in the legs and ribs. Children on a milk-free diet are at risk.
• Osgood Schlatter Disease. Pain, swelling and tenderness of the bone (tibia) just below the kneecap. The patellar tendon attaches to this bone. Caused by excessive jumping or running. Peak age is young teens. Harmless and goes away in 1 – 2 years.
• Viral Infections. Muscle aches in both legs are common with viral illness, especially influenza.
• Serious Causes. Fractures, deep vein thrombosis (blood clot in leg). Also, neuritis (a nerve infection) and arthritis (a joint infection).
• Septic Arthritis (Serious). A bacterial infection of any joint space is a medical emergency. The symptoms are severe joint pain, joint stiffness and a high fever.
• Toxic Synovitis of the hip is a harmless condition. It can imitate a septic arthritis of the hip. The symptoms are a limp, moderate pain and usually no fever. Toxic synovitis tends to occur in toddlers after jumping too much.

Pain Scale

• Mild: Your child feels pain and tells you about it. But, the pain does not keep your child from any normal activities. School, play and sleep are not changed.
• Moderate: The pain keeps your child from doing some normal activities. It may wake him or her up from sleep.
• Severe: The pain is very bad. It keeps your child from doing all normal activities.

When to Call for Leg Pain

Call 911 Now

• Not moving or too weak to stand
• You think your child has a life-threatening emergency

Call Doctor or Seek Care Now

• Fever and pain in one leg only
• Can’t move a hip, knee or ankle normally
• Swollen joint
• Calf pain on 1 side lasts more than 12 hours
• Numbness (loss of feeling) lasts more than 1 hour
• Severe pain or cries when leg is touched or moved
• Your child looks or acts very sick
• You think your child needs to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

• Walking is not normal (has a limp)
• Fever and pain in both legs
• Bright red area on skin
• You think your child needs to be seen, but the problem is not urgent

Contact Doctor During Office Hours

• Cause of leg pain is not clear
• Leg pain lasts more than 7 days
• Leg pains or muscle cramps are a frequent problem
• You have other questions or concerns

Self Care at Home

• Muscle cramps in the calf or foot
• Strained muscles caused by overuse (exercise or work)
• Growing pains suspected
• Cause is clear and harmless. (Examples are tight new shoes or a recent shot)

Seattle Children’s Urgent Care Locations

If your child’s illness or injury is life-threatening, call 911.

Care Advice for Leg Muscle Cramps, Strains, Growing Pains

1. What You Should Know About Leg Pain:
   • Strained muscles are common after too much exercise or hard sports.
   • Examples are hiking or running.
   • Weekend warriors who are out of shape get the most muscle pains.
   • Here is some care advice that should help.
2. Muscle Cramps Treatment:
   • Muscle cramps in the feet or calf muscles occur in a third of children.
   • Stretching. During attacks, stretch the painful muscle by pulling the foot and toes upward. Stretch as far as they will go to break the spasm. Stretch in the opposite direction to how it is being pulled by the cramp.
   • Cold Pack. Use a cold pack. You can also use ice wrapped in a wet cloth. Put it on the sore muscle for 20 minutes.
   • Water. Heat cramps can occur with hard sports on a hot day. If you suspect heat cramps, have your child drink lots of fluids. Water or sports drinks are good choices. Continue with stretching and using a cold pack.
   • Prevention. Future attacks may be prevented by daily stretching exercises of the heel cords. Stand with the knees straight. Then, stretch the ankles by leaning forward against a wall. Place a pillow under the covers at the foot of the bed at night. This gives the feet more room to move at night. Also, be sure your child gets enough calcium in the diet. Daily vitamin D3 may also help.
3. Strained Muscles from Overuse – Treatment:
   • Pain Medicine. To help with the pain, give an acetaminophen product (such as Tylenol). Another choice is an ibuprofen product (such as Advil). Use as needed.
   • Cold Pack. For pain or swelling, use a cold pack. You can also use ice wrapped in a wet cloth. Put it on the sore muscles for 20 minutes. Repeat 4 times on the first day, then as needed. Caution: Avoid frostbite.
   • Heat Pack. If pain lasts over 2 days, put heat on the sore muscle. Use a heat pack, heating pad or warm wet washcloth. Do this for 10 minutes, then as needed. Caution: Avoid burns. For stiffness all over, use a hot bath instead. Move the sore leg muscles under the warm water.
4. Growing Pains Treatment:
   • Most often, the pains are mild and don’t last long. No treatment is needed.
   • Massage. Rub the sore muscles to help the pain go away.
   • Pain Medicine. If the pain lasts more than 30 minutes, give a pain medicine. You can use either acetaminophen (such as Tylenol) or ibuprofen (such as Advil). Use as needed.
   • Prevention. Research has shown that daily stretching can prevent most growing pains. Stretch the quads, hamstrings and calf muscles. Also, be sure your child gets enough calcium and vitamin D in their diet.
5. What to Expect:
   • Muscle cramps usually last 5 to 30 minutes.
   • Once they go away, the muscle returns to normal quickly.
   • A strained muscle hurts for 3 to 7 days. The pain often peaks on day 2.
   • Following severe overuse, the pain may last a week.
6. Call Your Doctor If:
   • Muscle cramps occur often
   • Fever, limp, or a swollen joint occurs
   • Pain caused by work or sports lasts more than 7 days
   • You think your child needs to be seen
   • Your child becomes worse

And remember, contact your doctor if your child develops any of the ‘Call Your Doctor’ symptoms.

Last Reviewed: 10/14/2021

Last Revised: 09/30/2021

Copyright 2000-2021. Schmitt Pediatric Guidelines LLC.

Leg cramps causes & treatment – Illnesses & conditions

Leg cramps are a common and usually harmless condition where the muscles in your leg suddenly become tight and painful.

It usually occurs in the calf muscles, although it can affect any part of your leg, including your feet and thighs.

After the cramping has passed, you may have pain and tenderness in your leg for several hours.

Three out of four cases occur at night during sleep.

Read more about the symptoms of leg cramps.

What causes leg cramps?

Leg cramps can occur for no apparent reason, known as idiopathic leg cramps, or as a symptom or complication of a health condition, known as secondary leg cramps.

Causes of secondary leg cramps can include:

• pregnancy
• exercise 
• certain types of medication, such as statins (medicines that help lower cholesterol levels)
• liver disease

During a cramp, your muscles suddenly contract (shorten), causing pain in your leg. This is known as a spasm, and you cannot control the affected muscle.

The cramp can last from a few seconds to 10 minutes. When the spasm passes, you will be able to control the affected muscle again.

Read more about the causes of leg cramps.

When to see your GP

Speak to your GP if your leg cramps are affecting your quality of life; for example, if you have frequent leg cramps or they are interfering with your sleep.

Your GP will ask about your symptoms and examine your legs and feet. They may also ask if you have other symptoms, such as numbness or swelling, which may be a sign that you have secondary leg cramps caused by an underlying condition.

