Common Causes of Lower Leg Pain and Treatment Options

Everything you need to know about lower leg pain

Lower leg pain is common, but it can be tricky sorting out its many potential causes. That's because pain can feel like stabbing, burning, or cramping. Knowing what kind of pain you have can help your doctor figure out the cause. But many times, a detailed physical examination and an imaging test are needed to clinch the diagnosis.

This article will explain the most common lower leg pain conditions, ranging from muscle and bone issues to blood vessel and nerve problems.

Remember: You really shouldn't self-diagnose, especially if your leg pain is severe, sudden, or accompanied by swelling. You should also not self-diagnose if you have an underlying health condition like diabetes or a circulation problem.

See a healthcare provider for a proper diagnosis. It will allow you to receive prompt treatment and get back to feeling well. 

causes of lower leg pain

​Verywell / Emily Roberts

Muscle Cramps

A muscle cramp is a contraction of a muscle that is sudden and out of your control. The calf muscle is a common area for a cramp to occur. This is often referred to as a "Charley horse."

Symptoms

Muscle cramps can be mild and feel like a tiny twitch. They can also be severe and intensely sharp or stabbing.

Muscle cramps in the lower leg can last anywhere from a few seconds to several minutes, but muscle soreness may continue for days.

Causes

It's not totally clear why muscle cramps develop. Experts suspect that muscle tightness and fatigue interferes with how those muscles contract.

Additional factors that may increase your risk for developing muscle cramps, include:

There are also multiple conditions that may cause lower leg muscle cramps. These conditions include:

Pregnancy is another common cause of muscle cramps in the lower leg.

Statins are medications that lower your cholesterol. They may cause muscle cramps too.

Diagnosis

A medical history and physical examination may reveal a tender muscle or a lump you can feel with your fingers. This is generally enough to diagnose muscle cramps.

However, sometimes an underlying condition is suspected as a potential reason behind the cramps. If this is the case, your healthcare provider may order various blood or imaging tests.

Treatment

Treatment for leg cramps often involves:

  • Gentle stretching and massage
  • Hydration
  • Applying heat

Sometimes doctors recommend you take oral magnesium and/or calcium.

Treating any underlying condition is also key to easing your muscle cramps.

Muscle Strain

A strain is a common cause of leg pain. It results from an overstretching of a muscle that sometimes leads to a tear. The gastrocnemius muscle of the calf is a common area for strains and tears.

Symptoms

Muscle strains usually cause mild soreness. But you may also experience cramping or a sharp, tearing sensation. This is especially true if the strain is sudden or severe.

In addition to pain, swelling and bruising may also occur over the affected muscle.

Causes

Muscle strains may occur as a result of sudden trauma. You may experience a fall or a blow to the muscle.

A sudden change in direction, like when playing tennis or basketball, may also result in a calf muscle strain.

Overuse injuries involving the lower leg can also lead to muscle strains. Stressing a muscle again and again—for example, due to daily running—can cause tissue damage.

Diagnosis

A medical history and physical examination are generally enough to diagnose a muscle strain in the lower leg. Your healthcare provider may also order an X-ray to rule out a bone fracture.

Treatment

Doctors recommend the R.I.C.E protocol to treat a muscle strain.

4 Steps of the R.I.C.E. Method

  1. Rest the muscle.
  2. Apply ice to the painful area several times a day.
  3. Compress the muscle with an elastic bandage.
  4. Elevate the lower leg above the heart to reduce swelling.


In addition, your healthcare provider may also recommend taking a nonsteroidal anti-inflammatory drug (NSAID). This can help temper inflammation.

Physical therapy may help you ease back into activity after a muscle strain.

Tendonitis

Tendonitis is inflammation surrounding a tendon, which is a strong, cord-like structure that anchors a muscle to bone.

It is a common sports overuse injury but can strike anyone, regardless of activity level.

Common types of tendonitis that would cause lower leg pain around the ankle area are:

Symptoms

Tendonitis causes pain that increases with activity or stretching of the affected tendon. Other signs and symptoms may include:

  • Swelling that worsens with activity as the day progresses
  • Thickening of the tendon
  • Morning stiffness

A sudden pain and/or "pop" at the back of your calf or heel indicates a potential Achilles tendon tear or rupture. If this occurs, seek medical attention right away.

Causes

Trauma occurs from a fall or sudden increases in the intensity or frequency of physical activity. It may lead to tiny tears in the fibers that make up a tendon. These tiny tears trigger swelling and irritation.

Other factors increase your chances of developing Achilles tendonitis. These factors include:

  • Abnormalities in foot structure such as flat feet or high arches
  • Tight calf muscles
  • Leg length differences
  • Wearing improper or worn-out footwear
  • Exercising outside in cold weather

Diagnosis

Diagnosis of tendonitis usually involves a medical history and physical examination.

