Leg Pain

Is this your symptom?

  • Pain or swelling in the leg (hip to foot)
  • Includes minor muscle strains from walking, activities or sports (overuse)
  • If pain was caused by an injury, see Leg Injury care guide

Causes of Leg Pain

  • Muscle Overuse(strained muscles). Leg pains are often from hard muscle work or sports. Examples are too much walking or running. This type of pain can last from hours up to 7 days.
  • Muscle Cramps. Brief pains that last 1 to 15 minutes are often due to muscle cramps. These often occur in the calf or feet at night.
  • Trapped Nerves. The nerves in the lower leg can become trapped or squeezed where they pass through narrow spaces as they leave the spine. Sciatica is from pressure on a nerve in the back. It causes tingling, weakness or pain in the leg which may go right down to the toes. If symptoms do not go away with rest or treatment, surgery may be needed to release the nerve.
  • Viral Illness. Mild muscle aches in both legs also occur with many viral illnesses, such as flu.
  • Shingles. The zoster virus can cause leg pain, making the skin very sensitive or painful before a rash (shingles rash) appears.
  • Septic Arthritis (serious). This is a bacterial infection of a joint space. Main symptoms are fever and severe pain when you move the joint. It may not be possible to move the joint at all. This needs care right away.
  • Tendinitis. Inflammation of tendons where they attach to the bone, caused by overuse. This causes tenderness in the area and pain when the limb is used. An example is Achilles tendinitis which causes pain at the back of the heel. Often needs a long period of rest from the activity that caused it. Physical therapy (PT) and/or a steroid shot may be needed to reduce the pain.
  • Joint Inflammation. Examples are rheumatoid arthritis, osteoarthritis and gout. Some, like gout, may affect just one joint. Others affect multiple joints at the same time. Osteoarthritis is due to wear and tear on the joints. It can cause pain, stiffness and loss of movement. Rheumatoid arthritis usually affects the same joint(s) on both sides of the body. Early treatment may help prevent long-term damage to the joints involved.
  • More serious causes of leg pain:
    • Heart failure. If the heart is not pumping the blood around the body as it should, there can be swelling of the feet, ankles and legs. In severe cases, swelling can extend up the legs. There can also be fluid build-up in the lungs causing breathlessness, tiredness and a cough with pink frothy sputum.
    • Clots in the veins of the leg can cause pain and itching if they occur in veins near the surface of the skin. If clots occur in the deeper, bigger veins in the legs, it can be life-threatening. Pieces of the clot can break off and travel to the heart and lungs. If this happens, it can cause breathlessness, chest pain and coughing up blood.
    • Bone cancer or bone infection(osteomyelitis).
    • Fractures can happen during normal activity without there being an injury. Do not ignore ongoing leg pain.
    • Blockage of an artery. Arteries carry oxygen from your heart to the leg tissues. Symptoms of blockage are cold, pale numb and/or painful leg. The blockage will need to be cleared as an emergency when this happens. Partial blockage can cause pain, often in the calf, when walking. The pain will usually go away when at rest but may need treatment before the artery becomes completely blocked.

Pain Scale

  • Mild: you feel some pain, but it does not keep you from any normal activities. Work, chores and sleep are not changed.
  • Moderate: the pain keeps you from doing some normal activities. It may wake you up from sleep.
  • Severe: the pain is very bad. It keeps you from doing all normal activities.

When to Call for Leg Pain

When to Call for Leg Pain

Call 911 Now

  • Not moving or too weak to stand
  • You have pain in your back or abdomen as well as in your leg(s)
  • You have any of these symptoms:
    • lightheaded or dizzy
    • chest pain
    • very short of breath
  • Leg is cold, pale and very painful
  • You think you have a life-threatening emergency

Call Doctor or Seek Care Now

  • A joint (hip, knee, ankle) is red, warm to touch and painful
  • Muscles are weak (loss of strength)
  • Loss of feeling lasts more than 1 hour
  • Severe pain when leg is touched or moved
  • Fever is present
  • You are being treated for cancer or have recently been in the hospital for surgery or other problem
  • Bright red area on skin with lines tracking out from the area
  • You feel weak or very sick
  • You think you need to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

  • Leg pain starts when you walk and goes away after a few minutes if you rest
  • Can't move the hip, knee or ankle normally (limping)
  • Swollen joint(s)
  • You have a history of blood clots or a family member have a history of blood clots
  • You are pregnant, gave birth in the past 6 weeks or take estrogen (for hormone replacement therapy or birth control)
  • You have other health problems such as heart disease, chest problems, diabetes or you are more than 60 years old
  • You have a cast that :
    • is too tight or too loose
    • feels uncomfortable
    • has gotten wet
  • Pain gets worse over several days
  • Rash or area of blisters on the leg
  • You think you need to be seen, but the problem is not urgent