In this case, you may need further tests, such as blood tests and urine tests, to rule out other conditions.

Treating leg cramps

Most cases of leg cramps can be relieved by exercising the affected muscles. Exercising your legs during the day will often help reduce how often you get cramping episodes.

Stretches

To stretch your calf muscles, stand with the front half of your feet on a step, with your heels hanging off the edge. Slowly lower your heels so that they are below the level of the step. Hold for a few seconds before lifting your heels back up to the starting position. Repeat a number of times.

Medication is usually only needed in the most persistent cases where cramping does not respond to exercise.

If you have secondary leg cramps, treating the underlying cause may help relieve your symptoms.

Leg cramps that occur during pregnancy should pass after the baby is born.

Treating cramps that occur as a result of serious liver disease can be more difficult. Your treatment plan may include using medications such as muscle relaxants.

Read more about treating leg cramps

Preventing leg cramps

If you often get leg cramps, regularly stretching the muscles in your lower legs may help prevent the cramps or reduce their frequency.

You might find it useful to stretch your calves before you go to bed each night (see stretching advice above or try this post-exercise calf stretch).

The following night-time advice may also help:

• If you lie on your back, make sure that your toes point upwards – placing a pillow on its side at the end of your bed, with the soles of your feet propped up against it may help keep your feet in the right position. 
• If you lie on your front, hang your feet over the end of the bed – this will keep your feet in a relaxed position and help stop the muscles in your calves from contracting and tensing.
• Keep your sheets and blankets loose.

​Calf problems – Muscle, bone and joint injuries

Calf problems can cause a range of symptoms including pain, bruising, tightness and stiffness.

In many cases, new or flare-up of long-standing calf problems should begin to settle within 6 weeks without the need to see a healthcare professional.

When to seek help

Speak to a healthcare professional as soon as possible if:

• your calf is hot, swollen or tender and tense to touch – especially if you can’t recall an injury
• you can’t put any weight through your leg
• you can’t lift your heel off the floor

What causes calf muscle problems?

Calf problems are usually caused by injuries such as tripping, direct hit or sporting activities.

There are other less common causes of calf problems – such as back problems or circulatory complaints.

Can this cause problems anywhere else?

You may feel some pain in the muscles around your knee, ankle or foot. This should improve as your calf problem gets better.

Occasionally, problems felt in your calf can be due to a back problem – even though you do not feel pain in your back. People with this sort of problem often describe the pain as pins and needles, sharp, hot or burning pain, usually in the back of the calf.

If you experience these for longer than 6 weeks, you may need to speak to a healthcare professional.

Self-help

Keeping active is an essential part of your treatment and recovery and is the single best thing you can do for your health.

Being physically active can:

• maintain your current levels of fitness – even if you have to modify what you normally do, any activity is better than none
• keep your other muscles and joints strong and flexible
• prevent a recurrence of the problem
• help you aim for a healthy body weight

Avoid sports or heavy lifting until you have less discomfort and good movement. Remember to warm up fully before you start sporting activities.

Exercises to help with knee problems

Resting or moving?

Within the first 24 to 48 hours after a calf injury you should try to:

• rest your calf but avoid long spells of not moving at all
• move your ankle and knee gently for 10 to 20 seconds every hour when you are awake

After 48 hours:

• try to use your leg more – exercise really helps your calf and can relieve pain
• do whatever you normally would and stay at, or return to work – this is important and is the best way to get better
• lead with your good leg when going upstairs to reduce the strain on your calf
• lead with your problem leg when going downstairs to reduce the strain on your calf
• use a handrail (if available) when going up and downstairs

Pain treatments

Pain medication can help to reduce the pain and help you move more comfortably, which can help your recovery.

Speak to your community pharmacist or other healthcare professional about taking medication or other methods of pain relief. It’s important to take medication regularly.

More about taking painkillers

Work

It’s recommended you stay at or return to work as quickly as possible during your recovery. You don’t need to be pain and symptom-free to return to work.

Help and support

If your calf problem hasn’t improved within 6 weeks of following this advice, it’s a good idea to talk to a healthcare professional about your symptoms.

Leg Pain: When to Worry

What’s most important about having peripheral artery disease (PAD) isn’t the PAD itself — it’s what it says about your risk for other, life-threatening conditions.

Cynthia Shortell, MD, head of vascular surgery at Duke, says that being diagnosed with PAD means one thing for certain: You’ve got atherosclerosis — otherwise known as hardened arteries. “And you should definitely seek treatment and evaluation for that,” she said, as it’s a major risk factor for heart disease and stroke.

But she says that PAD is not, in and of itself, a condition that requires aggressive treatment in all people. Choosing treatment (or not) often depends on how much your symptoms interfere with your life.

In those with mild to moderate symptoms, Dr. Shortell says three therapies are most often recommended:

• Smoking cessation: Better blood flow in the limbs is one of many benefits to smokers who quit.
• An exercise routine: This can be as simple as a daily walk. Exercise is a very effective way to build new vessels and improve circulation — when the routine is maintained, of course.
• Medications: These can be useful for some patients, but they do have important side effects that should be weighed carefully with your physician.

For people with severe symptoms — persistent, debilitating leg pain or wounds that won’t heal — surgical procedures can open up the blocked veins. These are similar to the procedures used to open blood vessels in patients with advanced heart disease: opening a blocked vein by placing a balloon or stent into the vessel, or performing a bypass using a vein taken from the patient’s thigh.

Dr. Shortell says that for most patients with claudication, deciding to have one of these surgical procedures is not unlike the decision to have knee replacement surgery. “It’s a quality-of-life decision,” she said.

The effects are long-lasting, but not permanent — so in younger patients, or patients who have health problems that may require a bypass surgery later on, physicians often advise delaying extensive surgical treatment for as long as possible.

“We usually reserve bypass for very severe cases, such as those where, if you don’t do something, the patient may lose his leg,” said Dr. Shortell. But she notes that very few people — fewer than 5% — will actually lose a limb due to PAD. Diabetes, kidney disease, and smoking are the main reasons that PAD could become a limb- and life-threatening condition.

90,000 Pain in the calves, pain in the calves. Causes of pain.

Pain in the calves of the legs is common. Often it occurs as a result of prolonged physical exertion on the lower extremities and does not signal pathologies. However, the answer to the question “Why do calves hurt?” not always unambiguous, since the reasons may lie in very serious diseases. This applies to those cases when sharp pain and cramps are repeated regularly or a pulling pain in the leg in the calf does not go away for a long time.

If you are faced with a similar problem, we recommend contacting the CELT Pain Clinic! This is a unit that specializes in the diagnosis and treatment of pain syndromes in various locations. The high professional level of our specialists, their extensive experience, along with modern medical equipment and treatment methods, allows them to return our patients to a full life, excluding pain from it.

At CELT you can get advice from a specialist algologist.

