What can be behind it if you have calf pain like sore muscles but have not done any sport?
In this context, two main phenomena come into play. On the one hand, rheumatic muscle complaints can cause muscle pain similar to muscle soreness. However, the cause of the pain is to be seen here in an autoimmune reaction of the body against itself.
Not every rheumatic gets muscle pain within the calf, but inexplicable muscle sore similar 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 ingested dietary fats, which is why they are used in people with elevated cholesterol levels. However, SAMS are among the most 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”.
The diagnosis
In order to differentiate between the various causes of calf pain and to identify the problem of the affected patient, a targeted and precise anamnesis must first be performed, paying particular attention to the frequency, posture and position of the patient, as well as physical activity during the onset of pain, localization, accompanying symptoms and restriction of quality of life. A detailed physical examination should then be carried out, focusing on the calf circumference, calf muscles, skin color, temperature and firmness of the tissue, and skin tension. In addition, the examining physician should test the reflexes of the patient’s lower extremity to rule out nerve dysfunction or damage.
If nerve damage or a herniated disc is suspected, imaging, such as an MRI, may be necessary. However, if the reflexes are intact and the symptoms indicate a thrombosis, a Doppler sonography can be performed. This can confirm the diagnosis of deep vein thrombosis.
If the medical history and physical examination reveal a suspected herniated disc or damage to nerves, imaging should be performed to confirm the diagnosis. In this case, an MRI is particularly suitable, since soft tissue, such as the intervertebral disc, is recorded in great detail. An MRI or better still, a CT can also be performed to exclude degenerative changes in the spine.
In the case of degenerative changes, the spinal cord can be compressed, which can also lead to pain, numbness and a reduction in strength in the calf. In addition, possible bone fractures can also be detected by an X-ray or CT. If the symptoms indicate PAVK, a Doppler sonography of the vessels can be performed.Doppler sonography is a good way to detect possible narrow spots.
The examiner first measures the pulses close to the body, such as the pulse in the groin, and then works his way along the vascular and nerve bundle in the direction of the foot. If the pulse is no longer detectable at the foot, this may be a sign of PAVK. However, the diagnosis of thrombosis cannot be adequately diagnosed by this procedure.
A normal sonography is better suited to examine the deep veins of the leg. However, small thromboses cannot always be detected. An MRI with contrast medium is most suitable for this purpose.
