How is calf pain diagnosed?
In the first step, an exact anamnesis, especially the duration of pain in the calf, pain localization and the occurrence of the pain is crucial. This can provide initial indications of the cause of the pain. The calf is then examined in detail.
The examining doctor pays particular attention to signs of inflammation, such as redness, swelling and overheating of the calf. Pressure pain at a defined point can be an indication of a muscular injury.Furthermore, the blood is examined for inflammation, coagulation and heart disease. These can give signs of thrombosis.
A special examination, the determination of the D-dimers, quickly provides information about the presence of a thrombosis. If there is a suspicion of acute vascular dislocation, an ultrasound examination can show the course of the vessel and any existing thrombus can be visualized. If there is a suspicion of increasing vascular calcification, invasive imaging of the vessels using a catheter and contrast medium (vascular angiography) should be considered. Magnetic resonance imaging (MRI) is used when there is a suspicion of spinal disease with pain radiating into the legs.
Therapy of pain in the calf
The treatment of calf pain depends on the cause. If there is chronic pain caused by incorrect or excessive strain, it should be treated by changing behavior and movement patterns. In some cases, it can be helpful to stretch the aching muscles during exercise to relax the muscles.
In the case of acute muscle injuries, such as a torn muscle fibre or a sore muscle, the muscles in question should be spared and a rest period should be observed until the pain has passed. Ointment dressings, bandages or a tape bandage can help to relieve the pain and relieve the muscles. If acute thrombosis is suspected, compression and blood-thinning medication are necessary.
At the beginning, therapy is always carried out on an inpatient basis until the thrombus has organized itself and is stable. This reduces the risk of transport to the lungs. Vascular imaging with the administration of contrast medium not only allows the vessels to be visualized, but also to be treated.
Narrowed areas can be dilated by means of a balloon, or widened and kept open by using a stent. In some cases this therapy is not sufficient, so that a bypass has to be made. In this case, another long vein is removed, which serves as a bypass for the constricted vessel.
In this way the muscles can be supplied with blood again. However, this therapy is not sufficient in the long term, since lifestyle is often decisive for the prognosis of arteriosclerosis. Thus, besides a lot of exercise, weight reduction and nicotine withdrawal are among the decisive factors.
Spinal column diseases often have to be treated surgically. By relieving the compressed nerves, the pain in the calf is usually reduced. In the case of inflammation of the calf, antibiotic therapy should be initiated, often also as an in-patient.