• Initial consultation – 4 000
• Initial consultation of the head of the Pain Clinic – 4 500

Make an appointment

Causes of calf pain

The causes of pain in the calves of the legs may lie in muscle overwork, but often such a clinical manifestation can signal pathologies of arterial vessels, veins, tissues, surrounding muscles and the spine. If you constantly have pain in the calf of your left or right leg, or you regularly have cramps in your legs, you need to seek medical help, since the consequences can be unpredictable.

Diseases of veins

Pain symptom in venous diseases is a valuable signal, because it is thanks to it that serious pathologies can be identified that require immediate medical attention:

• Varicose veins – characterized by persistent pain in the calf muscles, which is felt in the afternoon and accompanied by swelling of the ankles. This disease can also be determined visually, since visible enlargements of the veins appear on the lower extremities.The reason that the calf of the right or left leg hurts, in this case, is the development of leg edema, as a result of which the nerve endings are compressed;
• Acute venous thrombosis – requires immediate treatment, since blood clots that form in deep veins can enter the vessels of the pulmonary circulation and clog arteries, leading to pulmonary embolism, which is often fatal. Pain in the affected calf covers the inner surface of the lower leg and spreads up to the thigh and down to the foot.They are accompanied by swelling of the lower leg, a feeling of heaviness in the legs and increased pain when trying to bend the foot.

More about venous thrombosis

Diseases of the arteries

Diseases of the arteries cause insufficient supply of oxygen and nutrients to tissues, which leads to their destruction. Pain in this case is caused by ischemia (lack of blood supply) and is different for different diseases:

• Acute obstruction of arterial vessels – characterized by acute pain with a burning sensation, which is accompanied by edema of the affected leg and its cold snap;
• Chronic arterial insufficiency – characterized by two types of pain: attacks with acute ischemia and constant pain due to chronic insufficiency of blood supply. Both types of pain can be accompanied by seizures, muscle atrophy, ulceration, and gangrene.

Muscle diseases

Muscular tissue lesions of various etiologies can also cause pain in the calves:

• Inflammatory processes of the gastrocnemius muscles (myositis) – characterized by pulling aching painful sensations that do not stop or occur in seizures and appear brighter with movements;
• Parasitic diseases (in particular – trichinosis) – characterized by muscle pain, accompanied by swelling of the face, fever, nausea, vomiting, diarrhea.

More about myositis

Damage to nerve fibers

One of the symptoms of neuritis and polyneuritis is severe pulling pain, which occurs in attacks and can spread along the affected nerve. This manifestation can be caused by compression of the nerve roots. Often, its companions are:

• trophic disorders in the innervated (ie, in the organs and tissues supplied with nerves) area;
• Feeling of numbness, tingling, or creeping;
• movement disorders in the innervated area;
• desensitization.

Other reasons

Pain in the calves of the legs may occur due to damage to adjacent tissues:

• osteomyelitis of the tibia;
• knee joint diseases;
• diseases of the ankle joint;
• skin inflammation.

Reflected pain in the calves of the lower extremities is one of the symptoms of osteochondrosis of the lumbar spine.

Diagnosis of pain in the calves of the legs

Special attention in the CELT Pain Clinic is given to carrying out diagnostic studies that allow to accurately establish the cause of pain in the calves.In addition to examination by a doctor and taking an anamnesis, the following diagnostic methods can be used:

Calf pain treatment

Treatment of pain in the calf muscles in our Pain Clinic often begins with the elimination of painful symptoms, if they are pronounced. Systemic therapy involves taking pills or intravenous injections according to an individually designed scheme. The process involves modern drugs that inhibit the transmission of pain sensations along the nerves or block their perception in the central nervous system.

In addition, all efforts of our specialists are aimed at eliminating the cause due to which it arose. The treatment technique is developed after all diagnostic studies have been carried out and the diagnosis has been correctly made. It takes into account the individual characteristics of the patient’s body and the root cause of the disease.

Thus, acute vascular pathologies often require urgent surgical intervention; in chronic forms, conservative treatment is carried out in a hospital.If it does not bring the desired results, surgical correction of the vascular defect can be performed.

Surgery is also indicated for diseases of the spine: neoplasms, prolapse of discs with severe neurological disorders.

Get treatment at the CELT Pain Clinic and return to your usual way of life!

90,000 Calf pain: differential diagnosis

The article presents the differential diagnosis of pain in the calf muscle, developing as a result of chronic venous insufficiency, acute venous insufficiency, chronic arterial insufficiency, acute arterial insufficiency, osteochondrosis, osteoarthritis, polyneuropathy, dermatomyitis , fibromyalgia, muscle injury.

Pain in the calf muscle (calf) is a universal symptom that can be observed with a large number of diseases.

The main muscle mass of the posterior surface of the leg (calf) is formed by two muscles – the superficial gastrocnemius muscle and the deeper soleus muscle. The tendons of these muscles join together and attach to the heel bone to form the so-called. Achilles tendon. The calf muscles provide movement in the ankle joint (flexion and extension), which is necessary for walking, maintaining body balance in an upright position and shock absorption during movement.
The arterial blood supply to the gastrocnemius muscle comes from its own arteries originating from the popliteal artery. Venous outflow is carried out along the veins accompanying the arteries, which in the thickness of the muscle form wide cavities lined with endothelium – the sural sinuses. The above muscles are innervated from the tibial nerve (L3-4).

Chronic venous insufficiency.

Today, three main components are distinguished in the genesis of pain in chronic venous diseases: distal, ischemic and inflammatory.

Distortion component arises due to hyperextension of the venous wall with excess blood in violation of the mechanisms of its outflow. Such disorders can be a consequence of dysfunction of the musculo-venous pump, which plays a leading role in ensuring venous outflow in the upright position of the body. Stagnation of blood in the veins of the leg can occur as a result of a decrease in the activity of the muscles of the calf, for example, due to prolonged stay in a motionless vertical or sitting position, as a result of damage to the valve apparatus of superficial (varicose veins) or deep (post-thrombotic syndrome) veins, which is accompanied by a violation of the normal centripetal blood flow and its throwing into the distal sections with each muscle contraction (reflux), as well as with damage to the corresponding muscles and adjacent joints. Such pain often occurs after prolonged static loads and is easily relieved by resting at night and / or by giving the limbs an elevated position.

The inflammatory component is a reflection of the currently accepted concept of leukocyte aggression as a leading component of the pathogenesis of chronic venous diseases. Its essence lies in the fact that with a decrease in the venous outflow rate and the appearance of signs of venous stasis in the veins of the leg, leukocyte-endothelial interaction occurs with the expression of co-branched adhesive molecules on the cell surface, which leads to the migration of white blood cells into the thickness of the vascular wall and their degranulation.Released free oxygen radicals, proteolytic enzymes and cytokines not only have a damaging effect on the structural components of the venous wall, primarily the collagen framework, but also activate myelin-free C-nociceptors responsible for the transmission of pain impulses. Thus, the inflammatory component of venous pain reflects not only stagnation of blood in the veins of the leg, but also the process of active development of chronic venous diseases, which can eventually lead to the appearance of varicose transformation. The addition of the inflammatory component makes the venous pain more persistent and not relieved by the elevated position of the limb and night rest.

