Pains in the leg can have various causes and can occur during the day, while working or standing for long periods or even at rest during the night.
In the majority of cases the pain may have no obvious or serious cause but there are occasions, such as thrombosis which requires immediate medical assistance. For this reason all cases of prolonged pain in the legs should be diagnosed medically initially.
Firstly let’s look at the more common causes of leg pain, which will involve the muscle.
Probably the most common cause of leg pain can be due to a muscle cramp or spasm (also known as charley horse and horse gummit in USA or dead leg in UK or corky in Australia). A muscle cramp or spasm of this type is a sudden, uncontrolled contraction of a muscle lasting for seconds to hours. It is most often experienced in the muscles that cross two joints. These can be very commonly the calf (crossing the ankle and knee), the hamstring (crossing the knee and hip) and the quadriceps (also crossing the knee and hip). While the cramp is short in duration the after effects may last some hours and leave a bruised feeling as if you have been kicked by a horse (hence the nickname). In some patients, the leg cramps occur primarily at night, and can violently awaken the patient from sleep.
The exact cause is not fully understood, but we do know of some circumstances that are thought to contribute to the occurrence. These can be: Muscle fatigue, Extreme exercising, Dehydration (caused by diabetes, high temperature etc.), High body weight (not necessarily obesity), Electrolyte imbalances and certain Medications (statins, prednisone, others...)
The first question - Is it possible to prevent leg cramps or pain ?
You must try to stay comfortably hydrated – while it is not fully understood how dehydration and muscle cramping are related, we do know that dehydration can cause leg cramps. The dehydration results in low amounts of potassium, sodium, calcium, or magnesium in the blood and can be aggravated by medications such as diuretics, which can cause you to lose too much fluid or minerals. You should try to drink at least three glasses of good quality liquid each day, including one before bedtime.(Coconut water is an excellent re-hydrating drink but be careful if diabetic as it can raise the potassium level). If exercising, increase the amount of fluid before, during, and after exercise.
You should try to stretch regularly which can relax muscle fibres. If you have an exercise regime follow a normal gym warm up, work out and cool down routine. However for the average person do not exercise vigorously just prior to sleep.
When the muscles cramp you can stop the leg pain by massage and stretching the sore area. This is a perfect instinctive reaction and often quickly solves the problem. If it is slow to stop try a hot shower or bath to warm and relax the muscle.
Muscles can be injured, fatigued or strained from overuse, by too much exercise, or holding a muscle in the same position for a long time (for instance standing for too long – which will affect shop workers).
Injury pain can be caused by - a torn or overstretched muscle (strain), Hairline crack in the bone (stress fracture), Inflamed tendon (tendinitis) and/or Shin splints ( pain in the front of your leg due to overuse or sports injury).
If leg cramps become a persistent and recurring problem, you should be checked out by your doctor. Because we know electrolyte imbalances can cause cramping, blood tests may be necessary to determine if the levels of potassium and other electrolytes are normal. There are also muscle relaxing tablets (2mg Diazepam is a common dose) that can be prescribed if the muscle cramping persists, particularly at night. Finally, your medications and medical history should be reviewed to see if the combination of drugs may be contributing to your leg cramps.
Moving away from muscle problems we should consider other common causes of leg pain:
Atherosclerosis is an arterial build-up that blocks blood flow (this type of pain, called claudication, is generally felt when exercising or walking and is relieved or reduced by rest)(See section later)
Blood clot (deep vein thrombosis) caused by long distance air/car/train travel, long periods of inactivity or as a result of long-term bed restriction.
Infection of the bone (osteomyelitis) or skin and soft tissue (cellulitis) – this needs prompt medical diagnosis.
Inflammation of the leg joints caused by arthritis, gout and several other inflammatory conditions.
Nerve damage -- common in people with diabetes, smokers, and alcoholics (symptoms include numbness, tingling, or a sensation of pins-and-needles in hands or feet)
Lymphatic drainage massage – This should be carried out by a trained physiotherapist and is a form of massage for those who suffer either oedemas or “heavy legs” by the end of the day. It improves the circulation and eliminates waste and toxins.
There are several less common causes that can include:
Autoimmune disorder - this occurs when the immune system mistakes part of the body as a disease and attacks it. These disorders typically cause pain in the area it assumes is in danger. Polymyalgia rheumatica is typical of an example of an autoimmune disorder that can cause leg muscle aches and fatigue and also will include fever, malaise and unintended weight loss. Polymyalgia rheumatica typically affects mature individuals and affects women more often than men.
Cancerous bone tumours (osteosarcoma, Ewing sarcoma)
Noncancerous (benign) tumours or cysts of the femur or tibia (osteoid osteoma)
The use of statins, to lower cholesterol which in some cases can cause mild to severe muscle pain primarily in the neck and shoulder area but may be experienced in other parts of the body also.
