Legs

Leg pain: leg pain


Leg pain is a common phenomenon that occurs in different parts of the leg and can therefore have a variety of causes. Often, relatively harmless injuries such as a bruise, stretching or the classic "muscle soreness" are the reason for the complaints, but there are often also circulatory disorders, problems with the joints (e.g. joint wear, arthritis) or the so-called "growing pains" in children.

Depending on the variety of causes, the pain can also occur in very different forms and intensities and, for example, be perceived as sharp, stabbing and getting worse when moving. Painful legs can also occur especially at night or when lying down and e.g. as in peripheral arterial occlusive disease (PAD) accompanied by tingling in the limbs. In many cases, the complaints have no serious cause and disappear very quickly with decreasing (over) strain on the affected leg. However, as soon as the pain persists for a longer period of time, is particularly pronounced, or occurs after an accident as a result of an injury, a doctor should be consulted in order to clarify the exact cause and thereby avoid health risks.

Causes of leg pain

The leg (medical: "lower extremity") is usually divided into the thigh (lat. Femur), lower leg (crus) and the foot (with the tarsus, metatarsus and toes), in addition there is the pelvic girdle (cingulum membri inferioris). Accordingly, the thigh bone, shin (tibia), fibula (fibula) and the foot bones form the bony structure of the leg, other components are muscles, tendons, joints, ligaments and nerves as well as blood vessels, lymphatic vessels and the skin.

Depending on the complex structure, pain in the leg can have a variety of causes, but often it involves injuries to the muscles (muscle soreness, cramps, tension etc.), ligaments or tendons (e.g. Achilles tendon tear), strains, bruises and fractures of the bones ( e.g. fracture of the shin) as well as the knee, hip or ankle joints. In addition to this, the cause of the complaints is often also joint complaints such as arthrosis or rheumatism, as well as circulatory disorders, e.g. as a result of hardening of the arteries (arteriosclerosis). Varicose veins, blood clots (thromboses and embolisms), itchy rash such as psoriasis or neurodermatitis, gout or a herniated disc can also be the trigger. Other possible causes are misalignments ("X" or "O" legs) or neurological diseases such as the so-called "restless legs syndrome" (English: "restless legs"), which is caused by emotional disorders as well as a (mainly occurring at rest ) Twitching, pain and tingling in the limbs is characterized.

In addition, malignant tumors of the bone tissue (bone cancer) can cause pain and swelling in the area of ​​the leg in an emergency. In addition, there are often restrictions on movement, and the bone often loses strength due to cancer, which means that a bone fracture occurs quickly even under normal stress (“pathological fracture”). Bone pain in the leg can also indicate osteoporosis ("bone loss"), which is a bone metabolism disorder that leads to a decrease in bone density and an accelerated breakdown of the bone substance and structure. As a result, there is also a significantly increased susceptibility to bone fracture, with vertebral body collapses and fractures of the femur occurring particularly frequently.

Symptoms

Depending on the many possible causes, leg pain can also occur in very different forms and intensities and can be accompanied by a variety of other symptoms. Accordingly, the complaints can be particularly pronounced when the joint is bruised, for example, whereas arteriosclerosis, severe pain can also occur when at rest. Depending on the cause, these can be perceived as sharp or stinging and shooting, for example in the case of a muscle tear, and tearing or pulling pain is also typical for calf cramps.

In other cases (such as arthritis in the knee joint), the painful, red-swollen area also feels warm or hot, often due to the swelling and pain there is also limited mobility or the taking of a gentle posture. If the nerves are affected (such as with diabetes), the symptoms can also be accompanied by numbness in the legs and muscle weakness, and severe, excruciating discomfort such as "tingling ants" or burning in the legs and feet are also common.