The ischemic component is associated with severe inflammatory changes in the venous wall with desolation of the vasa vasorum, which leads to a serious morphological restructuring of the affected veins. It should be assumed that the ischemic component occurs in severe forms of chronic venous diseases and can provide constant pain of the varicose nodes themselves.

Classic pain in venous insufficiency is of a dull, bursting character, increases after a long stay in a standing or sitting position, decreases or completely disappears after a night’s rest or giving the limb an elevated position. Often, pain is accompanied by transient edema of soft tissues in the lower third of the lower leg and cramps of the gastrocnemius muscle at night.

Acute venous insufficiency – deep vein thrombosis of the leg. As a result of a sudden obstruction of venous outflow from the lower extremities and the development of acute venous plethora, very intense constant bursting pains in the gastrocnemius muscle can be observed, slightly decreasing when the limb is elevated, accompanied by an increase in muscle volume and its compaction, skin cyanosis and an increase in the subcutaneous vascular pattern.The severity of symptoms will depend on the localization of thrombosis – the more veins are involved in the process, the more acute the manifestations will be. With isolated thrombosis of the sural sinuses, moderate intensity, well-localized pains can be observed, aggravated by plantar flexion of the ankle joint and by pressure on the site of the projection of the sinus onto the skin.

Chronic arterial insufficiency develops as a result of arterial occlusion by an atherosclerotic or autoimmune-inflammatory process.In such cases, the muscles experience oxygen starvation, switch to the anaerobic metabolic pathway, which leads to the accumulation of acidic products that irritate pain receptors. In case of arterial insufficiency, pain in the calf muscles is observed when walking and forces a person to stop (“intermittent claudication” syndrome), at the initial stages of the process at rest, pain does not bother. The pains are accompanied by coldness of the extremities, chilliness, the skin becomes pale, flaky, easily vulnerable, hair is lost.As the disease progresses, muscles and subcutaneous tissue become thinner.

Acute arterial insufficiency – sudden blockage of the arteries due to its thrombosis or embolism leads to acute limb ischemia. In this case, pain in the gastrocnemius muscle will be observed at rest, be intense, accompanied by impaired sensitivity and motor function up to the development of paralysis and muscle contracture.

Osteochondrosis of the lumbar spine (radicular syndrome) is the second most common cause of pain in the calf muscles.It is based on the compression of the spinal nerve root in the place of its exit from the spinal canal. The result is projected pain in the place where the nerve fibers go – including the calf. In this case, pain can be associated with both compression of the nerves and the generation of pain impulses in them, and with tonic muscle contraction and the subsequent development of fibro-dystrophic changes in muscle tissue. In radicular syndrome, pain is associated with certain movements and changes in body position (for example, tilting the body forward, to the sides, flexion of the limb in the hip joint).As a rule, pain increases with prolonged stay in a provocative position and decreases after a warm-up, physiotherapy exercises, massage, and thermal effects. With muscular-tonic syndrome, it is possible to detect areas of increased tone in the water of dense painful foci in the muscle tissue. Over time, the muscle can diffusely thicken due to the development of fibrotic changes in it. Subsequently, in connection with a violation of autonomic innervation, the addition of a stagnant (vasodilation) or ischemic (vasoconstriction) component of the pain syndrome may occur.

Peripheral polyneuropathy can be a complication of diabetes mellitus, a consequence of the toxic effects on the body of ethyl alcohol, etc. weakness and decreased skin and (primarily) vibration sensitivity. In this case, the pain can be very intense.The defeat of the autonomic nerves can lead to trophic disorders and the attachment of the vascular component of the pain syndrome.
Tibial neuritis is characterized by paroxysmal pain arising along the nerve fibers. Moreover, in the intervals between attacks, pain is completely absent.

Pathology of the knee joints – primarily osteoarthritis – is characterized by pain in the periarticular region during exercise. The pains are localized mainly in the area of ​​the anterior and inner surfaces of the knee joint, and are aggravated by prolonged stay in an upright position of the body, with long walking.Increased pain is especially characteristic when climbing and especially descending stairs. At the initial stages of the disease at rest, the pain completely disappears (and it is not required to give the limb an elevated position). With the development of active inflammation, pain at the beginning of movement and morning stiffness in the joints may appear. In the process of the development of the disease, it is possible to add the muscular-tonic component of the pain syndrome, in which the gastrocnemius muscle is in constant tension and becomes dense and painful on palpation.With the accumulation of effusion in the joint cavity, limited accumulations of it can form in the volvulus of the joint capsule – Becker’s cysts, which can aggravate pain syndrome, squeeze nerves and veins with the development of a neuropathic and vascular component.

Dermatomyositis, polymyositis – autoimmune inflammation of muscle tissue, characterized by constant dull persistent pain, aggravated by movements in the ankle joint, in combination with muscle weakness and symptoms of intoxication.The muscles become swollen, painful on palpation, over time, they can be compacted, heaviness, nodularity, fibrosis, the formation of calcifications up to complete atrophy. In autoimmune diseases, as a rule, lesions of other organs and systems are detected, primarily the skin: erythema and edema of the periorbital region, scaly erythema of the fingers and hands, redness of the periungual ridges, foci of hyperpigmentation-depigmentation of the skin – with dermatomyositis; edema-induration-atrophy of the skin with scleroderma, erythema on the face, kidney damage, heart damage with lupus, etc.Meanwhile, the defeat of the gastrocnemius muscles in autoimmune myositis is rare.

Myositis can also be a manifestation of cancer, parasitic diseases (trichinosis, toxoplasmosis, cysticercosis) or be a complication of a cold, injury or overstrain of the gastrocnemius muscle.

Fibromyalgia , a chronic autoimmune disease of muscle tissue, is rarely accompanied by isolated pain in the calf muscles. Intense persistent pain and severe muscle weakness in the proximal muscles of the girdles of the extremities are more common.There is also prolonged morning stiffness, and soreness at specific points on palpation.

Overstrain, stretching, muscle rupture can be accompanied by severe intense pain in the damaged area, sharply increasing when trying to move. The phenomena of inflammation (myositis) can join.

Added July 24, 2014

Leg Pain | Dikul center

Minor pain in the muscles of the legs is quite common.Foot problems most often occur when playing sports, when working with stress on the legs or household chores. In addition, injuries are a common cause of leg pain. Problems in the legs can be minor or, on the contrary, serious and manifest such symptoms as: pain, swelling, cramps, numbness, tingling, muscle weakness or changes in temperature, skin color. Symptoms often appear after exercise, daily exercise, and excessive exertion. People in the older age group are more prone to developing leg problems, as muscle loss occurs over the years.In childhood, foot problems can be caused by similar factors, as in adults, or be specific.

