Leg Pain Causes and Symptoms: A Comprehensive Guide

What are some of the Common Reasons for Leg Pain?

Our legs are made up of muscle, bone, nerves, tendons and ligaments, which all form part of our “musculoskeletal system”. Experiencing pain in our musculoskeletal system, including our legs, is a very common problem and can occur at any age. The causes can range from everyday reasons like overdoing exercise, making the same movements repeatedly, awkward posture, heavy lifting, to longer-term conditions such as arthritis, or a higher risk of musculoskeletal pain as we get older.

Some of the everyday reasons for leg pain

Sprains and strains

Sprains and strains affect the muscles and ligaments. A sprain can happen when you tear or twist a ligament - the tissue that connects a joint like your ankle or knee. A strain can result from overstretching or tearing a muscle in your leg, feet or knees. A sprain or strain may feel painful, tender and weak around your ankle, foot, knee or elsewhere in your leg. The area may appear swollen or bruised and you may have difficulty putting weight on the injured leg or foot. The muscles in your leg may also cramp or go into spasm (tighten on their own).

Delayed Onset Muscle Soreness (DOMS)

It’s normal to feel muscle aches and stiffness for a few days after exercising. This is known as “delayed onset muscle soreness” (DOMS). It can happen after trying a new sport or activity, or when you’ve pushed yourself a bit more than usual. The aching and stiffness usually goes away in 2 to 5 days. If the pain lasts longer or gets worse, contact your doctor.

Cramp

Leg cramps are common and can happen at any time, but often at night or when resting. Cramp is caused when a muscle in your leg tightens, making it difficult to move. It can affect the calf muscle (below the knee), muscles in the feet and thighs. Cramp can last for a few seconds or 10 minutes, but they are usually harmless. Stretching or rubbing the muscle may ease the pain during the cramp but most cramps go away without you doing anything. Your muscle might feel sore for up to 24 hours after the cramp has stopped.

Runners knee

Knee pain is a common complaint for runners and can be caused by many things. Runners knee may feel like pain at the front of the knee, around the knee or behind the kneecap during a run. The pain can be dull, sharp and severe. You should stop running and rest your knee if you have pain and see a GP if the pain has not gone after a week.

Hamstring

The hamstrings are tendons (strong bands of tissue) at the back of the thigh that attach the large thigh muscle to the bone. You don’t use them much whilst standing or walking, but they’re very active when you’re bending the knee, doing an activity like running or jumping you can injure your hamstring from sudden, powerful movements like sprinting or jumping, when your muscles or tendons are overstretched. However, hamstring injury can also happen gradually from slower movements. There are 3 grades of hamstring injuries, from mild, partial to severe. The injured hamstring may feel suddenly painful, tender and difficult to move for a mild injury, swollen and bruised with weakness in your leg for a partial tear and very painful, tender, swollen, bruised and difficult to walk or stand, for a severe injury.

Tendonitis

Tendons connect your muscles to bones in your joints, such as your knees. When a tendon is injured, it may feel swollen, painful in the joint and stiff. Tendon injuries usually feel better in 2 to 3 weeks. Tendonitis can be caused by sudden, sharp or repetitive movements such as running, jumping or throwing.

Ankle pain

Ankle sprains are one of the most common muscle and ligament injuries in active people. To find out more about sprains and strains to the leg, read here. Another reason for ankle pain, is an injury to the rubbery cord at the back of the ankle, called the Achilles tendon. This tendon connects leg muscle to bone and when injured, it may feel painful and swollen at the back of the ankle or heel. This pain can be continuous or sudden and sharp. It may feel worse, first thing in the morning. Runners may experience Achilles pain caused by wear and tear. A sudden sharp pain may mean you have a torn tendon, and should see a doctor immediately.

Heel pain

There can be several reasons for heel pain, but they can usually be treated at home. Heel pain is often caused by too much exercise or wearing shoes that are too tight. Other reasons include plantar fasciitis which feels like a sharp pain between the arch of your foot and your heel and feels worse when walking. Redness, swelling and a dull aching pain in the heel may be a sign of Bursitis (read more about bursitis below). ^10H Sudden sharp pain along with swelling, a popping or snapping sound during injury and difficulty walking may be a fractured heel or a ruptured Achilles tendon. You should get urgent medical care if you have severe heel pain after an injury, or if the pain is getting worse or keeps coming back, the pain has not improved after treating it at home for 2 weeks, you have any tingling or loss of sensation in your foot, or if you have diabetes and have heel pain.

Shin pain

Pain and tenderness along the front of your lower leg (shin) may be a sign of something called shin splints. Shin splints are usually caused by exercise, and are not serious. They happen when you put too much stress on your leg, particularly if you’ve started exercising after not being active for a while. Running and jumping on hard surfaces or an incorrect running technique may also cause shin splints.