The doctor may also order imaging tests, like magnetic resonance imaging (MRI), to help to confirm the diagnosis and determine the severity of the injury.

Treatment

As with muscle strains, doctors recommend the R.I.C.E. protocol—rest, ice, compression, and elevation—for tendonitis.

Anti-inflammatory medications, physical therapy, and/or orthotics are also often helpful. Orthotics are custom, prescription medical devices worn inside your shoes.

Recap

Tendonitis is a common sports injury, but it can happen to anyone. Your doctor will order imaging tests to determine if you have tendonitis. Usually, doctors recommend you use rest, ice compression, and elevation to treat the injury.

Shin Splints

Shin splints, also known as medial tibial stress syndrome, refers to inflammation of the:

  • Muscles
  • Tendons
  • Other tissues surrounding your shinbone, also called the tibia

Symptoms

The pain of shin splints may be sharp or dull. It's felt along the inside and back part of the tibia where the calf muscles attach to the bone.

The pain is usually felt during and after physical activity.

Causes

Shin splints are common exercise-related injuries. They often affects runners and those involved in sprinting or jumping sports.

Shin splints may be aggravated or triggered by a foot condition such as overpronation, when the ankle rolls too far downward and inward as you walk. It can be triggered by high-arched feet as well.

Improper or worn-out footwear can also increase your chances of developing shin splints.

Diagnosis

A medical history and physical examination are sufficient to diagnose shin splints.

However, your healthcare provider may order imaging tests to rule out mimicking conditions like a:

Treatment

Shin splints are extremely uncomfortable. But the good news is that you can follow simple steps to treat them.

These measures include:

  • Stopping the activity that led to the shin splints: Try substituting the activity with a gentler exercise like swimming.
  • Icing the area for 20 minutes several times a day: Be sure to place the ice in a towel or use a cold pack so there is no direct contact with your skin.
  • Compressing the area with an elastic bandage: This is especially helpful if swelling is present.
  • Stretching your lower leg muscles

In addition, medications like NSAIDs may be recommended by your healthcare provider to ease pain and reduce inflammation.

Stress Fracture

A stress fracture is a tiny break in a bone. It's a common occurrence in the lower leg.

Symptoms

The hallmark symptom of a stress fracture is localized, sharp pain that decreases when you rest.

Causes

Stress fractures are overuse injuries. Basically, the muscles surrounding the bone become fatigued from using them too much. They eventually transfer the stress onto the bone. This leads to a tiny break.

Stress fractures of the lower leg are most commonly seen in sports that place repetitive stress on the leg. Sports that involve running and jumping, like gymnastics, basketball, and tennis, may cause stress fractures.

Diagnosis

An X-ray is usually enough to diagnose a stress fracture in the lower leg.

But sometimes it's difficult for the doctor to see the fracture very well on an X-ray. Stress fractures may also not show up on an X-ray for several weeks.

In these cases, your healthcare provider may order a computed tomography (CT) scan or an MRI.

Treatment

The main treatment for stress fractures is rest, usually for six to eight weeks. Doctors also recommend placing ice on the injury.

o control the acute pain of a stress fracture, you can also use:

Deep Vein Thrombosis (DVT)

Deep vein thrombosis (DVT) is a serious and potentially life-threatening cause of leg pain. It occurs when a clot in a leg vein breaks off and travels to the lungs.

Symptoms

In addition to cramping calf pain, other symptoms of a DVT in the lower leg include:

  • Swelling
  • Warmth
  • Redness of the calf

Causes

A deep vein blood clot, called a thrombus, may occur as a result of an injury to the vein wall caused by a trauma or surgery.

It may also come from an underlying health condition that makes the blood more likely to clot, such as cancer or pregnancy.

Immobility, long hospital stays, and obesity prevent venous blood from flowing properly. All of these factors increase your risk for developing a DVT.

Diagnosis

Besides a careful medical history and physical examination, your healthcare provider can confirm the diagnosis of a DVT with an ultrasound.

Treatment

Treatment of a DVT involves taking an anticoagulant, or blood-thinning medication. This helps prevent the current clot from getting bigger and new clots from forming.

Chronic Venous Insufficiency

The veins of the legs are vessels that return blood back to the heart. They do this by using valves that help direct blood flow and control pressure.

If the valves are not working properly, blood can flow backward into the veins and collect in the legs.

Over time, this collection of blood can lead to increased venous pressure. This condition is called chronic venous insufficiency.

Symptoms

Some signs and symptoms of chronic venous insufficiency include:

  • An aching or cramping leg pain
  • Lower leg and ankle swelling
  • Itchy, dry skin
  • Patches of skin that are purple, dark red, or brown
  • Hardened skin
  • Presence of poorly healed wounds called venous ulcers, especially along the inner ankle
  • Presence of varicose veins

Causes

Increased pressure in the veins can damage the valves and interfere with blood flow. This can cause chronic venous insufficiency.