The causes of leg pain are divided into two groups: traumatic and non-traumatic.
By localization – pain in the hip, buttocks, pain in the lower leg and pain in the foot.
The main and most common causes of leg pain.

• Injuries associated with excessive exercise or repetitive movements (bursitis, tendonitis, plantar fasciitis).
• Muscle cramps.
• Schlatter’s Disease – Osgood
• Juvenile idiopathic arthritis
• Growth pain
• Medicines (side effects)
• Restless legs syndrome
• Transient ischemic attacks or stroke
• Obliterating peripheral arterial disease
• Venous thrombosis.
• Pregnancy
• Muscle Stretch
• Ruptured muscle
• Injury of muscle or lower limb
• Bone affection
• Popliteal cyst rupture (Baker’s cyst)
• Joint diseases (osteoarthritis, SLE, rheumatoid arthritis, arthrosis)
• Varicose veins
• Obesity
• Night Crumpies
• Fibromyalgia
• Infection
• Neurogenic pains (disc herniation, stenosis, disc protrusion, lumbosacral radicululitis)
• Diabetic polyneuropathy

Muscle cramps

Muscle cramps (cramps) are violent, painful muscle contractions and hardening that occur suddenly, lasting from a few seconds to several minutes.Muscle soreness may persist for several hours after the constriction episode (convulsions) stops. They usually go away on their own and do not require special treatment.

The cause of the onset of seizures is not always possible to find out. Muscle cramps can occur with various conditions or types of physical activity such as:

• Exercise, injury or overuse of muscles. A muscle with fatigue, with poor elasticity or an incorrect load vector, can give a cramp.
• Exercise-related dehydration during hot weather can cause heat cramps. In addition, with various conditions (vomiting, diarrhea or lack of water), there may also be convulsions.
• Pregnancy. Pregnancy cramps can occur due to a decrease in the amount of minerals in the body, such as calcium and magnesium, especially in the last months of pregnancy (when the formation of the musculoskeletal system of the fetus is completed).
• Exposure to cold temperatures, especially when immersed in cold water.
• Certain diseases (peripheral arterial occlusive disease, kidney disease, thyroid disease) multiple sclerosis, etc.
• Medications – Some medications can cause seizures (antipsychotics, diuretics). In any case, if there are recurrent episodes of seizures, you should see your doctor.

Osgood’s Disease – Schlatter

Osgood-Schlatter disease (sometimes also called Schlatter disease or osteochondrosis of the tibial tuberosity) is an inflammation in the upper part of the tibia where the patellar tendons attach to a tubercle called the tibial tuberosity.This disease is often the cause of knee pain in adolescence (from 10 to 15 years), is associated with the growth of the musculoskeletal system, and as the growth completes, the symptoms may disappear.

Osgood-Schlatter disease can present with pain, swelling and tenderness in the front of the knee, below the kneecap. As a rule, one knee is affected (sometimes on both sides). Symptoms worsen with stress on the tendon attached to the tibial tuberosity (eg, jumping).Diagnosis is by radiography. The main objective of treatment is aimed at preventing symptoms (reducing certain types of stress, immobilization during exacerbation, physiotherapy). Surgical treatments are rarely used.

Juvenile idiopathic arthritis

Juvenile idiopathic arthritis, often referred to as juvenile rheumatoid arthritis or juvenile chronic arthritis, is a childhood disease characterized by inflammation of the joints that become swollen and painful (with impaired joint mobility).It manifests itself in children with joint pain, gait disturbance, due to decreased mobility in the joints and stiffness in the joints, usually in the morning, with regression within 1-1.5 hours and after normal physical activity. The causes of this disease are not fully understood. Most researchers believe that the disease is caused by a combination of factors that cause the over-activation of the immune system. There are several types of juvenile arthritis. The division into types is based on the number of joints involved in the process during the first 6 months from the onset of the disease, the area of ​​the body where the disease manifested itself, the presence of other symptoms.Types of juvenile arthritis: oligoarthritis (damage to no more than 4 joints) polyarthritis (damage to 5 or more joints), rheumatic-positive and rheumatic-negative (depending on the presence of rheumatic factor in the blood), systemic (accompanied by rashes throughout the body, fever and damage eye).

Growth pain

Pain in the legs occurs with growing pains and is often found in children and adolescents. Most likely, pain manifestations are associated with uneven growth of muscles, bones and soft tissues.Pain, as a rule, is localized in the thighs or calf muscles and usually appears in the afternoon. The duration of pain can be 1-2 hours. Growth pain is not accompanied by other symptoms (fever, swelling). Over time, the symptoms disappear on their own. massage and sometimes paracetamol. Aspirin under 20 years of age is not recommended due to the possibility of Reye’s syndrome.

Medicines

Some medications can cause leg problems due to side effects.Combining with smoking or drinking alcohol increases the risk of medication side effects. The main groups of drugs that can cause problems in the legs:

• Drugs that provoke blood clots (e.g. contraceptives)
• Antipsychotics (chlorpromazine, haloperidol)
• Beta-2 receptor agonists (terbutaline or albuterol)
• Antihypertensive drugs (nifedipine, amlodipine or nicardipine)
• Statins are drugs that lower blood cholesterol levels (simvastatin or atorvastatin).
• Estrogens
• Lithium preparations
• Diuretics (lasix and others)
• Opiates
• Steroids

In the presence of medication (especially long-term), it is necessary to inform the attending physician about the appearance of pain or cramps in the legs.

Restless legs syndrome

Restless legs syndrome is a condition in which the patient experiences discomfort from the position of the legs and, sometimes, an irresistible urge to move the legs.This syndrome can lead to sleep disturbances and interfere with daily life.

Patients describe their sensations as touching needles in the legs, sometimes as pulling pains. Changing the position of the legs brings temporary relief. Most often, these sensations occur in the evening when a person is trying to relax or go to bed. The cause of this syndrome is not known. Certain medications (such as antidepressants), pregnancy or iron deficiency (anemia) can cause this syndrome. Restless legs syndrome is treated with drugs that increase dopamine levels in the brain (levodopa) or anticonvulsants (gabapentin) to control leg movements and improve sleep.Opiates are rarely used.

Transient ischemic attacks

Transient ischemic attacks are a temporary disruption of the blood supply to the brain. They are the harbingers of a stroke. The only difference from a stroke is that the symptoms gradually disappear. The following symptoms should be alarming:

• Sudden numbness, tingling and weakness in half of the body or limb
• Gait disorder
• Impaired perception of reality
• Impaired speech
• Severe headache.

Emergency medical attention is required if such symptoms appear

Obliterating peripheral arterial disease

OZPA is a permanent process of narrowing or blockage of the arteries that supply oxygen-rich blood to various organs, including the lower extremities.

The main cause of occlusive lesions of the peripheral vessels of the lower extremities is the accumulation of cholesterol, calcium and other substances on the walls of the arteries (atherosclerosis).The narrowing of the lumen of the artery leads to a decrease in the flow of arterial blood to the muscles of the legs, which is especially evident during physical activity. When the muscle is at rest, the blood supply can be adequate.

