What is leg pain?
Pain in the feet, ankles, knees or hip is typically dealt with individually and separately from ‘leg pain’ in general, for this article, leg pain is said to occur anywhere between the groin and ankle, thus excluding the hip and feet.1
Pain can be experienced in a number of different ways. Pain in the leg, as in other parts of the body, can be described as sharp, dull, numbing, tingling, burning, aching, and so on.
Pain can be acute (short-term) or chronic (long-term), and can be rated on a scale of severity from mild to severe, often rated on a numerical scale.
Sensory neurons (nerves) are responsible for our experience of pain, and these are triggered by stimuli such as high levels of pressure, high or low temperatures and chemicals, which can be released by tissue damage.2
What causes leg pain?
The obvious causes of leg pain are injuries, perhaps sustained during a sports game, or due to an accident – damage that doctors call trauma.
Since the causes of trauma pain are obvious, and the treatment is applied accordingly, this article deals with leg pain that is not associated with traumatic injury.
Sports can also cause injury in a less immediate way – shin splints, for example, are caused by excessive exercise.3
Long-distance running is associated with a higher incidence of leg pain of numerous types – bone, musculo-tendinous, and vascular.4 Around half of people running more than three kilometres, who train steadily and regularly take part in a long-distance run, sustain a running-related injury each year.4
Three broad areas cover the medical causes of leg pain (follow the links for more MNT detail on individual conditions):3,5
Neurological (nervous) causes, including:
- Restless legs syndrome
- Trapped nerve
- Sciatic nerve pain.
Musculoskeletal causes, including:
- Arthritis, which affects joints – the hip, knee, or ankle
- Muscle, tendon or ligament strains – for example, due to sports injury
- Night cramps
- Exertional/chronic compartment syndrome
- Medial tibial stress syndrome
- Stress fracture
Vascular causes (relating to blood vessels), including:
- Intermittent claudication due to peripheral vascular disease (PVD)/peripheral arterial disease (PAD)
- Deep vein thrombosis (blood clot).
Signs and symptoms of leg pain
Leg cramps are transient episodes of pain, usually for several minutes, when muscle – usually the calf at the back of the lower leg – goes into a spasm, which cannot be controlled.1,6,7
If there is no obvious injury, leg pain may have a nerve, musculoskeletal or blood vessel cause.
There is a tightening sensation during cramps, which are more common at night and in older people – an estimated third of people over 60 years of age suffer from this problem.7
Intermittent claudication is the name given for pain in the leg due to poor circulation, which is known as Peripheral Arterial Disease (PAD).8
This is common and associated with significant morbidity and mortality.13
Leg pain caused by atherosclerosis or narrowing of the arteries in the leg has distinguishing features and is known as claudication or intermittent claudication. The word claudication is from the Latin word meaning limp.8
Other terms for this atherosclerotic disease are:
- Peripheral arterial disease
- Peripheral arterial occlusive disease
- Peripheral vascular disease.
It occurs due to a restricted blood supply reaching the leg muscles and as the muscles are not getting enough blood, oxygen and nutrients they start to hurt.9
Claudication produces a leg pain that, in classic cases, is:8,9,14
- A cramp-like muscle pain during exercise or exertion
- Pain occurs in the buttocks, thighs, calves and feet
- Symptoms usually ease on resting
- Pain when walking or climbing stairs
- The cramps consistently occur after the same walking distances
- The pain, usually in the calf, eases with rest, and is relieved after 10 minutes.
Many cases of claudication are not classic in this way, many show no symptoms, or produce a pain that is not typical, perhaps in the thigh or buttock.8,9
Some people with severe arterial disease experience terrible pains in the leg at night, causing them to have to hang their leg over the side of the bed to gain relief.