Lower Leg Pain

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Many of us experience pain in the lower legs at some point in our lives. If and when we do, this can be a significant constraint on the quality of our lives. Our lower legs play a pivotal role in many essential daily activities from just standing up to walking, running and climbing and descending stairs. Of course, if we happen to play a sport, our lower legs will almost certainly be a vital part of that activity as well.

Unfortunately, lower leg pain can have any of a number of causes. As a result, the required treatment for the pain is not always obvious. To complicate matters, two different causes of lower leg pain can sometimes have similar symptoms. In that event doctors must perform differential diagnoses to eliminate potential causes of the pain before treating the one that remains after all others have been eliminated.

Below, we will list 10 possible causes of lower leg pain and give a general description of each type of pain. We will then briefly summarize the standard treatments for each.

If you are suffering from this type of pain, we suggest that you use this article only as guidance for determining how to proceed. In some cases, the causes of lower leg pain  can be quite serious and may even be life threatening. If you are experiencing any of the symptoms listed below, our advice would be to see a doctor as soon as possible.

Calf Muscle Cramps


If you experience a lower leg cramp, the pain will likely be sudden, tight and very intense. It can also happen at any time, even in the middle of your sleep or at other times when you are not engaged in any physical activity.


Probably the best way to avoid these cramps altogether is to be careful to keep hydrated at all times. Cramps are usually the result of tired or dehydrated muscles.

Calf muscle stretches may also help to reduce the intensity of cramps or may stop them altogether. You should also try stretching or massaging the calf muscle area both before and after your exercise or other activity.

Shin Splints


This sports related injury causes lower leg pain that you can usually along the entire length of your shin. You also experience inflammation of the muscles along the edge of your shin bone (tibia), making it difficult for you to walk, run or jump.

If you try these activities on a hard unyielding surface like concrete, the symptoms will be worse. In fact, running, jumping or other high impact activity on such a surface often brings on shin splints.

The risk of getting shin splints is also higher if you have adult acquired flat foot or tend to walk with your feet turned outwards.


As with many soft tissue injuries, shin splints will often get better with rest. For added improvement, apply ice or a cold compress to your painful shins. Pain and inflammation reducing medications like aspirin or ibuprofen will bring extra relief. Compression using a calf sleeve or tensor bandage will also help.

For more information on shin splints and its treatment, please read our post on the subject.

Achilles Tendonitis


This is another sports related injury that causes lower leg pain. This time, however, the pain occurs low down along the back of your leg and just above your heel. Achilles tendonitis is caused by damage to the achilles tendon that connects the soleus and gastrocnemius calf muscles to your heel bone.

The injury is frequently the result of overstressing your calf muscles. You may find that activities such as climbing stairs (or generally any activity involving plantar flexion) may cause the pain to get worse.


As with shin splints, rest and icing will help with this cause of lower leg pain. Anti inflammatory medications will provide additional relief.

Physical therapy exercises that require you to stretch and strengthen your calf muscles will also help relieve the pain and move you towards injury recovery.

In extreme cases of this injury, the tendon may actually be torn. One sign of this is difficulty achieving planter extension (pointing your toes downward). If this is the case, your doctor may suggest surgery as a necessary step to repair the injury.

For more information, please read our post on achilles tendonitis.

Calf Sprains & Strains


If you are feeling pain in your lower leg from a calf strain or sprain, you may have heard or felt a snap or pop in your calf at the time the injury occurred. This would be followed by pain in your calf area as well as tenderness, bruising and possibly swelling in the same area.

This is an injury caused by damage (overstretching or partial or complete tearing) to lower leg muscles, tendons or ligaments.


This is another soft tissue injury treatable by resting and icing your calf. Pain relief or anti inflammatory medications will provide further relief of pain and swelling respectively. In addition, compressing as well as elevating the injured area above heart level will help you to recover from the injury.

We have more information about this type of injury in our posts on calf sprains and strains.

Stress Fractures


Lower leg stress fractures are caused by excessive stresses over time on your shin bone or tibia. That dress eventually leads to microscopic fractures in the bone and sharp, localized pain in the shin area. You will likely find that this pain increases with activity (particularly high impact activity like running) and reduces when you are resting .


To treat lower leg pain from stress fractures, your doctor will probably suggest taking a break from high impact athletic activities. A 6-8 week break may be recommended. Combined with regular icing and use of pain relief medication like Tylenol, you should be back to full health in a couple of months.

Blood Clotting


Blood clots are another possible cause of lower leg pain. They are accused by your blood thickening and eventually forming lumps in your veins. If this happens in a vein that is located deep under the surface of your skin, the result is a potentially life threatening condition called Deep Vein Thrombosis (DVT).

Many of these clots tend to happen in the thigh or lower leg. However, if they break off and travel to a lung artery, they could block your blood circulation. Although DVT is frequently painless, it sometimes causes lower leg pain akin to cramping or a general soreness in the leg. Swelling is another symptom, as are redness, discoloration and warmth of the skin of the lower leg.


To treat blood clotting and DVT, consider using blood thinning medications (e.g. aspirin) and wearing compression stockings. If you are overweight, weight loss can sometimes be helpful.

Varicose Veins


This condition has a unique appearance – twisted leg veins that are dark blue or purple in color. It is caused by weak blood vessel valves and walls. The condiiton is frequently accompanied by lower leg pain of a dull, aching nature. The pain may worsen after long periods standing up.


To treat varicose veins, try wearing compression stockings or socks similar to the ones you would wear to combat DVT.

Peripheral Arterial Disease (PAD)


Contrary to DVT, this condition arises when the lower leg arteries (instead of veins) become damaged. This may restrict the blood flow to the lower legs and cause lower leg pain of a cramping nature.


PAD is best treated by lifestyle changes such as quitting smoking, healthier eating, exercise and weight management.

You may also need to take medications to control conditions like cholesterol, hypertension or diabetes that may contribute to the problem.

Stenosis & Sciatica


Norrowing of the spinal canal (stenosis) can lead to pinched nerves, including nerves carrying pain signals from the lower legs. This condition is called sciatica and it causes a cramping or burning pain in the lower legs. You may also experience numbness, tingling, fatigue and weakness in the lower legs and buttocks.


Contrary to the treatment of other causes of lower leg pain, rest will not help heal sciatica. However, you may gain some relief with pain and inflammation reducing medications as well as hot and/or cold therapy. Physical therapy exercises to stretch and strengthen the back area may also be beneficial.

If these approaches are not successful, your doctors may recommend surgery to correct the problem.

Diabetic Neuropathy


Diabetic neuropathy is another form of nerve damage that can cause lower leg pain in some places along with numbness and loss of feeling in others. The damage is caused by persistently high blood sugar levels.


You will need to take medications to control your blood sugar levels. Another way to do this is via lifestyle changes like weight loss or modifying your diet (eating less sugar or carbohydrate rich foods). Your doctor can advise you in greater detail.

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