Aching legs at night / lying down

If leg pain occurs primarily at night or after a long period of lying down, there is in many cases a so-called "peripheral arterial occlusive disease" (abbreviated to paVK), which is a circulatory disorder of the limbs. The chronic vascular disease of the arteries is primarily caused by arteriosclerosis (“hardening of the arteries”), in the development of which smoking plays a central role. Accordingly, paVK in the advanced stage is often referred to as "smoking leg", whereby calcification of the arteries can also be favored by other risk factors such as lack of exercise, obesity, diabetes mellitus, fat metabolism disorders, high blood pressure or hyperthyroidism.

PaVK usually begins slowly and unnoticed because early symptoms such as occasional leg pain, pale face, skin problems on the legs and feet, hair loss on the legs or chills are often not consciously perceived or taken seriously. In the further course, however, increasing calf pain occurs when walking, which is caused by the fact that the affected leg does not receive enough oxygen due to the impaired blood circulation. As a result, it is now usually only possible to walk short distances without pain, and instead breaks are frequently taken, which is why colloquially often referred to as the "window disease". In addition, there are often foot and buttock pain as well as complaints in the thighs. Later, the calf pain will also appear at rest, which can often be a real pain, especially at night or after lying down for a long time.

If the disease reaches the last stage, the blood circulation is already reduced to such an extent that even minor injuries heal poorly at this point. As a result, infections, chronic wounds and ulcers on the feet and toes are at risk. In addition, there is a risk that the surrounding tissue will die (necrosis), which can even lead to amputation in severe cases. Accordingly, it is important for good blood circulation and healthy vessels to reduce risk factors such as smoking or being overweight, and to undergo regular medical check-ups and preventive medical checkups with increasing age, in order to get early signs of PAD such as dry skin on the legs and feet or pain in the calves in good time to recognize and thereby initiate appropriate treatment steps.

Leg pain in the thigh

If the complaints appear in the thigh, various causes can also be considered here, whereby there is often no serious illness. Nevertheless, the thigh pain can become a real agony for the person concerned and mean a severe physical restriction. The pain in this area often arises from injuries such as a bruise (contusion) due to blunt violence (fall, blow, impact, etc.). A typical example here is the collision with a teammate in so-called “contact sports” such as soccer, handball or hockey, through which tiny blood vessels burst under the skin, causing blood to get into the surrounding tissue. There is swelling and severe pain, a short time later the skin turns blue in the affected area and a hematoma arises, which can reach enormous dimensions. In addition, the injury often results in massive restrictions on movement, with severe bruises even brief paralysis is possible.

A muscle fiber tear in the thigh or calf muscles can also lead to severe leg pain. This is a sports injury in which a sudden, particularly violent movement or due to extreme overload causes muscle tissue to tear. Typical here is a sudden, severe pain, combined with a clearly audible “tearing”, and the function of the leg is immediately disturbed, which means that it is no longer possible to appear or walk. In addition, an indentation is often felt at the affected area, from which a severe swelling forms a few hours after the injury.

In addition, a strain can be the cause of the complaints in the upper or lower leg, which is one of the most common sports-related injuries. In this case, the affected person usually feels tension in the affected muscle and a slight pull at the beginning, and the affected area feels hard. In addition, there are cramp-like pains, which typically become slowly and continuously stronger, the same applies to the function of the muscle, which continues to decrease over time. A strain occurs particularly quickly when athletes do not warm up sufficiently or due to muscle overload, as well as in sports with very abrupt movements (such as basketball). There are also other risk factors such as poor health due to illness, inappropriate shoes or misaligned feet.

There are also a number of orthopedic or neurological causes for the pain. For example, the following are possible Impairment of the femur nerve, which arises from the spinal cord segments of the lumbar vertebrae (L1 - L4) and leads to the thigh through the so-called "muscle portal". If the pain suddenly sets in and the affected area is red, warm and swollen at the same time, in rare cases it can also be a occlusion (thrombosis) of the leg veins. In addition, a herniated disc can be the trigger, the thigh feels tight and hard below the buttocks, and the sciatic nerve can also be pinched.