The main symptom of obliterating disease of the leg arteries is pain in the calf muscles, thighs and buttocks, which appear after physical exertion (such as climbing a hill or stairs, running, walking). This pain is called intermittent claudication. This usually occurs after a certain amount of movement and disappears after rest.As the disease progresses, symptoms appear with minimal physical exertion. In addition to pain, patients are often worried about: a decrease in muscle strength in the legs and balance, in a standing position, numbness of one leg or two, the appearance of ulcers that slowly heal. Treatment is usually conservative. With a pronounced violation of the blood supply, surgical methods of treatment are indicated.

Venous thrombosis

The occurrence of pain during thrombosis (blockage of a vein by a blood clot) is facilitated by inflammation of the vessel wall or surrounding tissues.In addition, a violation of the outflow can lead to swelling, discoloration of the skin (pallor, cyanosis, redness). Pallor can be found in the early stages of thrombosis of the veins of the ilio-femoral region. Cyanosis is caused by congestive hypoxia and usually occurs when the proximal leg veins are obstructed. Pain in thrombosis can be aching, sharp or dull, intense and moderate. Often, the pain intensifies when walking, carrying weights. Relief of pain, possibly by lying down with raised legs.With thrombosis of superficial veins, diagnosis is not difficult. If there is a suspicion of deep vein thrombosis, then objective research methods are required.

Pregnancy

Pain and soreness in the lower leg (less often in the thigh) may occur during pregnancy. In pregnant women, pain may be accompanied by swelling of the leg and thigh (both one and both limbs). The causes of leg pain in pregnant women are not completely clear. On the one hand, this is due to impaired outflow from the venous network of the lower extremities at the expense of the fetus.On the other hand, a decrease in blood electrolytes contributes to the appearance of muscle cramps, which are one of the sources of pain. Unilateral swelling and pain in the limb may be associated with compression of the iliac artery by an enlarged uterus.

Stretching the muscles

Muscle pain can appear after brisk walking, running, playing sports, walking in poorly fitted shoes. As a rule, discomfort occurs immediately after exercise or after 12-24 hours. Most often, pain is in the legs, sometimes in the thighs.Soreness on palpation is possible. Sometimes there is swelling of the lower leg. If there is a clear connection with physical activity and bilateral pain, then the diagnosis is beyond doubt. In cases where the pain is unilateral, it is necessary to exclude possible venous thrombosis using objective diagnostic methods.

Tearing muscle

Most often, muscle rupture occurs in the lower leg (possibly in the thigh). The rupture occurs as a result of sudden stretching or contraction of the muscle. As a rule, there is a rupture of a small section of the muscle at the point of its connection with the tendon.But there are also large ruptures, up to the separation of the muscle from the tendon or the separation of the tendon. Muscle rupture occurs mainly with a sharp bend of the limb in the direction opposite to the acting force. The rupture is accompanied by acute pain immediately after overuse. For a while, the pain may subside, but as the hematoma grows, the pain will gradually increase. There is swelling in the area of ​​the injured muscle and limitation of the range of motion.

Bone affection

Lesions of the bone tissue of the lower extremities (tumors, subperiosteal hematomas, fractures) may be accompanied by pain, soreness to the touch, and swelling of the extremity.The clinical presentation may be similar to venous thrombosis. It is especially difficult to diagnose a hip fracture in the elderly (often accompanied by swelling of the lower limb). Taking into account involutional changes in the central nervous system (sclerosis of the cerebral vessels), it is sometimes difficult to collect anamnesis in this category of patients. In addition, older people often have a combination of a hip fracture with venous thrombosis.

Rupture of the popliteal cyst (Baker’s cyst)

The fluid contained in the Baker’s cyst, upon rupture (in the case of injury, arthritis or surgery in the knee joint area), can go down into the intermuscular space and cause an inflammatory reaction.This can manifest itself as pain, swelling in the lower leg, tenderness on palpation and resemble a picture of venous thrombosis. Rupture of a Baker cyst can occur without provoking reasons. The diagnosis can be made on the basis of radiography. But a possible combination of cyst rupture and venous thrombosis requires first of all the exclusion of thrombosis.

Diagnostics

First of all, to diagnose the cause of pain, the doctor needs to get answers to a number of questions:

1. Localization of pain
2. Presence of pain in one or two limbs
3. Nature of pain (acute, dull)
4. The dependence of pain on the time of day
5. Dependence of pain intensity on physical activity
6. Ability to reduce pain when lifting legs
7. Other symptoms (fever, weakness, back pain).

In addition, the physician will perform a physical examination (visual examination, palpation, various tests). Instrumental examination methods:

• Laboratory research
• Ultrasound of the vessels of the lower extremities (Doppler ultrasonography of veins and arteries)
• Arteriogram
• Scintigraphy
• MRI
• CT
• Radiography

Treatment

Treatment of leg pain directly depends on the disease and can be either conservative (drug treatment, intra-articular injections, physiotherapy, acupuncture, exercise therapy, orthotics), and operational.The following recommendations can be preventive:

• No smoking
• Do not abuse alcohol
• Monitor blood sugar (if you have diabetes)
• Control cholesterol levels
• During physical exercise, a mandatory warm-up before and sufficient rest after exercise
• Drinking enough fluids during exercise.

Author: V.I. Dikul

90,000 “Pains in the calves of the legs periodically disturb. With what it can be connected?”

“Pains in the calves of the legs periodically disturb. With what it can be connected?”

Antonina P., Brest region.

A wide variety of conditions can cause leg muscle pain. I will name only the most common ones.

With lumbosacral radiculitis, the sciatic nerve is affected, which gives pain to the leg.With gout, the content of uric acid in the blood increases and its salts (urates) accumulate in the tissues of the joints. A typical gouty attack begins with pain in the joint of the big toe. If the disease progresses, then the pathological process spreads to an increasing number of joints – polyarthritis occurs. Most often, with gout, the joints of the lower extremities are affected. The onset of an attack, which usually occurs at night, is provoked by the use of alcoholic beverages, the abuse of meat and fatty foods, cocoa, coffee or strong tea, as well as bath procedures.

Arthritis is a chronic or acute inflammation in the joint and surrounding tissues, including muscles. Arthritic pain occurs not only during movement, but also at rest.

In osteoarthritis, the joint is affected degeneratively and dystrophically. Hence – the mechanical nature of the pain, morning stiffness, limitation of freedom of movement in the limbs and painful seals.

One of the causes of constant pain in the muscles of the lower extremities can be flat feet, when the arch of the foot becomes flatter, unable to absorb the load.And if this does not happen, then they lie on the joints and muscles of the legs.

Atherosclerosis of the arteries of the lower extremities can also give pain in the legs. This pathology develops with the deposition of cholesterol plaques on the inner wall of the artery. It thickens, there is a feeling of constricting pain, especially in the calf muscles. The pain is worse when walking. Also, a characteristic sign of atherosclerosis – regardless of the season, the feeling of cold feet.

