Leg pain is a common symptom that can be caused by a variety of underlying conditions, ranging from mild to severe. Some of the most common diseases and disorders that result in leg pain include:
Arthritis
Arthritis is a condition that causes swelling, stiffness and pain in the joints. Osteoarthritis and rheumatoid arthritis are the two most common types that affect the legs and knees. In osteoarthritis, the cartilage in the joints breaks down over time, allowing the bones to rub together. This causes pain, swelling and stiffness. Rheumatoid arthritis is an autoimmune disease where the immune system attacks the joints, resulting in painful inflammation. Arthritis in the knees, hips and ankles commonly causes leg pain.
Peripheral Artery Disease
Peripheral artery disease (PAD) is a circulatory condition in which the peripheral arteries become narrowed, usually by atherosclerosis or fatty deposits. This restricts blood flow to the legs and feet, which can cause painful cramping in the calves, thighs or buttocks during activity. The pain usually goes away with rest. People with diabetes, high blood pressure, high cholesterol or who smoke have an increased risk for PAD.
Blood Clots
Deep vein thrombosis (DVT) occurs when a blood clot forms in one of the deep veins of the body, usually in the legs. Part of the clot can break off and travel to the lungs, causing a pulmonary embolism. DVT often causes pain, swelling and tenderness in the affected leg. Risk factors include prolonged immobility, recent surgery, pregnancy, obesity, smoking, cancer and genetic clotting disorders.
Sciatica
Sciatica refers to pain caused by irritation or compression of the sciatic nerve, which runs from the lower back down the back of each leg. A herniated disc, bone spur or narrowing of the spinal canal (spinal stenosis) can pinch the sciatic nerve, resulting in shooting, burning pain that radiates from the buttocks and hip down to the back of the thigh and calf. Coughing, sneezing or sitting for long periods can worsen sciatica pain.
Diabetic Neuropathy
Diabetic neuropathy is a common complication of diabetes that causes damage to the peripheral nerves. This can produce tingling, numbness, pain and weakness, often beginning in the toes and feet but sometimes spreading up to the legs. It is thought to result from high blood sugar levels damaging nerve fibers. Keeping blood sugar tightly controlled can help prevent progression of diabetic neuropathy.
Vascular Diseases
Several diseases that affect the blood vessels can restrict circulation in the legs and lead to leg pain. These include Buerger’s disease (thromboangiitis obliterans), which causes inflammation and clotting in small and medium arteries of the limbs; vasculitis, or inflammation of blood vessel walls; and atherosclerosis, the buildup of fatty deposits in arteries. These conditions reduce blood flow, resulting in claudication pain in the calves, thighs or buttocks during activity.
Muscle Injuries and Strains
Tears or strains of the muscles or tendons in the legs are common injuries that cause acute pain, swelling and difficulty walking. The quadriceps, hamstrings and calf muscles are frequently affected. Muscle strains can happen when warming up or during exercise and sports activities. Treatment involves rest, ice, compression and elevation.
Shin Splints
Shin splints describe pain along the inner border of the shin bone or tibia. It is commonly caused by muscle overuse and repetitive impact on the lower legs. Shin splints are a common complaint in runners, dancers and military recruits. Treatment involves rest, ice, stretching and strengthening exercises. Custom orthotics can also help provide arch support.
Stress Fractures
Stress fractures occur when repetitive stresses on the bone lead to tiny cracks or fractures. In the legs, they often affect the tibia and metatarsals in the foot. Stress fractures cause localized pain that worsens with activity. They are commonly seen in runners and athletes who do a lot of jumping. Treatment requires rest and avoiding impact exercises until fully healed.
Leg Ulcers
Leg ulcers are open, painful sores that develop on the skin of the legs. Common causes include venous insufficiency, arterial disease and diabetes. Venous leg ulcers form due to improper functioning of the valves in the veins, while arterial leg ulcers are associated with peripheral artery disease. Diabetic ulcers result from nerve damage and poor circulation in diabetics. Treatment focuses on addressing the underlying cause.
Gout
Gout results from a buildup of uric acid crystals in the joints, causing inflammation and intense pain. Gout frequently affects the big toe, ankle, knees, heels and insteps. Attacks cause redness, swelling and a sensation of fire in the joint. Gout can be managed with medications that reduce uric acid levels and by avoiding foods high in purines.
