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8 Causes of Lower Leg Pain

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Updated April 02, 2014

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

The lower leg is a common problem area for soreness. The muscles of the lower leg control foot motion and stability, so increases in activity or changes in footwear can sometimes cause sore muscles or tendonitis. An increase in physical activity is a leading cause of lower leg pain, but there are many other health conditions that can cause leg pain as well. Leg pain that is severe, sudden, or accompanied by swelling should always be evaluated by a physician. Some of the more common causes of lower leg pain include:

1. Muscle Strain or Fatigue

Muscle fatigue or strain is the most common cause of leg soreness. Usually a muscle strain happens from increased activity and causes a minimal amount of soreness. The soreness is easily relieved by rest and cold or warm compresses. However, sudden or severe injuries can cause a muscle tear or tendon rupture which is significantly more painful. The gastronemius muscle of the calf is a common area for strain and tear. Stretching prior to exercise helps decrease the chance of muscle injury.

2. Exercise-Related Injuries

Shin splints, also known as medial tibial stress syndrome, is a common exercise-related injury. Shin splints often affect runners and those involved in sprinting or jumping sports. The pain is felt along the inside (medial) and back (posterior) part of the tibia bone where the calf muscles attach to the bone. Shin splints may be aggravated or triggered by foot conditions such as over-pronation or high-arched feet. A stress fracture of the tibia bone is another condition seen in running and jumping sports and like shin splints, causes leg pain with activity. A less common cause of exercise-related leg pain is exercise-induced compartment syndrome. This condition is more often associated with a recent increase in leg muscle mass and causes intense leg pain, cramping, and a tight feeling in the leg muscles with activity.

3. Tendonitis

Tendonitis is a common sports overuse injury but can strike anyone, regardless of activity levels. Tendonitis is inflammation surrounding a tendon, which is a strong, cord-like structure that anchors a muscle to bone. Abnormalities in foot structure such as flat feet or high arches can trigger tendonitis. Tendonitis presents as pain that increases with activity or stretching of the affected tendon. Common types of tendonitis that would cause lower leg pain around the ankle area are Achilles tendonitis and posterior tibial tendonitis.

4. Vein Problems

The veins of the legs return blood back to the heart. When vein problems occur, leg swelling (edema) and sometimes pain or tenderness may occur. One common vein problem is venous insufficiency, which can lead to varicose veins, recurrent leg swelling, and skin changes such as a brown discoloration near the ankles. A serious and potentially life-threatening cause of leg pain is known as Deep Vein Thrombosis (DVT). A DVT is a clot in a leg vein that can break-off and travel to the lungs or other organs.

5. Peripheral Artery Disease (PAD)

With PAD, blood flow to the leg is compromised because of narrowing of one or more leg arteries. PAD is associated with leg pain while walking that is relieved by rest. While vein problems often cause a redness or warmth in the leg, PAD can lead to a cold, and often pale limb that has an increased sensitivity to pain. Risk factors for PAD include a history of smoking, heart disease, and diabetes.

6. Pregnancy

Foot and leg problems are a common problem for pregnant women, especially in the third trimester. Sore legs and feet are often due to the increase in weight plus hormonal changes that cause the foot's arch to relax and compress down a little more. This causes a tendency toward flat feet and can also cause the leg muscles to work a little harder at maintaining foot stability, resulting in sore leg muscles. Painful leg cramps in pregnancy may be caused by blood volume changes or from sciatic nerve compression by the expanding uterus.

7. Medical Conditions

There are many medical conditions that can cause leg pain. Fibromyalgia sufferers frequently experience restless leg syndrome and painful lower leg cramps. Leg pain can also be associated with autoimmune disorders such as multiple sclerosis and rheumatoid arthritis. Thyroid disease can also cause pain in the legs. Also, medications for certain medical conditions are known to cause leg pain or cramps. Diuretics and statin drugs for high cholesterol are common examples. Check with your provider if you suspect your medication may be causing leg pain.

8. Back Problems

Compression of the large sciatic nerve causes shooting pain that can extend all the way down to the foot. The pain typically starts at the buttock and is felt on the side and back of the leg. Irritation of the sciatic nerve, or sciatica, is usually caused by a herniated spinal disc, spinal stenosis, or irritation from a tight muscle, such as seen with piriformis syndrome.
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