Some of the medical and long-term reasons for leg pain

Peripheral arterial disease (PAD)

PAD is a common condition where build-up of fatty deposits in the arteries restricts blood to leg muscles, resulting in a painful ache in the legs when walking. Some people may have no symptoms at all. The pain can range from mild to severe but usually disappears after a few minutes rest. Often, both legs are affected at the same time, but pain may be worse in one leg. The symptoms often develop slowly over time but if they develop quickly or worsen suddenly, it may be a sign of a serious problem that requires immediate medical attention.

Rheumatoid Arthritis

Rheumatoid arthritis is a long-term condition that causes pain, swelling and stiffness in the joints, such as in the feet. It’s caused by your immune system mistakenly attacking cells that line your joints, making the joints swollen, stiff and painful. Eventually it may damage the joints, cartilage and bone. Although it can happen in any joint, it often affects small joints such as those in the hands and feet, first. It can affect both sides of the body at the same time. The pain is usually throbbing, aching and usually worse in the mornings after not moving for some time. Morning stiffness in osteoarthritis usually wears off within 30 minutes of getting up, but morning stiffness in rheumatoid arthritis often lasts longer. Joints affected by arthritis may also feel swollen, tender and hot to the touch.

Osteoarthritis

Unlike Rheumatoid Arthritis, osteoarthritis pain is caused by the break-down or wearing away of the protective cartilage around the ends of your bones. This causes pain, swelling and problems moving the joint. Bony growths can also develop, which may cause the area to become red and swollen. You may have osteoarthritis if you also experience a grating or crackling sound when bending leg joints such as your knees. You may also have joint pain that gets worse, the more you move your joints and stiffness that lasts less than 30 minutes.

Bursitis

Painful and swollen joints may also be a sign of bursitis, which is when the fluid filled sacs that cushion your joints, called bursa, become inflamed and swollen. You might feel a dull aching pain in one of your joints with tender or warm skin around the joint, which may also be swollen and more painful when you move or press on it.

Sciatica

We have a nerve that runs from our lower back to our feet, called the sciatic nerve. It can become irritated or compressed, causing what is known as sciatica. There are a few causes of sciatica, but the most common cause is when the soft cushion or disc between the bones in your spine, pushes out (known as a slipped disc) and rubs on the sciatic nerve. It may cause pain, tingling, numbness and weakness in your buttocks, back of the leg or foot and toes. It usually gets better in 4 to 6 weeks, but can last longer.

Gout

Gout is another type of arthritis that causes sudden, severe joint pain, usually in your big toe, but can also be felt in other joints in your feet, as well as your knees, hands, wrists or elbows. You may also have red, swollen skin over the affected joint. If left untreated, a gout attack may last from 1 to 2 weeks. You should see a GP immediately to help during attacks, stop attacks lasting longer and to prevent lasting damage to your joints.

When to seek medical advice for leg pain

Get advice from 111 now or see your GP:

• If you have injured yourself and the injury is not feeling any better after treating it yourself, the pain or swelling is getting worse and you also have a very high temperature or feel hot and shivery (this could be a sign of an infection)
• If you have an injury with bruising that is getting worse, it hurts to put weight on it, it feels very stiff or is difficult to move.
• If you’ve injured the back of your thigh (hamstring) or a tendon in your leg and:
  • you think it's a severe injury, it's not healing, or your symptoms are getting worse.
  • your symptoms do not improve within a few weeks, you're in a lot of pain, you think you have ruptured (torn) a tendon or you heard a popping or snapping sound when the pain started.
• If you have leg cramps and the cramps are disturbing your sleep, you also have numbness or swelling in your legs or the cramps last longer than 10 minutes.
• If you have heel pain and it’s severe or stopping you doing normal activities, getting worse or keeps coming back, has not improved after 2 weeks, you have any tingling or loss of sensation in your foot, you have diabetes (foot problems can be more serious if you have diabetes)
• If you have pain in your shins or you’ve injured a shin and the pain is severe, the pain is getting worse or the pain has not improved after a week
• If you experience recurring leg pain when exercising, particularly if you are an otherwise healthy person and regardless of your age, you may have PAD
• If you have Bursitis or Sciatica and
  • your symptoms have not improved or are getting worse after 1 to 2 weeks, you have a high temperature, or you feel hot and shivery,
  • you cannot move the affected joint or you have very severe, sharp, or shooting pains in the joint
  • your sciatica is stopping you doing your normal activities
• If you think you have gout and the pain is getting worse or have a very high temperature (you feel hot and shivery), feel sick or cannot eat, then these symptoms could mean you have an infection inside your joint and may need urgent medical help. Seek medical help if you have symptoms of gout for the first time or if you have gout and your usual treatments are not helping.

Go to A&E or call 999 if:

You’ve injured your leg and:

• you heard a crack when you had your injury, your leg, knee, foot or ankle has changed shape or pointing at an odd angle or your leg is numb, tingling or has pins and needles, is discoloured or cold to touch. You may have broken a bone and will need an X-ray.
• have severe pain after an injury, feel faint, dizzy or sick from the pain, heard a snap, grinding or popping noise at the time of injury, are not able to walk.