Bursitis
Bursae are fluid-filled sacs that cushion joints. When inflamed, they cause pain and limit mobility. Trochanteric bursitis affecting the hip, pes anserine affecting the knee, and retrocalcaneal bursitis affecting the heel are a few examples of bursitis that can cause leg pain. Treatment may involve rest, ice, NSAID medications and injections.
Compartment Syndrome
Acute compartment syndrome is a serious condition where pressure builds up inside a muscle compartment, compromising blood flow. It causes severe, throbbing leg pain, numbness and weakness, usually after a traumatic injury. Compartment syndrome is a medical emergency requiring immediate treatment to prevent muscle damage, disability and death in severe cases. Fasciotomy surgery is done to relieve pressure.
Spinal Stenosis
Spinal stenosis is an abnormal narrowing of the spinal canal. It commonly affects the lumbar spine and can compress the nerve roots in this region, leading to symptoms like sciatica pain that radiates down the leg. Numbness, tingling and weakness in the legs may also occur. Treatments for spinal stenosis include medications, physical therapy and surgery.
Osteonecrosis
Osteonecrosis, also called avascular necrosis, results when blood supply to bone is disrupted. This causes bone death and the eventual collapse of the bone. In the legs, osteonecrosis most often affects the hip joint. It causes gradually worsening hip and thigh pain. Risk factors include trauma, steroid use, alcoholism and autoimmune diseases. Early treatment is aimed at preventing collapse of the hip socket.
Bone Tumors
Both cancerous and noncancerous tumors that develop in or on the bones can cause leg pain. Osteosarcoma and Ewing’s sarcoma are two cancerous bone tumors that most often affect the long bones of the legs in children and teens. Other benign bone tumors like osteoid osteoma and osteoblastoma occur in the legs and cause localized, nighttime pain that increases with activity.
Referred Pain
Referred pain means pain that originates from one location is felt in another part of the body. For example, irritation of nerves arising from the lumbar spine can be perceived as pain, numbness or tingling traveling down the leg. Pain from a heart attack may radiate down the left arm. Identifying the true source of the pain requires a detailed diagnostic workup.
Nerve Compression
Pressure or damage to a nerve can produce pain, tingling or numbness along the path of the affected nerve. Meralgia paresthetica causes numbness or pain in the outer thigh from compression of the lateral femoral cutaneous nerve. Tarsal tunnel syndrome is caused by compression of the tibial nerve in the ankle, causing pain on the inside of the ankle and sole of the foot.
Complex Regional Pain Syndrome
Complex regional pain syndrome (CRPS) is a chronic pain condition that usually affects one limb, like an arm or leg. It typically develops after an injury, surgery or heart attack but is out of proportion to the initial trauma. CRPS causes severe, debilitating pain, swelling, skin changes and hypersensitivity in the affected limb. Physical therapy and medication can help manage the symptoms.
Less Common Causes
Some less common causes of leg pain include:
- Fibromyalgia – Chronic widespread pain and tenderness.
- Polymyalgia rheumatica – Muscle inflammation and stiffness.
- Rhabdomyolysis – Muscle breakdown with severe muscle pain.
- Ehlers-Danlos syndrome – Rare connective tissue disorder that causes joint pain.
- Lyme disease – Bacterial infection that can cause joint pain.
- Paget’s disease – Bone disorder that can lead to bone pain.
When to See a Doctor
Make an appointment with your doctor if you experience:
- Unexplained or persistent leg pain lasting more than a few days
- Severe leg pain that limits your mobility or activities
- Leg pain accompanied by swelling, redness or warmth in the leg
- Weakness, numbness or difficulty moving the leg
- Injury to the leg that causes intense or worsening pain
- Leg pain that occurs at night or keeps you from sleeping
Seeking prompt medical attention is crucial when leg pain occurs alongside symptoms like chest pain, shortness of breath, sudden onset of weakness, loss of bowel or bladder control, or paralysis. These can indicate a medical emergency requiring immediate treatment.
Diagnosing the Cause of Leg Pain
To identify the underlying cause, the doctor will begin with a physical exam of the legs and ask about symptoms. Important questions they may ask include:
- Where exactly is the pain located?
- Does the pain radiate anywhere?
- When did the pain begin?
- How severe is the pain? What makes it better or worse?
- Is the pain constant or intermittent?
- Is there numbness, tingling or weakness?
- Have there been any injuries, falls or trauma?
- Have there been any recent illnesses or hospitalizations?
- What medications are you taking?