The muscles of the legs can also whine with varicose veins.Varicose veins develop slowly – over decades. Its progression is accelerated by prolonged static loads on the lower limbs while in an upright position, a sedentary lifestyle, overweight, prolonged sitting, as well as the use of hormonal contraceptives and pregnancy.

With thrombophlebitis, the venous vessels become inflamed, the blood stagnates in the legs, its coagulability increases and blood clots form – dense blood clots.

Swelling of the legs, malnutrition of the skin and the formation of trophic ulcers on it, the development of erysipelas … All these are clear signs of lymphostasis – a congenital or acquired disease associated with a violation of the outflow of fluid from peripheral lymphatic vessels and capillaries of the lower extremities.

Myositis, an inflammation of muscle tissue, also leads to pain. It can be a complication after various diseases, including the flu. With myositis, pain makes itself felt not only when moving, but even at night, at rest, or when the weather changes.If a person is forced to spend a long time in a standing position, then blood stagnation occurs in the lower extremities. The muscle tissues of the legs begin to experience oxygen starvation, and decomposition products, in particular, lactic acid, cease to be excreted from them. As a result, pain in the leg muscles.

A reason for consulting a specialist – and frequent spontaneous cramps in the legs (especially at night). When jogging, brisk walking, doing any active sport, and sometimes even wearing poorly fitted shoes, painful stretching of the leg muscles is possible.

Pain syndrome can also appear with excessive body weight, when an additional load is placed on the lower extremities. This inevitably leads to pain in the muscles of the legs, especially with small feet.

In order to prevent the onset of pain in the muscles of the legs in time, certain rules must be followed. With vascular pathology, limit the content of fatty and cholesterol-rich foods in your diet. Lose excess weight, as well as regularly perform a special set of exercises aimed at preventing the development of varicose veins.Do not be in a static, sitting or standing position for a long time. If your type of activity requires it, then regularly take breaks and warm-ups, change your body position. For diseases of the spine or joints, exercises that strengthen the muscles and relieve muscle tension in the lower back should be performed.

Phlebologists, traumatologists, orthopedists, surgeons, manual and physiotherapists are involved in the treatment of leg pain.

Olga PERESADA, Professor of the Department of Obstetrics and Gynecology, BelMAPO, Doctor of Medical Sciences.

Soviet Belarus № 112 (24994). Wednesday 15 June 2016

90,000 Growth pains – SCCH

What is growing pains?

Growth pain – clinically insignificant pain in the legs.

How common are growing pains?

50% of children experience pain in the legs at any age. Leg pain usually occurs around the age of 4, but it is most common between the ages of 6 and 11.

Why do growing pains occur?

The condition is often hereditary.

The best explanation for the mechanism of growth pain is the stretching of the muscles and tendons with a rapid increase in the length of the leg bones.

During the day, the child is active and the information that his brain receives from the tense muscles and tendons is lost in the flow of information from many other events. At night, when the child falls asleep, and there are no distractions, pain impulses that come from tense muscles and tendons reach the higher nerve centers and the child wakes up from pain.Therefore, this condition is observed during the period of the most intensive growth of the child and after days of high physical activity.

Are growing pains dangerous?

Growing pains can cause anxiety for both parents and the child, especially when painful episodes are repeated several nights in a row.

How are growing pains manifested?

Growing pains never appear during daytime.

Regardless of the severity of the nocturnal pain attack, if these are pains of growth, then in the morning the child always feels good / great.

Most often, the muscles of the legs and hips, the area of ​​the knee joints hurt. The upper limbs are rarely affected. The child may also have a headache or abdominal pain.

The child wakes up unexpectedly at night against the background of deep sleep and complains of pain in the leg. Parents immediately understand that the child has a health problem because he wakes up and cries in bed. Most often, these episodes occur several hours after the child has fallen asleep, but sometimes the child can wake up in the middle of the night.In typical manifestations, the child shows that he or she has pain in the knee – front or back, or pain in the muscles just above the knee. Usually, the pain disappears after ten or fifteen minutes against the background of a light massage and does not remind of itself in the morning. In most cases, growing pains hurt large joints, such as the knee, rather than the fingers or toes. Sometimes a child may wake up in pain for several nights in a row, but more often, such episodes happen from time to time – over several weeks or several months.Growing pains often appear after days when the child was especially physically active. They may disappear for several months or years and then reappear during a period of particularly rapid growth.

How is growing pain diagnosed?

Any child who has pain in the morning or during the day requires a complete medical examination.

It is necessary to assume another cause of the pain syndrome if the child has the following manifestations:

• prolonged pain in one limb
• combination of pain with lameness and / or general disorder
• symptoms occur in the morning or during the day

If atypical signs appear, it is necessary to consult a pediatrician, conduct at least a general blood test and determine the level of ESR.

Clinically insignificant leg pain (so-called “growing pain”) is diagnosed on the basis of clinical manifestations after arthritis has been ruled out. In children under 4 years of age, a different disorder should be assumed. It is necessary to assess the psychosocial background, especially in the presence of other manifestations (headache, abdominal pain). Recurrent limb pain without organic causes occurs in children during the growth period.

The main point in assessing growth pains is that in the morning after waking up, the child feels absolutely healthy.

What methods of treatment and prevention of growing pains are available?

In most cases, light massage and conversation is enough to get the child to sleep. Children with more severe pain often stop complaining after taking the usual dose of acetaminophen or ibuprofen at the average dosage for age. If the child wakes up for several nights in a row, in this case, pain reliever can be given before the child goes to bed. This will reduce pain sensitivity, so the child can sleep through the night peacefully.After two or three nights without pain, you must stop giving the child the medicine.

90,000 Severe pain in the calf muscle

Calf muscles

If you translate the Latin name for these muscles (gastrocnemius), it literally means the stomach of the lower legs. Look again at your calves: it is the calf muscles that give the legs an expanding contour. The calf muscles begin at the lower end of the thighbone just above the back of the knee. In the middle of the lower leg, the muscle connects to the Achilles tendon, which then attaches to the heel bone.Due to the orientation of the fibers in the two heads of these muscles, they can lift body weight. This is essential for jumping, climbing and controlled descent from stairs and hills. More subtle functions include stabilizing the knee and ankle joints and controlling leg manipulation to maintain balance. It is interesting to note that the gastrocnemius muscles, in fact, have very little involvement in forward movement of the body, they help mainly in sudden movements from a place. At first, signs of problems in the calf muscles are felt in the feet.The logic behind reflected pain seems to be that you have the pain you need to pay attention to in order to stop the activity that causes muscle fatigue.

Symptoms

Pain in the arch of the foot is the main symptom of lesions of the gastrocnemius muscle (Fig. 10.23). Pain from starting point 1 can also rise to the back of the calf, knee, and inner ankle (not shown). Trigger points elsewhere in the calf muscles produce pain mainly in the muscle itself (Fig.10.24). Occasionally, however, the highest point is pain in the outside of the heel (not shown). When the trigger points shorten the muscle, it can be difficult to straighten the knee if the heel is on the floor.

