Leg Pain, Cramps due to Fatigue, Back Spasms

Leg Pain, Cramps due to Fatigue, Back Spasms
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Leg pain is a common problem and has many causes. It stems from bones, joints muscles, tendons, ligaments, blood vessels, nerves or skin.

Leg pain is one of the common ailments, afflicting children, adults and seniors. It has diverse causes. 

It comes from bones, joints, muscles, tendons, ligaments, blood vessels, nerves or skin. It affects any part of the foot from the toes, occurring in the sole of the foot. It hurts the heel, around the ankle, shin below the knee, in the knee or behind the knee. But also in the thigh or hip joint.

It arises during exertion, exercise, sports, hiking, but also normal walking. And this is not only because of an injury.

Leg pain at rest or in a lying position is uncomfortable.

It can wake the person from sleep at night

It affects both lower limbs or only one leg

It can be acute, resolving quickly, or chronic and recurrent

It occurs not only as a result of injury, strain or sprain, but also due to inflammatory and other diseases. 

Their experience is shared by women during the menstrual cycle, when the pain is accompanied by swelling, and by pregnant women who are in pain for a number of reasons.

Leg, lower leg, thigh, knee, shin, calf, ankle, heel, shin, foot and toes. Throughout this broad region there is an abundance of tissue.

The cause of leg pain can be minor, but also, on the contrary, severe, complicating and health- and life-threatening.

Concomitant difficulties that co-occur in addition to leg pain:

  • weakness and fatigue or inefficiency
  • tingling, tingling in the limb
  • skin numbness or changes in skin sensitivity
  • redness of the skin or, on the contrary, blueness to pallor 
  • skin defect and ulcer
  • muscle spasms
  • increase in body temperature
  • swelling
  • and so on

Pain can take several forms. It can be sharp, stabbing or throbbing, or dull and less pronounced, or cramping. It passes and reappears, proceeding in waves.

It sets in after strain and subsides at rest. 

Conversely, it can set in at rest and is aggravated when lying down, and is relieved by stretching and standing. 

Night pain is unpleasant and can wake the person from sleep. 

The foot or leg can be painful to the touch or when pressed against it, or in a certain position and movement.

Information about the origin, the provoking factor, but also about the nature and accompanying difficulties, plus associated diseases, are important anamnestic data. They simplify the search for the source of the problem and speed up the diagnosis of the disease. 

Neglecting or ignoriung such difficulties can lead to worsening and complications of the disease. 

Therefore, early diagnosis and early treatment are important even in the case of a seemingly minor symptom such as leg pain.

Want to know more?
Why does lower limb pain occur? 
What minor or complicated problems do they signify? 
Read on.

Leg pain due to injury or overuse and orthopaedic problems

An accident, injury as a frequent reason for foot pain affects children and adults, seniors. 

In the event of an injury, there may be damage to bones, tendons and their attachments, but also to muscles, skin and other structures and tissues.

The injury can be less severe than a common sprain, but can also be severe when a more complex mechanism of injury affects multiple parts and tissues of the leg.

A broken bone, a hairline fracture of a bone, a torn or severed Achilles tendon, but also a pulled muscle, a tendon tendon tendon. 

The thigh and hip joint...

Pain in the thigh can be present for a number of reasons. An example is the stretching of the muscles during physical activity. 

Femur fractures are common in the elderly. An especially common situation among the elderly is a femoral neck fracture.

This type of fracture is more common in women and in people suffering from osteoporosis, i.e. thinning of the bones.

A hamstring strain is mostly known to athletes. Hamstring pain occurs in this case due to excessive stretching and tearing of the muscle fibres.

Even injury to a small number of fibers will cause temporary loss of activity and pain. 

Pain can shoot up into the groin, however, the latter can be present for a variety of reasons. Similarly, pain radiates into the lower extremity from the spine and from the hip joint. 

People of all ages suffer from spinal pain

But what causes it?

Radiating pain into the lower limb occurs, for example, due to:

Radiation of pain and other unpleasant sensations due to nerve irritation = radiculopathy.

The femur is a strong, durable and long bone, surrounded by muscles and other soft structures. The thigh bone is needed for walking and because of pain in this area, there is partial to complete limitation of walking.

The knee...

The knees are among the most stressed joints. Increased load, but also degenerative wear of cartilage, menisci, tearing of knee tendons or Baker's cyst are the reason for the problem.

A Baker's cyst, also called a popliteal cyst, is a sac that fills with synovial fluid. Which is the kind of fluid normally found in joints.

It can lead to injury complications or inflammation.

The manifestation of Baker's cyst is a sensation of pressure in the knee or pain. There can also be some swelling. The cyst may restrict the affected person's ability to move. It often runs its course without symptoms and associated discomforts.