Calf pain

A common cause of calf pain is muscle cramps, which are usually completely unexpected e.g. occur while jogging and normally make normal walking impossible until resolution. Calf cramps are usually triggered by under or overworking the muscles, which often affects athletes when their muscles are overused. Excessive sweating during sport is usually an additional risk factor, because this causes the body to lose not only fluids but also important minerals (e.g. magnesium or potassium), which are, however, essential for muscle function. However, people who tend to overexert their muscles by sitting at the desk or a general lack of exercise are also more prone to cramps. As a result, nighttime calf cramps can occur, which can also be caused, for example, by overloading the feet (e.g. by wearing unsuitable shoes for a long time), misaligned feet, excessive alcohol consumption, medication (diuretics, high blood pressure, etc.) or a disease such as e.g. Diabetes or varicose veins (varices) can be triggered.

A torn muscle fiber can also be the reason for calf pain. This occurs when muscle tissue in the calf tears due to sudden overexertion (e.g. when jumping off) or permanent heavy use (e.g. in competitive sports). Accordingly, it is also a typical sports injury, which occurs particularly frequently in those sports in which, e.g. Running and stopping again in football or using the speed force in sprinting or jumping, for example. In addition to this, direct violence (kick, punch, etc.) can also cause a muscle fiber tear, as well as e.g. Misaligned feet, insufficient regeneration after an injury or muscle hardening. Characteristic of a torn muscle fiber is above all a sudden shooting pain or the feeling that something "breaks" in the calf. In addition, walking and standing on tiptoe is only possible with extremely severe pain or in some cases even no longer possible. In addition, this injury sometimes leads to the formation of an indentation. After a while, thick calves usually develop due to the strong swelling around the affected area.

If the pain suddenly appears, deep vein thrombosis (phlebothrombosis) can also be the trigger, in which the formation of a blood clot (thrombus) in a deep leg vein partially or even completely closes the vessel. Typical symptoms here are a sudden, severe swelling and that the calf feels unusually warm or hot and / or tense, the thrombosis is externally recognizable by a bluish or reddish discoloration of the skin. Since deep untreated leg vein thrombosis can lead to complications such as pulmonary embolism or post-thrombotic syndrome (PTS) relatively quickly, any suspicion should be clarified immediately by a doctor.

There are also a number of other possible causes of an aching calf, such as Chronic circulatory disorders ("peripheral arterial occlusive disease", abbreviated: PAD) or a so-called "compartment syndrome", in which e.g. as a result of a bruise there is increased tissue pressure in a defined area ("compartment") of the lower leg. Also an intervertebral disc hernia, through which those affected can feel the most massive, deep thigh or back pain, depending on the area and type, which radiates down to the calves or even feet. These complaints are often colloquially referred to as "lumbago" or "sciatica pain", which typically intensify when moving and usually last for a longer period of time.

Leg pain in children

Many parents feel familiar when the children suddenly complain of pain in their feet or legs while walking. In many cases, however, there is no need to worry, instead, especially children in pre-school and primary school are often so-called "growing pains" that occur frequently in the evening or at night. These can - but do not necessarily have to - occur in both legs at the same time and sometimes last for a while, but they often disappear on their own after a few minutes. In principle, the symptoms can be felt in the entire leg and feet, but the knees and lower legs are particularly often affected. Why waxing hurts in some cases has not yet been fully clarified, but a strong stretching of the tendons and ligaments due to the growth spurts at night and an overload of the not yet mature muscles are suspected, among other things. Regardless of the cause, the pain can become very severe and stressful for a young person, so it is particularly important to show a lot of understanding, to be there for the child and to give them physical closeness and emotional care.