The physical examination will check for injury, swelling, redness, weakness or nerve problems in the legs. The type and location of pain can help determine if it is coming from the joints, muscles, bones or nerves.
The doctor may order imaging or tests to identify the cause, including:
- X-rays – To check bones and joints for fractures, arthritis, tumors or injury.
- MRI or CT Scan – For a detailed look at the muscles, nerves, tissues and bones.
- Bone Scan – To detect bone tumors, injuries and arthritis.
- Nerve conduction study – Measures how well nerves transmit signals.
- Electromyography – Records electrical activity of muscles.
- Ultrasound – Visualizes tissues, arteries and blood flow.
- Blood tests – Help detect infections, arthritis, diabetes, and muscle or bone disorders.
Treating Leg Pain
The appropriate treatment depends on the diagnosed cause of leg pain. Some general treatment approaches include:
- Rest – Avoiding activities and movements that aggravate the pain.
- Ice or heat – Applying ice packs or heating pads can relieve muscle and joint pain.
- Compression – Elastic bandages or compression stockings can help reduce swelling.
- Elevation – Keeping legs raised above the level of the heart helps decrease swelling.
- Immobilization – Crutches or splints may be needed to immobilize injuries.
- Physical therapy – Stretching, strengthening exercises and modalities like ultrasound can help improve mobility and reduce pain.
- Medications – Over-the-counter pain relievers, prescription NSAIDs, steroids or other drugs to reduce inflammation and pain.
- Surgery – Such as arthroscopy for joint problems, angioplasty to open blocked arteries, or spinal decompression for nerve compression.
Lifestyle measures like losing weight, eating a healthy diet, minimizing alcohol, quitting smoking and managing conditions like diabetes also help reduce leg pain.
When Leg Pain Signals an Emergency
While leg pain often results from relatively benign muscle or joint problems, in some cases it can indicate an urgent medical crisis requiring emergency care.
Seek emergency treatment if leg pain occurs with any of the following:
- Chest pain, shortness of breath or coughing up blood
- Sudden, severe pain with no apparent cause
- Difficulty breathing or rapid heart rate
- Feeling faint or actually losing consciousness
- Uncontrolled bleeding or vomiting blood
- Sudden inability to move the leg
- New leg weakness or numbness
- Sudden, severe headache
- Slurred speech
- Confusion
- Bluish skin discoloration
These symptoms can indicate a possible heart attack, stroke, pulmonary embolism, compartment syndrome, blood clot, or other immediately life-threatening problem that requires emergency assessment.
Preventing Leg Pain
While not all leg pain can be prevented, the following measures can reduce your risk:
- Maintain a healthy weight
- Regular exercise to build strength and flexibility
- Warm up and cool down during exercise
- Wear properly fitted, supportive shoes
- Treat preexisting conditions like diabetes and arteriosclerosis
- Avoid smoking and limit alcohol
- Consume a nutritious diet with calcium and Vitamin D
- Use proper posture and body mechanics during activities
- Rest between periods of prolonged standing or walking
- Avoid high-impact activities if you have injuries or joint problems
- Strengthen muscles to provide support and stability
When to See a Doctor for Leg Pain
Consult your doctor if you have:
- Unexplained leg pain lasting over 1 week
- Inability to bear weight on the leg
- Pain that disrupts sleep or daily activities
- Leg pain with swelling, redness or warmth
- Calf pain with swelling
- Injury causing severe, persistent or worsening pain
- Tingling, numbness or weakness in the leg
- Pain after long periods of immobilization
While most leg pain resolves with self-care, persistent or worsening symptoms warrant medical attention to determine the cause. Prompt diagnosis and treatment can often improve outcomes and prevent complications of underlying conditions.
Conclusion
Leg pain has many potential causes, from minor muscle strains to serious diseases like PAD and blood clots. Typical symptoms are aching, cramping or shooting pain in the hips, thighs, knees, calves or feet. Arthritis, sciatica, diabetic neuropathy and vascular diseases are just some of the many conditions that can produce leg pain.
A thorough medical workup is needed to identify the exact cause in each case. Treatment aims to relieve pain, address any underlying condition, and improve physical function. While mostly manageable with conservative measures, leg pain can sometimes indicate an emergency like a pulmonary embolism or compartment syndrome requiring immediate treatment.
Being aware of the wide range of causes and when to seek urgent care is important for properly evaluating and treating any unexplained leg pain.