Treatment at Home
Self-care at home depends upon the reason for the leg pain.
- For sprains and strains, RICE is the initial recommendation: rest, ice, compression, and elevation. Acetaminophen (Tylenol) and ibuprofen(Advil) may be used for pain control. Over-the-counter medicines are usually safe to take but may interact with other prescription medications. Health care providers or pharmacists are usually available for questions and advice.
- Hamstring and calf injuries generally heal with the body’s production of collagen fibers to build scar tissue in the area of muscle damage. Depending upon the severity of damage, it may take days to weeks to completely heal. The treatment of a strain is RICE (rest, ice, compression, and elevation). Once the initial phase of recovery begins, it is important that the muscle regain its length. Often, stretching exercises and massage are used to help restore the hamstring muscles to their full length to allow full range of motion of the knee and leg. The decision as to when to start these exercises or to use other types of physical therapy is individualized for every patient and is often made by the health care provider.
Crutches may be used in the first few days after injury to rest the leg. Elastic bandages (Ace wraps) may be applied to the thigh, beginning at the knee and moving upward to the hip joint to provide compression.
Ibuprofen may be suggested as an anti-inflammatory medication and for pain control. As with any over-the-counter medication, it is important to check with a pharmacist or health care provider to make certain that it is safe to take ibuprofen in each specific case. - People with sciatic pain should continue with activity as tolerated. Bed rest is no longer recommended. People with sciatic pain tend to return to normal activity more quickly if the amount of bed rest is minimized. Alternating ice and heat may be helpful; acetaminophen and ibuprofen may also be used. Chiropractic or physical therapy treatments may be of help. If the pain is associated with a change in bowel or bladder function, this may indicate cauda equina syndrome, in which the spinal cord is at risk of permanent damage, and emergency care should be accessed immediately.
- For patients with chronic medical conditions, prevention is often the best treatment. The pain of neuropathy in people with diabetes is very hard to control; a lifetime of blood-sugar control minimizes the risk of this and other complications in later life.
- Similarly, lifetime control of high blood pressure, high cholesterol, and diabetes along with smoking avoidance will minimize the risk of peripheral vascular disease, heart attack, and stroke.
- Most conditions that cause leg pain arise slowly, and home care should be individualized for each patient. One’s health care provider is an important resource for diagnosis, prevention, and treatment.
- If acute pain with leg swelling or loss of feeling associated with a cold leg occurs, medical care should be accessed immediately
Medical Treatment
Therapy for leg pain depends upon the cause. Once the diagnosis is confirmed, care will be tailored to the specific needs of the patient.
Pain in the legs may be due to injury or inflammation of any of the structures that are found in the leg, including bones, joints, leg muscles, tendons, ligaments, blood vessels, nerves, and skin. Inflammation of tissue is usually the cause of pain.
What Causes Leg Pain?
Trauma
Trauma is the most obvious cause of leg pain. Falls, near falls, direct blows, and twisting injuries can damage bones, muscles, and joints of the leg or a combination of all three. Back pain, due to injury, can inflame the sciatic nerve and cause sciatica. This pain that radiates down the leg that follows the path of one of the many nerve roots that leave the spinal cord and make up the sciatic nerve. Sciatic pain usually begins in the back and radiates to the buttock and into the front or back of the thigh and potentially down the leg to the foot, depending upon which nerve root exiting the back is inflamed.
Overuse injuries may cause pain; these injuries are multiple minor traumatic injuries to muscles, tendons, and joints that occur over a longer time span.
- Fractures: When referring to a bone, the terms fracture, broken, and cracked all mean the same thing — the integrity of the bone has been compromised. The most common symptom is pain that occurs because the nerve endings located in the fibrous tissue lining of the bone, called the periosteum (peri=surrounding +osteum=bone), have become damaged and inflamed. As well, the muscles surrounding the bone go into spasm and intensify the pain.
- Stress fractures: Some fractures occur because of repetitive small traumas to a specific area of the body. March fractures describe a fracture of one or more of the metatarsal bones in the foot (the long bones at the base of the toes) that are caused by overuse that fatigues the bone. The name comes from the fact that they are found in soldiers who are forced to march long distances as part of their training.
- Shin splints are an overuse injury to the tibia or shinbone. This condition is also known as tibial stress syndrome. Running, jumping, and dancing are the most common causes. Microscopic fractures occur in the tibia, causing pain and swelling. If the person continues to exercise and disregards the pain, a shin splint can progress to break the bone completely.