Growing pains are a so-called “exclusion diagnosis”, which means that all serious causes of the complaints must first be excluded. If the complaints often occur suddenly while running, you should first check whether they could have a "harmless" reason such as slipped socks, poorly fitting or too small shoes or a blister, pressure point or abrasion on the foot. If, on the other hand, there is persistent pain (especially at night), the child should be examined by a doctor in any case, because in addition to the frequently occurring and harmless “side effects” of growing, there are a number of other causes for leg pain. For example, an incorrect loading of the leg or a so-called "hip runny nose" (coxitis fugax), which is a non-bacterial inflammation of the hip joint, which mostly affects children or adolescents from three to ten years. The exact cause is so far unknown, but in many cases a viral disease such as e.g. a flu infection ahead. Typical of the usually harmless disease are primarily hip pain, which usually occurs on one side and can radiate from the groin to the thigh or even the knee. As a result, the children do not want to continue walking, and due to the limited mobility, it is often only possible to limp.

In addition, injuries (bruises, compression, stretching, etc.) as a result of falls, accidents, etc., particularly frequently lead to acute leg pain in children. Furthermore, in rare cases there can also be a serious cause such as an inflammation of the joints due to an infection with viruses (e.g. mumps, ringed rubella) or bacteria (e.g. streptococci or borrelia). Juvenile idiopathic arthritis ("childhood rheumatism "), A so-called" femoral head necrosis "as a result of circulatory disorders, blood, tumor or immune diseases and coagulation disorders.

Accordingly, sudden, severe or prolonged leg pain in children should be taken seriously in any case and, above all, be examined by a doctor if swelling and / or overheating of the joint, larger hematomas or a larger wound are evident. The same applies in the event that the child can no longer occur, minimal movements are already causing severe pain or the sensation of pain is restricted or switched off.

Treatment for leg pain

Therapy for painful legs depends on the cause and can therefore include very different measures. If, for example, there is muscle soreness, rest, patience and the administration of magnesium are often sufficient, but in the case of vein-related leg complaints such as varicose veins or water in the legs, e.g. Vein remedies made from horse chestnut extract or arnica as well as compression stockings are used, sometimes procedures such as obliteration or surgical removal are carried out.

For example, if there is a bruise, the initial treatment is ideally carried out according to the so-called "PECH scheme". This means that in order to avoid further damage, the person affected should absolutely stop doing sport and instead keep the leg still (pause). In addition, the affected area should be cooled as quickly as possible with ice packs, envelopes, cold compresses or spray to prevent the swelling from spreading (ice). It is also advisable to put on an elastic compression bandage through which pressure is exerted on the corresponding area and the internal bleeding can be further inhibited (compression). Further bleeding into the surrounding tissue and swollen legs can also be prevented by lifting up, since less blood gets to the affected part of the body due to gravity. In most cases, the swelling of a bruise regresses after several days and leaves no consequences, but a short sports break is usually recommended so that the injury can heal completely. In the event of a severe or large bruise, a doctor should always be consulted as a precaution to be able to rule out deeper injuries.

A torn muscle fiber is usually first treated using the PECH method, in addition to which pain-relieving and anti-inflammatory drugs (e.g. ibuprofen) are usually added. In addition, measures such as lymphatic drainage or cold applications are sometimes used for further treatment. In the case of injuries with impaired function, however, surgical intervention is usually necessary, especially for athletes, since otherwise deformities and functional disorders are at risk. After the operation, the affected muscle should then be immobilized for six weeks to prevent it from tearing again. Elevation and cooling are also the means of choice in the event of a strain. In addition, athletic training should be avoided for at least one week or the leg should only be stressed again when the hardening and the pain have completely disappeared.

In other cases, such as in the case of circulatory disorders, on the other hand, moderate exercise therapy (walking training, walking exercises, etc.) helps against the pain in the leg. In addition, medication (e.g. acetylsalicylic acid, clopidogrel) is usually used, but in some cases medical interventions such as an embolectomy, stretching of the affected vessel or surgery are necessary. In addition, the patient's active participation is particularly important to avoid complications and serious consequences of a circulatory disorder such as a heart attack, stroke or an amputation. Accordingly, smoking should be given up and weight loss should be aimed at being overweight. Other important factors in the treatment are regular exercise, a healthy, balanced diet and timely and consistent treatment of existing diseases such as diabetes mellitus or an elevated cholesterol level.

