The symptoms
Depending on the underlying cause, different symptoms occur. In peripheral arterial occlusive disease (pAOD), symptoms such as wound healing disorders in the foot or ankle are observed in addition to calf pain, which increases under stress. A pulse is often no longer palpable and the legs are cold and pale.
In the case of PAVK, several stages of the disease can be differentiated. From stage 2 on, the patient has pain when walking. In a thrombosis, on the other hand, the blood literally reaches the legs, but cannot flow back.
The thrombosis clogs the vessel and hinders or slows down the return flow. For this reason, the leg swells up. This is accompanied by a bluish or reddish discoloration, overheating, a feeling of heaviness or tension and pain.
The symptoms often improve when lying down. In addition to the closure of the deep leg veins, an inflammation of the superficial leg veins, a so-called thrombophlebitis, can also occur, which causes severe pain in the calf. Varicose veins or even joint inflammation can also radiate into the calves and cause pain here.
Overloading during sports activities can also lead to hardening. This is caused by the overacidification of the muscles.However, this is a temporary symptom. Muscle hardening of the calf muscles usually results from a long-term overloading of the calf muscles, such as when running a long distance.
The hardening of the muscles occurs with sudden onset of pain, which often affects only part of the calf muscles. In addition, the hardening of the muscles can only be felt within the calf, as usually only part of the muscle is hardened. However, the hardening of the muscle could spread further with continued strain. In addition, the pain could worsen, as the permanent contraction of the muscle area could also lead to a partial circulatory disorder.
When does the calf pain occur?
Calf pain under movement or strain can have several causes, which can be either orthopaedic or internal. The orthopedic cause usually consists of an incorrect posture or malposition of the leg or foot, which is particularly painful under stress. Other reasons could be poor footwear or compression stockings that are too tight.
Another typical example of calf pain during movement is calf cramps during sports. They can result from a disturbed electrolyte balance of the blood or a simple overloading of the muscles. While this type of calf pain is directly related to movement, another problem underlies pAVK, peripheral arterial occlusive disease.
In this disease, arteriosclerosis (hardening of the blood vessels) ensures that not enough blood can flow to the muscle. This results in a so-called ischemic pain for the patient. This pain usually improves again at rest, as the muscles require less blood.
Calf pain at rest is rather rare, but can occur. Calf cramps would be a typical example of this, since they do not necessarily have to occur during sport, but can also occur at rest. Often electrolyte disorders of the blood are the cause of the development of calf cramps, which makes their treatment quite simple.
Furthermore, a strongly advanced tendon inflammation after sports overloading can also lead to pain at rest. However, complaints must have already preceded athletic activity. In rare cases, it can also be rather exotic-looking diseases such as neuroborelliosis as a late consequence of a tick bite or a soft tissue tumor within the calf muscles.
In connection with nocturnal calf pain, pain is actually only reported for calf cramps. Another disorder of the calves, but also of the remaining leg muscles, is restless legs syndrome. Calf cramps are a typical phenomenon of old age, but also occur in many young patients.
Often a disturbed electrolyte balance is the reason for the nocturnal cramps. Due to the accumulation of lactate in the muscle or the development of tiny tears in the muscle fibers, the cramp can lead to a painful calf. This is different with restless legs syndrome.
Here, a disturbed nerve conduction is at the root of the cramp, which triggers a tingling sensation within the legs. Only in rare cases is the feeling described as really painful. The cause of restless-legs syndrome is usually not clearly identifiable.
However, it can be caused by certain drugs, especially neuroleptics. Consultation with the doctor is therefore recommended in any case, especially since there are a number of drugs available for the treatment of this syndrome. Calf pain after a cramp is probably something that every person suffering from cramps has experienced at least once.
Basically, there are two possibilities that can explain the pain even after the cramp. The first possibility is a “sore muscle”. Due to the strong contraction, some small muscle fibres are torn, which then start to hurt.
The second explanation is based on the assumption that the contracted muscle was not supplied with sufficient oxygen during the cramp. This causes the muscle to produce the energy it needs for involuntary contraction under anaerobic conditions, producing lactic acid, known as lactate. If the lactate is too high, it causes a burning, unpleasant feeling inside the muscle until it has been sufficiently removed by the blood flow.First and foremost, this is a positive sign, since the body’s own immune system is now fighting the pathogens.
Responsible for this are messenger substances of the immune system, which, in addition to a pilot function for the defence cells, also make the body more sensitive to pain. However, the calf pain or general muscle pain disappears as soon as you are on the road to recovery. Treatment with painkillers is potentially possible, but in this case, care should be taken to ensure a sufficient amount to drink and a potential stomach protection.
Calf pain is a common phenomenon during pregnancy. Calf cramps are often the cause of pain in expectant mothers. However, thromboses can also be the cause of calf pain in the later course of pregnancy.
While calf cramps are usually caused by a disturbance in the electrolyte balance and are quite simple to treat, thromboses can be much more risky and should definitely be treated. In most cases of calf cramps, the substitution of magnesium and an occasional massage of the calf muscles is sufficient to prevent the cramps. In the case of thromboses, however, medical help is absolutely necessary. Thrombosis results from a protective mechanism in the body that makes the blood thicker shortly before birth to prevent uncontrollable bleeding during birth.
