Introduction
Pain in the legs can occur in various places and have numerous causes. Since the leg consists of different bones as well as numerous muscles, nerves and vessels, all these structures can be diseased or injured and cause pain. Joint problems in the hip joint or knee joint, bone fractures or circulatory problems are particularly often responsible for the pain. The diagnosis is based on the patient’s medical history, imaging and laboratory parameters. According to the numerous causes, the therapy is manifold.
Causes of pain in the legs
Causes for pain in the legs can be very diverse. They can originate from any structure in the leg (bones, joints, vessels, nerves or even muscles). Acute pain in the legs can be caused by injuries to the ligaments and tendons (see also tendonitis in the leg) or pulled muscles.
Broken bones or joint injuries also cause acute pain. Signs of wear and tear or chronic circulatory disorders (PAD) usually develop over time and cause the pain in the legs to increase slowly but continuously. Broken bones of the femur (femur) or of the tibia (tibia) or fibula (fibula) usually occur as a result of accidents.
Depending on the bone structure, even a simple fall can lead to a fracture of the thigh. Injuries to the joints (hip or knee joint) also occur in the context of accidents and lead to severe pain. If the ligaments, tendons or muscles are stretched severely due to incorrect movement or other causes, they can tear and thus also cause pain and restricted movement.
Venous diseases can also cause pain in the legs. Here the patient often notices that his legs feel tired and heavy. Little exercise, being overweight but also not drinking enough and an unhealthy lifestyle can lead to vein diseases.
But hereditary factors also play a role here. Varicose veins (varicosis), spider veins and leg vein thrombosis can be counted among venous diseases. Spider veins mainly affect small skin vessels, but these do not usually cause any complaints.
The situation is different for varicose veins. Here, larger, superficial vessels are affected, which can be seen at first glance. In varicosis, the vessels dilate for various reasons.
The consequence of this dilatation is that the so-called venous valves, which normally prevent the blood from flowing back in the opposite direction, can no longer close properly. As a result, the blood no longer flows back in its original direction to the heart, but follows gravity and flows back into the legs. This backflow leads to a further stretching of the vessels, making them more permeable to fluid and causing oedema.
These are most noticeable at the ankles. As a late stage of this disease, in the worst case, “open spots” may appear on the legs. Prolonged standing or even prolonged sitting often worsens the situation, so that the patient is advised to put the legs up as often as possible.
In order to counteract and improve the pain and the remaining symptoms, special vein gymnastics are recommended, which serve to promote the blood flow back to the heart. If this is not sufficient, there is also the possibility of wearing compression stockings. Inflammation of the veins can also lead to pain in the legs.
Usually only one leg is affected and the inflammation develops along the course of the veins. The skin is reddened and warmed, the pain is sudden and can have a pulling character. Various circulatory disorders can lead to pain or pulling in the legs.
Peripheral arterial occlusive disease (pAVK) occurs in the context of diabetes. It is caused by arteriosclerosis, especially in the leg vessels. As a result, the legs are no longer sufficiently supplied with blood and lead to pain, especially under stress.
Embolisms or thromboses of the leg vessels, on the other hand, lead to sudden and acute severe pain and must be taken seriously. The sudden interruption of the blood flow leads to an acute lack of blood supply to the muscles and thus to pain. In addition, a circulatory disorder can lead to open sores, a so-called leg ulcer.Inflammation of muscles, tendons or bones can be caused by chronic stress or germs.
Usually these inflammations are accompanied by other symptoms. The chronic inflammations in the context of arthritis (inflammation of the joints) often develop over a long period of time and can usually only be cured by a consistent, long-term therapy. A chronic neuropathy in the context of diabetes can also lead to severe pain and loss of sensitivity.
A herniated disc in the lumbar spine can also cause pain in the legs if a nerve supplying the leg has been pinched by the disc. Especially the herniated disc of the lumbar spine is of great importance, but in many cases other causes for the pain can be identified. If you suspect a herniated disc behind the pain, we recommend our topic:
- Slipped disc of the lumbar spine
Polyneuropathies are nervous diseases that affect several nerves.