Home remedies for leg pain

If the complaints appear in the calves in a mild form, which, according to a medical assessment, are no more serious causes, e.g. If you have a chronic circulatory disorder, various home remedies for calf pain can help relieve it. Since the pain often occurs in the form of cramps after physical exertion, e.g. often the consumption of foods containing minerals such as Apple juice spritzer, banana or almonds have a preventive effect, and you should always ensure that you warm up sufficiently before exercising. Muscle-relaxing and therefore beneficial for cramps is also rubbed with cold-pressed oil, which is enriched with a few drops of essential lavender or rosemary oil.

Calf wraps are also a tried and tested home remedy for calf pain and cramps, e.g. by applied with low fat curd have a cooling and relieving effect. These are easy and quick to make by applying some curd cheese to a sheet, then the corners of the sheet are wrapped and the whole thing is wrapped around the affected calf.

Naturopathy for aching legs

In the case of growth-related leg pain, which occurs primarily in the evening or at night, the affected child primarily needs a lot of parental care and closeness to be distracted from the symptoms and to find sleep. Warmth is also beneficial, e.g. in the form of a hot water bottle or a grain pillow, which is placed on the affected area. Alternatively, a warm bath is also very suitable, which enables the little patient to relax and the pain is often quickly relieved. Parents can also do something good for their children with a gentle massage of the leg, in which circular movements e.g. relaxing and pain relieving arnica ointment or a few drops of St. John's wort oil is applied to the affected areas.

Naturopathy also offers some effective procedures for patients with circulatory disorders, which can be used in addition. Here, for example, applications of hydrotherapy come into question, for which, above all, the property of water is used as an ideal coolant and heat transfer medium. However, it is important to note that some measures, such as a foot bath is contraindicated in the case of a disordered shower bleeding and should therefore not be used. On the other hand, it can be beneficial to have a simple hot-cold alternating shower, which promotes the elasticity of the vessels and gets the circulation going. For this purpose, the warm shower spray is first directed upwards towards the heart and then back again. This process is then repeated two to three times and then repeated two to three times with cold water. A so-called “carbonic acid bath” is also good for functional or arterial circulatory disorders, since it has a disinfecting and pain-relieving effect, among other things, and has a positive influence on the blood circulation and flow properties of the blood. The application is carried out either as a partial or whole body bath in water enriched with carbon dioxide, whereby between 1000 and 1400 milligrams of carbon dioxide per liter of water are necessary for a therapeutic effect. The temperature of the bath should be between 28 and 31 ° C. Accordingly, this special application must be carried out by qualified specialists in the event of problems with blood circulation.

A calf massage can also relieve the feeling of an “internal blood congestion”. To do this, the calf is gripped with both hands and light pressure is applied, which loosens the muscles and stimulates blood flow. In order to support the veins in the transport of the blood to the heart "from the bottom up" and thereby ensure adequate blood circulation, regular simple exercises from venous gymnastics can help. A "classic" here is the rocking on the toes ("rocker"), in which you stand on your toes for a few seconds and then the foot is rolled off again. Now proceed the other way round by stretching the toes up and rolling them back on the ball. This exercise can be repeated at will, but at least five runs should be done.

In the early stages of a circulatory disorder, homeopathic medicines can also have a positive effect. Here, for example, tingling in the limbs, feelings of numbness and pain in the legs come into consideration abrotanum (boar diamond), the complaints with heat and movement intensify (such as with the "shop window disease"), tabacum can also be the method of choice. In addition, depending on the respective complaints, e.g. Espeletia grandiflora, Secale cornutum (ergot) and Creosotum (beechwood tar) are also used, so you should always speak to an appropriate expert before taking them. (No)

Author and source information

This text corresponds to the requirements of the medical literature, medical guidelines and current studies and has been checked by medical doctors.

Dipl. Social Science Nina Reese

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Video: Remedies for the excruciating pain of charley horse leg cramps (November 2021).