You have sciatica and

• the sciatica symptoms are on both sides of your body
• have pain, weakness, or numbness in both legs that's severe or getting worse, have numbness around or under your genitals, or around your bottom (anus)
• find it hard to start peeing, cannot pee or cannot control when you pee or poo, do not notice when you need to poo – and this is not normal for you

(These could be symptoms of a serious back problem that needs to be treated in hospital as soon as possible.)

How To Relieve Leg Pain

RICE for sprains and strains, heel pain and hamstring injuries

RICE stands for Rest, Ice, Compression and Elevate:

Rest – stop any exercise or activities and try not to put any weight on the injury.

Ice – apply an ice pack (or a bag of frozen vegetables wrapped in a tea towel) to the injury for up to 20 minutes every 2to 3 hours.

Compression – wrap a bandage around the injury to support it.

Elevate – keep it raised on a pillow as much as possible.

To help prevent swelling, try to avoid heat (such as hot baths and heat packs), alcohol and massages for the first couple of days. When you can move the injured area without pain stopping you, try to keep moving it so the joint or muscle does not become stiff.

Applying an ice pack may also help with knee pain and bursitis. However if you have sciatica, heat packs may help with the painful areas.

Massage and stretching for DOMS, cramp, knee pain, sciatica, and hamstring,

Stretching and massaging the muscle may ease the pain during a cramp, although most cramps go away without you doing anything. Massage also helps with DOMS. Your doctor may suggest stretching to help relieve sciatica along with exercises. Gentle stretching may help with hamstring injury once pain has subsided. Regular gentle stretches will help with heel pain and knee pain.

Physiotherapy

A doctor may recommend physiotherapy as treatment for tendonitis, shin splints, sprains and strains, as well as sciatica. Physiotherapy may also be helpful as supportive treatment for rheumatoid arthritis.

Painkillers

Paracetamol or ibuprofen tablets can help to ease muscle soreness after a leg cramp and for leg pain from sprains and strains, DOMS, hamstring injuries, shin splints, rheumatoid arthritis, osteoarthritis, bursitis or gout. Ibuprofen gel or medicated plasters may help relieve pain and inflammation from sprains, strains and tendonitis. Nurofen contains ibuprofen, and is available as capsules as well as gel or medicated plasters.

Is Exercise Good for Leg Problems?

For some types of leg pain, exercise is helpful and for some, it’s not. Here are some tips for when to keep moving, and when to rest your aching legs:

• If you’re a runner and you have knee, Achilles or shin pain, it’s a good idea to rest and stop running for a while to allow the injury to recover. You can try running once the pain has gone but see your GP if the pain does not go away or returns when you run.
• If you have a hamstring injury, start doing gentle stretches once the pain has started to go, but be careful not to go straight back to strenuous exercise, as this could make the injury worse. You can return to gentle exercises like walking, cycling and hamstring strengthening exercises after a few days of stretching. It’s also important to remember that avoiding exercise for too long can cause your hamstring muscles to shrink and scar tissue to form around the tear.
• If you’ve had tendonitis, you may need to change the type of exercise that you do, to prevent it happening again. For instance, repetitive movements like running or jumping can cause tendonitis. You should also make sure to warm up properly before exercise, and stretch your legs afterwards. To help reduce the chances of tendon injury, you should wear supportive shoes or insoles when exercising and take regular breaks from repetitive exercises.
• There are exercises you can do to help reduce heel pain. Ask your GP or a physiotherapist about what will work for you.
• If you have shin splints, you’ll need to switch to gentle exercise such as swimming or yoga, whilst healing. Also make sure you warm up before, and stretch after exercising. Don’t continue to do the same exercise that caused your shin splints. You may need to build up your exercise routine gradually.
• Having a regular exercise routine can help ease the symptoms of conditions like peripheral arterial disease, Rheumatoid Arthritis, osteoarthritis and sciatica
• If you have OA or gout, avoid exercises that put strain on your joints. Activities like swimming and cycling are preferable since these do not force your joints to bear too much weight.
• Regular exercise is recommended for everyone, as it can help reduce your risk of many conditions, can help relieve stress, help keep your joints mobile, and strengthen the muscles supporting your joints. Exercise can also help you lose weight if you're overweight, which can put extra strain on your joints.
• Find the best activities and the right balance for you. It's usually best to increase the amount of exercise you do gradually, especially after an injury.

FAQs

What is the main reason for leg pain?

There is no main reason for leg pain, since there can be many causes.  Read here for some of the more common reasons for leg pain.

How do I know if my leg pain is serious?

Read here for possible reasons to call 111, your GP or go to A&E about leg pain.

Is leg pain a symptom of any disease?

There may be several conditions that cause leg pain, including some diseases. Read here for some of the more common disease that may cause leg pain.

How do I get my leg to stop aching?

Depending on what is causing your leg pain, there are a few ways to treat your pain. Read here for some ways to ease your leg pain.

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