Table of ContentsView AllTable of ContentsWhen to Go to the ERWhen to See a ProviderCauses and Treatment
Table of ContentsView All
View All
Table of Contents
When to Go to the ER
When to See a Provider
Causes and Treatment
Calf muscle pain is common and can be severe, even if the underlying cause is benign (harmless) and reversible, like an exercise-associated muscle cramp or strain. In some cases, though, calf pain is a sign of a serious health problem, like nerve damage, narrowing of blood vessels, or a blood clot deep within a lower leg vein—called deep venous thrombosis.
If you are experiencing calf pain, it’s important to know when to seek medical attention and, if the cause is mild and muscular, what remedies you can implement at home to ease the pain.
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Calf painis not usually a cause for concern. However, the following symptoms or scenarios indicate that something potentially dangerous may be happening.
Go to your nearest emergency room if you are experiencing calf pain along with the following symptoms/scenarios:
When to Contact a Healthcare Provider
While not necessarily an emergency, contact a healthcare provider if your calf pain persists despite conservative/home remedies (discussed below). You might have a nerve, hormonal, or joint condition requiring additional care.
Also, see a healthcare provider if you have calf pain and:
Potential Causes and Treatment of Acute Calf Pain
Multiple possible causes of acute (sudden) calf pain exist, including irritation or damage to the calf muscle or the tendons, nerves, and blood vessels connecting to or feeding it.
Cramps
Calf muscle cramps can occur for several reasons.Common causes include:
In some cases, though, calf muscle cramps are a sign of a serious health condition related to the nerves and blood vessels in the lower body.
Treatment of calf muscle cramps entails identifying and fixing the underlying problem.
For example, if you wake up in the middle of the night with a calf cramp or develop one after going for a long run, these strategies are usually sufficient to ease the cramps:
Strain
Acalf strainis a tear injury to one of the muscles or tendons (which connect muscle to bone) in the back of the lower leg. Like calf muscle cramps, it’s one of the most common causes of calf pain, although it usually occurs in athletes who run up hills, jump, or play football, soccer, tennis, or basketball.
The calf has two muscles—thegastrocnemiusand thesoleus—and tears to the fibers of these muscles can be mild or severe and cause sudden or gradual, intermittent pain. Severe strains refer to a complete muscle tear, resulting in a loss of function.
The pain of a calf strain feels tight, cramping, gripping, sharp, or sore. Muscle weakness or swelling may accompany the pain.
Treatment for a calf strain typically involves theRICE protocol, which stands for:
Besides the RICE protocol, short-term use of an over-the-counter pain medication like Tylenol (acetaminophen). Or, anonsteroidal anti-inflammatory drug(NSAID), such as Advil and Motrin (ibuprofen) or Aleve (naproxen),may be recommended.
Precaution for OTC MedicationsDue to possible harm, take OTC medications, including painkillers, only under the guidance of a healthcare provider.
Precaution for OTC Medications
Due to possible harm, take OTC medications, including painkillers, only under the guidance of a healthcare provider.
Physical therapyor home-based exercises are implemented to ease pain and restore movement. Surgery is rarely performed and is reserved for severe tears.
Achilles Tendonitis
Achilles tendonitis symptoms include soreness and stiffness along the tendon and back of the leg, especially after activity and in the morning after getting out of bed.
Other symptoms include:
Treatment involves several elements:
Varicose Veins
Varicose veinsare bulging, twisted superficial veins that primarily manifest on the legs, including the calf region. They are generally harmless and present in 10% to 40% of adults between 30 and 70.
If varicose veins cause symptoms, they’re usually mild. They cause a heavy, burning, tired, or aching sensation that worsens after standing or sitting for long periods. Itching and skin discoloration may also be present.
Treatment of varicose veins aims to soothe symptoms and prevent the condition from worsening.
Therapies often include a combination of the following:
In some cases,sclerotherapy(a procedure that involves injecting a solution into the vein to seal it off) may be performed to improve symptoms or the cosmetic appearance of the leg.
Baker’s Cyst
ABaker’s cystis a fluid-filled sac that forms in the back of the knee. It most commonly develops in adults between the ages of 35 and 70 and individuals with a history ofarthritisor a knee joint injury (e.g.,meniscus tear).
Most people with a Baker’s cyst have no symptoms, although some experience a bulging sensation behind the knee associated with vague pain or stiffness.
A Baker’s cyst sometimes breaks open, and the knee joint fluid leaks through tissue into the calf area. Symptoms like calf swelling, redness, tenderness, and bruising may develop in such cases.
If a Baker’s cyst causes no symptoms, treatment is not usually necessary as the cyst resolves on its own. If symptoms are present, treatment options include:
Sciatica
Sciaticadescribes pain in the sciatic nerve, a wide and large nerve that runs from the right and left sides of the lower back down the buttocks and leg, ending just below each knee.The sciatic nerve then divides into several branches that continue into the foot.
Symptoms of sciatica range from a mild burning or aching pain to a severe shooting pain that can travel from the low back down the back of the leg, over the calf, and toward the heel. Weakness and numbness in the leg or foot may also be present.