- Sprains and strains: A ligament injury is a sprain and occurs when the ligament fibers are stretched, or partially or completely torn. People can stretch or tear muscles and tendons, causing a strain. Both sprains and strains result in swelling and inflammation that causes pain. Sometimes a sprain or strain can occur at the location where the structures attach to bone, and a small fleck of bone pulls off at the insertion of the muscle, tendon, or ligament. This is an avulsion fracture that health care providers often treat in the same manner as a strain.
- Bursitis: There are small, fluid-filled sacs that cover large bony prominences and allow tendons to slide across the bone. Bursitis, or inflammation of the bursa sac, may occur with overuse or injury, like a direct blow. Two bursas in the leg that may commonly become inflamed are the trochanteric bursa that covers the bony prominence of the femur on the outside of the hip and the ischial bursa that covers part of the pelvic bone where we sit.
- Bleeding: Injuries can also cause bleeding into tissues and joints. Since it isn’t possible to compress blood, the swelling causes a significant amount of pain as the pressure increases. Blood is also very irritating to the surrounding tissues when it leaves blood vessels and causes pain by its presence alone.
- Compartment syndrome is a medical emergency. It describes the situation in which excessive swelling occurs within the sections or compartments of the leg that contain muscles. This may cause increased pressure within the compartment that is greater than the blood pressure generated when the heart beats. Blood supply cuts off within the compartment, causing pain, numbness, and an inability to move the foot or ankle. This is a true surgical emergency, requiring opening of the compartments and relieving the pressure within to restore blood supply and prevent permanent disability. One of the hallmarks of the diagnosis is the finding of pain out of proportion to physical findings. Health care professionals confirm the diagnosis by measuring pressures within the compartment.
Treatment at Home
Self-care at home depends upon the reason for the leg pain.
- For sprains and strains, RICE is the initial recommendation: rest, ice, compression, and elevation. Acetaminophen (Tylenol) and ibuprofen(Advil) may be used for pain control. Over-the-counter medicines are usually safe to take but may interact with other prescription medications. Health care providers or pharmacists are usually available for questions and advice.
- Hamstring and calf injuries generally heal with the body’s production of collagen fibers to build scar tissue in the area of muscle damage. Depending upon the severity of damage, it may take days to weeks to completely heal. The treatment of a strain is RICE (rest, ice, compression, and elevation). Once the initial phase of recovery begins, it is important that the muscle regain its length. Often, stretching exercises and massage are used to help restore the hamstring muscles to their full length to allow full range of motion of the knee and leg. The decision as to when to start these exercises or to use other types of physical therapy is individualized for every patient and is often made by the health care provider.
Crutches may be used in the first few days after injury to rest the leg. Elastic bandages (Ace wraps) may be applied to the thigh, beginning at the knee and moving upward to the hip joint to provide compression.
Ibuprofen may be suggested as an anti-inflammatory medication and for pain control. As with any over-the-counter medication, it is important to check with a pharmacist or health care provider to make certain that it is safe to take ibuprofen in each specific case. - People with sciatic pain should continue with activity as tolerated. Bed rest is no longer recommended. People with sciatic pain tend to return to normal activity more quickly if the amount of bed rest is minimized. Alternating ice and heat may be helpful; acetaminophen and ibuprofen may also be used. Chiropractic or physical therapy treatments may be of help. If the pain is associated with a change in bowel or bladder function, this may indicate cauda equina syndrome, in which the spinal cord is at risk of permanent damage, and emergency care should be accessed immediately.
- For patients with chronic medical conditions, prevention is often the best treatment. The pain of neuropathy in people with diabetes is very hard to control; a lifetime of blood-sugar control minimizes the risk of this and other complications in later life.
- Similarly, lifetime control of high blood pressure, high cholesterol, and diabetes along with smoking avoidance will minimize the risk of peripheral vascular disease, heart attack, and stroke.
- Most conditions that cause leg pain arise slowly, and home care should be individualized for each patient. One’s health care provider is an important resource for diagnosis, prevention, and treatment.
- If acute pain with leg swelling or loss of feeling associated with a cold leg occurs, medical care should be accessed immediately
Medical Treatment
Therapy for leg pain depends upon the cause. Once the diagnosis is confirmed, care will be tailored to the specific needs of the patient.