Drugs such as allopurinol and corticosteroids
Legg-Calve-Perthes disease -- restricted blood flow to the ball joint of the hip that may result in its damage. Mostly seen in children of the 4-10 age group.
Sciatic nerve pain (radiating pain down the leg) caused by a slipped or pinched disk in the back or pressure on a nerve.
Slipped capital femoral epiphysis – movement of the hip ball joint usually occurring in teenage boys, particularly if overweight.
There are several ways by which you can help reduce the pain or causes of pain.
If you feel certain that the pain or discomfort is caused by muscular problems then you can help yourself by trying the following:
Rest as much as possible finding a position in which you can be as relaxed as possible with your leg/s elevated.
Apply ice or cold pack to the affected joint area for up to 15 minutes.
Apply a heat pack or microwavable wheat bag to the affected muscles.
Gently stretch and massage cramping muscles using an essential oil massage formulation (see my massage oil formulation link at the end of the article). This will sooth and relieve the pain.
If the pain is mild to moderate take over-the-counter pain medications like acetaminophen or ibuprofen. If, however, the pain is more severe, or the muscle is in spasm then speak with your doctor about muscle relaxants and stronger painkillers.
For leg pain caused by varicose veins, ensure the leg is elevated and wear suitable support stockings which are freely available from your pharmacy. In an emergency you can use flight stockings that will give similar support.
Stop or reduce using alcohol and tobacco
Wear well-fitting shoes. Shoes that are badly worn offer little or no support and will stress your leg muscles. The same applies to fashionable shoes with high heels worn for long periods.
We have now reached the point where the pain needs to be discussed with your doctor or specialist rather than self-diagnosis.
The following conditions need to be diagnosed by your doctor or following detailed examination by a specialist or consultant.
The painful leg is swollen, hot or red
You have a fever in addition to leg pain.
Your pain gets worse when you walk or exercise and improves with rest.
The leg is black and blue
The leg is cold and pale or appears bruised
You are on medications where the side effects indicate that it may cause leg pain. Seek immediate medical attention. DO NOT stop taking or change any of your medicines without talking to your doctor.
Any of the normal self-help steps do not help.
If you suffer from diabetes and your control is poor
Your doctor or specialist will perform a physical examination, with careful attention to your legs, feet, thighs, hips, back, knees, and ankles. If he/she suspects intermittent claudication (restriction in the arterial blood flow) or a nerve disorder (possibly diabetic neuropathy) then you will be referred to the appropriate consultant in that field.
That consultant will carry out a variety of tests including bloods, blood flow, ultrasound scan, bone scan and x-rays. The neurologist will carry out various electronic tests to try and identify any nerve problems.
In the case of intermittent claudication this is caused by a build-up of plaque similar to that which affects the heart. Stents or by-pass surgery on the leg arteries is often very successful but there is a natural remedy that I can recommend you try while waiting for an operation date. It is a natural citrus/pectin powder by the trade name of “PROFIBE” and is manufactured and supplied from Florida. It naturally cleans out the blockages in the arteries and avoids the need for by-pass surgery. If you have problems in your legs you will almost certainly have them in your heart and as an added bonus it will work simultaneously there also. I personally know people who have used Profibe for a couple of months and the blockage has cleared sufficiently for their by-pass surgery to be cancelled. The manufacturer will supply direct and you should contact them on www.profibe.com
Hub link for essential oil massage oil: http://petergeekie.hubpages.com/hub/Massage-Oil-General-information
Backache and Lumbago
- Backache or Lumbago You can reduce the pain and stiffness
Backache can be helped by massage with essential oils together with the use of pain killers. These oils help reduce the inflamation and pain deep in the muscles.There are some dietary and herbal remedies
- Varicose veins - Their cause,symptoms and cure.
Varicose veins can be painful and unsightly, but can be helped with essential oils. Gentle massage with oils can help both pain and appearance.In addition certain herbal supplements can help along with compression stockings.
© 2012 Peter Geekie
Peter Geekie (author) from Sittingbourne on October 30, 2012:
Dear Ruby H Rose
Thank you for your kind comments. I really hope the article was of some help to those who need it.
Kind regards Peter
Maree Michael Martin from Northwest Washington on an Island on October 30, 2012:
For many reasons we suffer from temporary to extended leg pain. Thank you for such a helpful hub on the subject. Some new techniques to try, our legs are precious. On to the massage information now. Awesome.
Peter Geekie (author) from Sittingbourne on October 09, 2012:
Thank you teaches12345
It is a subject that affects many of us but is difficult to identify the cause.
I hope it will be of some help to sufferers.
kind regards Peter
Dianna Mendez on October 08, 2012:
I learned lots here today on the subject of pain and legs. I have had this on occasion and found applying moist warm heat does help with the pain. Great post and well written.