These symptoms due to myofascial trigger points are very common in children. Start points closer to the middle of the calf are more likely to cause nocturnal cramps than those higher. It is important to remember that nocturnal cramps in the voyeur calves have many other causes, including vitamin deficiencies, drug side effects and poor circulation.However, myofascial trigger points rank first as the cause of this phenomenon. You may experience cramps when you walk or run because the muscles that have lost their elasticity interfere with blood circulation. Serious medical problems are often diagnosed due to the same symptoms that occur with trigger points in the calf muscles. These include tearing of the vertebral discs and tendons, posterior compartment syndrome (which prevents the muscle from flowing normally), phlebitis, and cysts in the pocket behind the knee.However, signs of trigger points in the calf muscles can be misinterpreted as signs of any of these conditions if the doctor is not aware of the myofascial causes.

Reasons

The calf muscles are overloaded when climbing, climbing and cycling. They wear out at work, when leaning forward in a standing position, which lasts for a long time, and in these cases, starting points are formed in them. Other reasons include swimming when the toes are stretched out and hitting the water, the habit of wearing high-heeled shoes and sitting on chairs if they press on the back of the thighs, restricting blood flow Leading causes of calf problems are footstocks and a chaise longue that stress the calves …Lack of movement due to a plaster cast on the leg or lack of systematic exercise also leads to the formation of starting points. Viral diseases lead to muscle stiffness and make them vulnerable to overload. Cooling down predisposes them to undue stress. Toes that are stretched out at night keep the calves in a shortened state and contribute to cramps. This hazard can be prevented by not wrapping the blanket under your feet

Treatment

The location of the calf muscles on the upper half of the lower leg is usually easy to determine by the shape of the calf.You can also feel the abdomen of the muscle with your fingers if you stretch your toes. Use weighted fingers, Nobbles, or Thera Caine for precise, targeted calf massage. If you are going to massage with your fingers, it is easiest to do this by placing your foot on a bed or chair (Figure 10.25). Deep massage with the other knee is especially effective on the back of the lower leg and is very easy to perform. This method is suitable for a lying or sitting position, with bare feet (fig. 10.26 and 1 0.27).Simply move your leg down the knee in three or four parallel lines, starting at the ankle and then working up to the back of the knee. When you come across a starting point, work more on the area and sweep over it in short strokes several times. Massage the length and breadth of the muscle. It is advisable not to slide the knee on the skin, but to move it along with the knee. Poor physical fitness is perhaps the biggest source of calf problems. When they are weak and constrained, they are not hardy and overstretched.Remember, even therapeutic traction can: r have a harmful effect if, under the influence of the trigger points, the muscle remains tight.

Based on Claire Davis “Trigger Points” and Kelly Starrett “Becoming a Supple Leopard”

90,000 legs, thigh and calf

Diseases of the muscles of the legs combine a huge number of nosologies associated with damage to the skeletal muscles of the lower extremities, as well as with damage to the articular apparatus, blood vessels that feed them, and nerves.One of the symptoms of diseases of the joints and muscles of the legs can be pain, which is localized in different parts of the lower limb.

Myositis of the legs

Diseases of the muscles of the thighs, legs, feet can have various causes: infection, autoimmune diseases, trauma, helminthic invasion, intoxication, tumors, connective tissue diseases, orthopedic pathology. Common symptoms of neuromuscular diseases are myalgias (pains), muscle tension, weakness, etc.A common manifestation of diseases of the calf muscles in both children and adults is Crumpy syndrome – cramps of the calf muscles that occur in healthy people and can be a manifestation of a neurological disease, with endocrinopathies, with electrolyte imbalance (for example, after taking diuretics), with acute or postponed infection.

Vascular myalgias and their causes

These are changes that occur in the skeletal muscles of the legs and arms with insufficient blood supply (for example, with atherosclerosis of the vessels of the lower extremities, with Raynaud’s syndrome) and are manifested by cold snap, feeling of numbness, paleness or cyanosis of the fingers, in severe cases, trophic ulcers occur.The cause of Raynaud’s syndrome is a violation of the regulation of vascular tone due to cooling or emotional stress, stress.

Patients with suspected vascular pathology are referred for consultation with a cardiologist / rheumatologist and a vascular surgeon.

Neurogenic myalgias

Neuromuscular diseases, when the work of the muscles is disrupted, i.e. damage to the muscles itself or due to dysfunction of the neuromuscular junction, diseases of the spinal cord, damage to peripheral nerves or damage to the motor nuclei of the brain stem.

With osteochondrosis of the thoracic and lumbar spine, there may be plexopathies, radiculopathy, plexoradiculopathy. Concerned about pain, limitation of movement, impaired sensitivity, muscle atrophy, paresis and paralysis may develop.

Progressive muscular dystrophies are classified as genetic hereditary diseases and more often occur in childhood.

Inflammatory myopathies or myositis can occur with inflammation or due to autoimmune diseases.

Mitochondrial myopathies are hereditary diseases, the cause of which is the disruption of the work of mitochondria – the “power stations” of cells, in which most of the ATP necessary for the cell is synthesized. This is a huge spectrum of diseases.

There are several different mitochondrial diseases with primary lesions of striated muscles or combined lesions of muscle tissue and brain:

• – Kearns-Sayra syndrome is characterized by ophthalmoplegia, ataxia, muscle weakness, impaired cardiac conduction, etc.;
• – MELAS syndrome – encephalomyopathy, lactic acidosis, stroke-like episodes;

Leber’s optic neuropathy – acute loss of central vision in young men and many others.

Conditions associated with impaired cellular energy are very common and are not limited to hereditary syndromes. Among them: chronic fatigue syndrome, migraine, cardiomyopathy, glycogenosis, connective tissue diseases, diabetes, rickets, hypoparathyroidism and many others.

The diagnosis of mitochondrial myopathies is based on morphological diagnosis and detection of the RRF phenomenon (“regged” red fibers, “torn” or “rough” red fibers).

Articular myalgia

Myalgias also develop when the joints are affected, the articulation of two or more bones. With the help of nerves and muscles, which are innervated by them, ligaments move in the joints.

Depending on the anatomical location, the joints can be large (hip, knee, shoulder) and small (hand and foot joints).

Depending on the cause that causes joint damage, rheumatic, gouty, psoriatic, chlamydial and other arthritis are distinguished. The main symptoms of arthritis / arthrosis are pain, limitation of movement, there may be swelling and redness of the skin, edema. The acute process is accompanied by an increase in temperature, changes in blood and urine tests.

X-ray, MRI, arthroscopy are used in diagnostics. Diagnosis of lower limb muscle diseases

Required research methods include:

• – ENMG, including needle myography;
• – MRI of muscles, joints, spine.