Often these diseases cause sensations in or on the body. Those affected experience a tingling, pain, numbness or even a loss of sensation, for which there is no corresponding correlate at the perceived location. Rather, the nerves are damaged and therefore tend to convey sensations that do not really exist.
In the case of numbness it can even happen that a nerve is completely dead. In most cases a whole leg or foot is affected by this “false sensation”. Risk factors for polyneuropathy are poorly controlled diabetes or smoking.
More about this:
- Symptoms of polyneuropathy
Pain in the legs can also occur in MS (= Multiple Sclerosis). In one third of patients, the first symptoms of the disease are disturbances of sensation, which manifest themselves mainly as tingling and numbness in the arms and legs. In the course of the disease, muscle cramps occur frequently, which can cause equally severe pain.
Furthermore, patients with multiple sclerosis experience pain mainly in the legs, back and face. A cause at the affected pain site often cannot be found, so that it is assumed that in these cases the pain center in the brain is affected by multiple sclerosis and thus the pain is caused. Unfortunately, conventional painkillers such as ibuprofen or aspirin are then often ineffective.
Restless Legs Syndrome (RLS) is a neurological disease of the legs. The affected persons feel sensitive sensations in their legs. This can range from numbness and tingling to pain.
This results in an urge to move, which leads to an improvement of the symptoms. As a rule, the sensations usually only occur when the patient is at rest and become apparent late in the evening or at night when the patient comes to rest or is lying in bed. RLS can be genetically inherited, but is often also caused by psychiatric drugs such as neuroleptics.
Even if the cause has not yet really been clarified, the complaints can be treated quite satisfactorily with painkillers and dopamine preparations. In many cases, however, the focus is not on the sensitive symptoms but on the exhaustion caused by the disturbed night’s rest. Diabetes as a disease in itself is not responsible for leg pain.
It is the consequences of diabetes that can cause leg pain. Poorly controlled diabetes with permanently high blood sugar levels leads to damage to blood vessels as well as nerves. In this case one speaks of a diabetic polyneuropathy.
The damaged nerves give the affected person the feeling of suffering from pain, although there are no corresponding correlates on the body. Often, however, diabetic polyneuropathy occurs more as a tingling sensation than as pain. However, if polyneuropathy progresses even further, diabetics in particular find that their feet become completely insensitive to sensitive stimuli.
This means that diabetics at this stage cannot really perceive injuries, hypothermia or the like. Therefore diabetics should let examine regularly the feet of the family doctor. More about this:
- Consequences of diabetes
Bone tumors of the thigh bone or both lower leg bones are the Ewing sarcoma or osteosarcoma.Ewing’s sarcoma is the most common tumor disease in children, and osteosarcoma is equally common in adults and children.
All in all, bone tumors are a rare disease, which often leads to pain only late in life. Yes, leg pain can indeed be the result of a vitamin deficiency. However, this is not only a few weeks, but already several years, to have such serious effects.
In all rule components from the Vitamin B row, which can lead with a lack to nerve damage and thus then to leg pain, are. The vitamins have a protective function for the nerves to shield them from damage and to ensure their correct build-up. In the absence of these vitamins, the damaged nerve transmits a pain stimulus for which there is actually no correlative on the leg surface or within the muscles.
These topics may be of interest to you:
- Vitamin B12
- Folic acid
In this context, two main phenomena come into play. On the one hand, rheumatic muscle complaints can cause pain similar to aching muscles. However, the cause of the pain is to be seen here in an autoimmune reaction of the body against itself.
Not every rheumatism sufferer gets muscle pain within the calf, but inexplicable muscle soreness like calf pain could be an indication of the presence of a rheumatic disease. The second potential factor is so-called statin-associated muscle symptoms, or SAMS for short. Statins are a group of drugs that belong to the lipid-lowering group.
They have the effect of synthesizing less cholesterol from the dietary fats ingested, which is why they can be used in people with elevated cholesterol levels. However, SAMS are among the common side effects of statins. Up to five percent of all statin patients complain of the above-mentioned statin-associated muscle symptoms, which often affect the calf muscles. The most extreme form of these symptoms is the so-called rhabdomyolysis, which can lead to “muscle disintegration”.
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