Contact Doctor During Office Hours

  • You have diabetes and have a burning feeling or loss of feeling in your feet or legs
  • Leg pain lasts more than 7 days
  • Pain in the shins gets worse with exercise
  • Leg pains or muscle cramps happen often
  • Leg pain keeps you from work or other activities
  • You have other questions or concerns

Self Care at Home

  • Caused by overusing the leg
  • Mild leg pain

Call 911 Now

  • Not moving or too weak to stand
  • You have pain in your back or abdomen as well as in your leg(s)
  • You have any of these symptoms:
    • lightheaded or dizzy
    • chest pain
    • very short of breath
  • Leg is cold, pale and very painful
  • You think you have a life-threatening emergency

Call Doctor or Seek Care Now

  • A joint (hip, knee, ankle) is red, warm to touch and painful
  • Muscles are weak (loss of strength)
  • Loss of feeling lasts more than 1 hour
  • Severe pain when leg is touched or moved
  • Fever is present
  • You are being treated for cancer or have recently been in the hospital for surgery or other problem
  • Bright red area on skin with lines tracking out from the area
  • You feel weak or very sick
  • You think you need to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

  • Leg pain starts when you walk and goes away after a few minutes if you rest
  • Can't move the hip, knee or ankle normally (limping)
  • Swollen joint(s)
  • You have a history of blood clots or a family member have a history of blood clots
  • You are pregnant, gave birth in the past 6 weeks or take estrogen (for hormone replacement therapy or birth control)
  • You have other health problems such as heart disease, chest problems, diabetes or you are more than 60 years old
  • You have a cast that :
    • is too tight or too loose
    • feels uncomfortable
    • has gotten wet
  • Pain gets worse over several days
  • Rash or area of blisters on the leg
  • You think you need to be seen, but the problem is not urgent

Contact Doctor During Office Hours

  • You have diabetes and have a burning feeling or loss of feeling in your feet or legs
  • Leg pain lasts more than 7 days
  • Pain in the shins gets worse with exercise
  • Leg pains or muscle cramps happen often
  • Leg pain keeps you from work or other activities
  • You have other questions or concerns

Self Care at Home

  • Caused by overusing the leg
  • Mild leg pain

Care Advice

  1. What You Should Know About Mild Leg Pain:
    • Strained muscles, tendons and ligaments are common after using them too much during sports or other activities. They can also happen from a fall.
    • Examples are running or walking too much or doing weights at the gym. They could be strained from starting a new sport.
    • Weekend warriors who are out of shape get the most muscle pains.
    • Here is some care advice that should help.
  2. Pain Medicine:
    • To help with the pain, take an acetaminophen product (such as Tylenol).
    • Another choice is an ibuprofen product (such as Advil). Ibuprofen works well for this type of pain.
    • Use as needed, but do not take more than the maximum recommended dosage as stated on the package.
    • If you are not sure what to take, ask a pharmacist.
  3. Cold Pack for Pain:
    • For pain or swelling, use a cold pack. You can also use ice wrapped in a wet cloth.
    • Put it on the sore muscles for 20 minutes.
    • Repeat 4 times on the first day, then as needed.
    • Caution: avoid frostbite by wrapping the ice pack. Do not put ice directly onto the skin.
  4. Use Heat After 48 Hours:
    • If pain lasts more than 2 days, put heat on the sore muscle.
    • Use a heat pack, heating pad or warm wet washcloth.
    • Do this for 10 minutes, then as needed.
    • Reason: increase blood flow and improve healing.
    • Caution: avoid burns by wrapping the heat pack. Do not put it directly onto the skin.
  5. Rest the Leg:
    • Rest the painful area as much as possible for 48 hours. Keep the foot, toes and other joints moving gently if you can.
    • Keep the leg raised above the level of your heart, if you can, to help limit swelling. Lying down with your leg raised on pillows or a rolled blanket can help.
  6. What to Expect:
    • A strained muscle hurts for 2 or 3 days.
    • The pain often peaks on day 2.
    • After severe overuse, the pain may last a week or more.
  7. Call Your Doctor If:
    • Fever or a swollen joint occurs
    • Pain lasts more than 7 days
    • Pain gets worse over several days
    • You get a blistered rash on the leg
    • You get swelling and redness over a joint
    • You think you need to be seen

And remember, contact your doctor if you develop any of the 'Call Your Doctor' symptoms.

Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.

Copyright 2023 Schmitt Decision Logic LLC.

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