Treatment often includes a combination of strategies, such as:
If the pain persists or is severe despite the above measures, apain specialistcaninject cortisone (a steroid) into the epidural space. This is the area between the spine and the outer tissue surrounding the spinal cord.
Surgery to treat the underlying cause (e.g., a herniated disc) is considered a last resort option
Lower Leg Fracture
The intensity of pain associated with a calf bone fracture depends on the extent and type of injury. With fractures from minor falls or injuries, people can typically walk, although the pain worsens when doing so.
Swelling along the lower leg, bruises, cuts, and, in severe cases, jutting out of the bone through the skin may also be present.
For isolated, nondisplaced (the bone does not move far out of place) fibular fractures, treatment includes:
Keep in mind that for more significant traumas, like a severe crush injury, both the fibula and the shin bone (tibia) may break.
Such cases require immediate referral to anorthopedic surgeon(a surgeon specializing in treating diseases of bone and surrounding tissues).
Claudication
Claudicationrefers to muscle pain felt deep within the calves, thighs, or buttocks during movement due to insufficient blood flow.The pain is typically reported as crampy and relieved with rest.
The most common location of pain from claudication is the calf. Pain severity varies widely, depending on several factors, such as the number of arteries affected, the degree of narrowing, and the activity being performed (e.g., pain is more intense when climbing stairs).
Treatment involves several elements, including:
Neurogenic Claudication
Neurogenic claudication—also known aspseudoclaudication—is a hallmark feature oflumbar spinal stenosis, a lower back condition in which the space between the bones in thelumbar spinenarrows.
Unlike claudication (discussed above), neurogenic claudication is not a blood vessel problem but a nerve problem resulting from compression of spinal nerves in the lower back.
Symptoms include tingling, aching, or cramping pain in one or both buttocks, thighs, or calves. Balance problems, numbness, and weakness may also be present.The pain worsens with walking and standing upright and is alleviated when leaning forward or sitting down.
Treatment often involves a combination of therapies like taking painkillers, physical therapy, epidural steroid injections, and sometimes complementary therapies likeacupuncture.
For severe or persistent symptoms, an operation called alaminectomymay be performed to relieve the nerve compression in the lower back.
Bone Infection
Symptoms of osteomyelitis include a dull, constant pain at the affected site, sometimes along with swelling and fever.
Treatment usually begins with surgery to remove the tissue and bone that died from the infection. After surgery, antibiotics are given for several weeks, if not months (orantifungals, if the germ is a fungus).
Deep Vein Thrombosis (DVT)
Adeep vein thrombosisis a blood clot found in a deep vein, usually within the leg. Some DVTs cause no symptoms, but if they are present, a DVT in the calf may cause swelling, pain, warmth, and redness or discoloration.
Danger of a Pulmonary Embolism
This complication, called apulmonary embolism, is potentially fatal. Symptoms may include:
The standard treatment for a DVT is taking ananticoagulant(blood thinner).Anticoagulants help prevent new blood clots from developing and DVT complications like pulmonary embolism andpostthrombotic syndrome—a type ofchronic venous insufficiencythat causes pain and swelling near the affected vein.
Depending on the scenario, other treatment options for a DVT include:
Here’s How to Get Rid of Blood Clots
Chronic Compartment Syndrome
Chronic compartment syndromegenerally manifests as a result of athletic exertion, often running. Pressure accumulates to such high levels within the muscles being used that vital blood flow to nerve and muscle cells is temporarily interrupted.
The cramping pain of chronic compartment syndrome is typically felt deep within both calves or shins. It slowly increases in intensity after physical activity begins and then resolves within 15 minutes of stopping.
Numbness of the foot and ankle and muscle bulging or swelling may accompany the pain.
Chronic compartment syndrome is not dangerous since symptoms resolve when the activity is stopped. However, to continue the activity, various measures may be implemented to try to prevent the syndrome from developing in the first place.
Examples of such measures may include;
If nonsurgical measures fail, an operation called afasciotomymay be considered. With a fasciotomy, the tissue surrounding the affected muscle is opened, allowing room for the muscle to swell during exertion.
Diabetic Peripheral Neuropathy
Symptoms ofdiabetic peripheral neuropathytend to be worse at night and include:
The severity varies widely, but as the condition progresses, the pain and abnormal sensations move up the left to the mid-calves and hands.
Treatment of diabetic peripheral neuropathy involves several elements, including:
Summary
Some causes of calf pain, like nighttime leg cramps, a mild calf muscle tear, or Achilles tendon inflammation, are generally harmless and reversible with conservative/home remedies.
Other causes of calf pain, though, are more serious. They may indicate nerve damage or blood vessel narrowing within the leg. A blood clot within a deep vein of the calf (DVT) is especially alarming, as it can travel to the lungs and be fatal.
Seek medical attention if the cause of your calf pain is unknown, severe, persistent, or associated with worrisome symptoms mentioned above—for example, redness or warmth, trouble or inability to walk, or skin discoloration.
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