For example, standing too long, obesity, and pregnancy can place additional weight and pressure on the veins in the legs. This may ultimately result in valve damage.

A history of leg trauma can lead to chronic venous insufficiency. A clot within a vein may block blood flow and damage the valves. This may also lead to chronic venous insufficiency.

Diagnosis

Diagnosis of chronic venous insufficiency involves:

  • A medical history
  • Physical examination
  • A venous duplex ultrasound—an imaging test that uses sound waves to seen how blood travels through your veins

Treatment

Treatment of venous insufficiency involves elevating the leg and wearing compression stockings.

Peripheral Artery Disease (PAD)

With peripheral artery disease (PAD), one or more leg arteries become narrow. This interferes with proper blood flow to the leg.

Symptoms

PAD is associated with a cramp-like pain in the calf, thigh, or buttock. It's brought on with activity. It feels better when you rest.

In addition to cramping pain, PAD can lead to a cool and often pale limb that has an increased sensitivity to pain.

Other signs of peripheral arterial disease include:

  • Wounds that do not heal
  • Toenail changes
  • Shiny skin
  • Loss of hair near the area of the leg that is affected

Causes

The narrowing of an artery occurs as a result of fatty deposit buildup within the artery's walls. This condition is called atherosclerosis.

Factors that increase a person's chance of developing PAD include:

Diagnosis

If your doctor suspects PAD, they will first perform a physical examination. The doctor will inspect your legs and examine your pulse.

To confirm a diagnosis of PAD, your doctor will also perform a test called the ankle-brachial index (ABI). This test measures the blood pressure of your ankle.

Imaging tests, such as an ultrasound, may also be used to take a closer look at the blood vessels in your legs.

Treatment

Treatment may involve lifestyle changes such as:

  • Stopping smoking
  • Starting a daily walking program
  • Taking medication like aspirin or Plavix (clopidogrel) to thin your blood

It also involves getting underlying medical conditions, like diabetes, high blood pressure, and high cholesterol, under control with medication.

In more severe cases, angioplasty is necessary. During this procedure, the doctor uses an inflated balloon to open the blockage inside the artery. They then place a stent, which is a tube placed in the artery to keep it open.

Bypass surgery may also be considered. With this, the surgeon uses a graft to re-route blood flow from a blocked artery.

Lumbosacral Radiculopathy

Lumbosacral radiculopathy is often called sciatica. It refers to compression or irritation of one or more of the nerves that travel from your lower spine to your leg.

Symptoms

Lumbosacral radiculopathy causes an electric or shock-like pain in the:

  • Lower back
  • Buttocks
  • Down the leg

Other symptoms of lumbosacral radiculopathy include:

  • Numbness
  • Tingling
  • Burning sensations
  • Weakness in the leg

Causes

Lumbosacral radiculopathy may be caused by a herniated spinal disc or irritation from a tight muscle, such as seen with piriformis syndrome.

Spinal stenosis occurs when the area around a person's spinal cord is narrowed. This may also lead to nerve compression in the lower spine.

Less commonly, an infection or tumor may be the cause of lumbosacral radiculopathy.

Diagnosis

In addition to a medical history and physical examination, your healthcare provider may order imaging tests such as an MRI or a CT scan to confirm lumbosacral radiculopathy and better understand its cause.

If imaging tests are not revealing, your healthcare provider may order an electromyography (EMG) and nerve conduction study.

Treatment

Treatment of lumbosacral radiculopathy often includes a combination of the following:

Surgery is generally chosen for people with persistent, disabling symptoms or those with cauda equina syndrome. This is a rare but very serious lumbar/sacral nerve condition that causes bladder, bowel, and/or sexual dysfunction.

Summary

Various medical conditions may cause leg pain. Visiting your doctor for a physical examination and imaging tests can help determine what's causing it. Treatment will depend on on the cause of your leg pain.

It's important to avoid self-diagnosing your injury or medical condition. Only a doctor can determine whether your condition is something that is a simple muscle strain or something more serious.

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7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Michigan Medicine. Rest, ice, compression, and elevation (rice).

  2. Li HY, Hua YH. Achilles tendinopathy: current concepts about the basic science and clinical treatments. Biomed Res Int. 2016;2016:6492597. doi:10.1155/2016/6492597

  3. OrthoInfo. Shin splints.

  4. OrthoInfo. Stress fractures.

  5. Stone J, Hangge P, Albadawi H, et al. Deep vein thrombosis: pathogenesis, diagnosis, and medical management. Cardiovasc Diagn Ther. 2017;7(Suppl 3):S276-S284. doi:10.21037/cdt.2017.09.01

  6. Spiridon M, Corduneanu D. Chronic venous insufficiency: a frequently underdiagnosed and undertreated pathology. Maedica (Buchar). 2017;12(1):59-61.

  7. Aronow WS. Peripheral arterial disease of the lower extremities. Arch Med Sci. 2012;8(2):375-88.

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