Pain in a knee disorder can radiate below or above the knee.

Jumper's knee is also a frequent case of overuse injury. The source of the pain is a muscle misalignment.

Below the knee...

Lower leg muscles, or calf muscles, can be stretched when moving carelessly. Similarly, muscle pain is also caused by tension, stress, and overuse if the person does not do regular sports.

Further examples:
A shin splint,
or MTSS,
that stands for medial tibial stress syndrome
and is also called soleus syndrome,
tibial stress syndrome
and periostitis

It occurs due to repetitive strain and overuse = enthesopathy, tendon tendonitis.

The pain is in the region of the anterior part of the shin, the fistula. It is aggravated and provoked by loading or pressure on the affected area

Risks of developing MTSS:

  • incorrect and worn footwear
  • improper exercise technique and movement mechanics
  • anatomical condition
  • flat foot
  • lack of flexibility
  • running downhill and on sloping surfaces

The ankle...

A sprained ankle is overstretched, sprained or torn tendon in the area of the complex ankle joint.

Who hasn't sprained an ankle?

Of course, in addition to stretching the tendons of the ankle, fractures may occur. These are complicated and disable a person from normal life for a certain period of time. 

An Achilles tendon injury is similar. The tendon can be stretched or torn. Achilles tendonitis is also an example, due to mechanical overload.

The heel... 

The heel can break, too. Alternatively, difficulties form and tendon tendons are irritated by various outgrowths - heel spurs. Friction of soft structures against this bony outgrowth causes pain.

The leg and the foot...

The leg and foot are, of course, necessary for walking. Any pathological change will manifest in pain.

The foot and leg can be overloaded due to wrong footwear = too narrow toe of the shoe or high heels. Women feel this pain after a full day of walking as tired and heavy feet.

Tired and heavy legs can also be caused by disease...

Tendonitis, tendonitis, is also an example. In this case, plantar fasciitis occurs, i.e. pain in the heel and bottom of the foot.

Overloading and improper loading of the lower limbs is familiar to runners. The risk factor is improper running technique, inappropriate footwear, bad terrain.

Bunions, i.e. hallux valgus, are an unpleasant condition that is not only an aesthetic issue. Leg pain and difficulty walking are more significant problems.

Also, toes can get injured.

Who hasn't stubbed their toe...?

The smell, as well as the pain and other unpleasant experiences, will cause foot, toe and nail fungus

Overloading or unnatural loading of the foot also occurs in various sports such as skiing or skating and other sports where special footwear is required.

Hiking or climbing and similar activities require the appropriate type of footwear.  

Diseases of the blood vessels

Diseases of the cardiovascular system are a worldwide problem. Atherosclerosis and high blood pressure cause considerable health complications and are behind many cases of heart attacks and brain attacks.

However, when it comes to the lower limbs and legs, the disease of the arteries of the lower limbs is significant.

Similarly, disease states also occur with the veins.

Table: the most common vascular diseases of the lower limbs

Peripheral arterial disease
  • a group of diseases affecting the arteries of the human body
  • a common disease worldwide
  • damage to the arteries leads to impaired blood supply, oxygen and nutrients to the tissues
  • malfunction occurs
  • multiple arteries of the human body are damaged = global impact
  • atherosclerosis causes 90% of lower limb atherosclerosis
  • claudication pain of the limb is characteristic
    • when walking - after walking a certain distance
  • limb pain
  • also can occur acutely or run chronically
  • skin changes, pale, blue and cold skin
  • rest pain is typical
    • long-term - pain is worse when lying down, when the limb is horizontal, due to poorer blood circulation
    • when the limb is lowered, gravity helps blood flow to the tissues in the leg
    • therefore the pain often occurs at night and during sleep
    • awakens a person from sleep
  • has 4 stages and especially careful in diabetes
  • limb ischemia is CRITICAL = restriction in blood supply with risk of necrosis
    • black toes up to part of the foot and the need for amputation
(more in reference to the disease)
Chronic venous insufficiency
  • chronic venous insufficiency and chronic venous disease
  • diseases affecting the veins
  • modern problems of civilisation
  • Chronic venous insufficiency is a more severe form of chronic venous disease
  • includes the presence of an increase in blood pressure in the venous system of the lower limbs + the resulting complications
  • Symptoms
    • feeling of heavy legs
    • leg fatigue
    • pain in the lower limbs, shins
      • burning sensation
      • pressure in legs
      • feeling cold
      • numbness
      • tingling
      • itching
      • increased sweating of the feet
      • restless legs syndrome
      • cramps in the legs, which occur mainly at night
    • dilated veins on the surface of the skin
    • varicose veins
    • skin changes
    • lower leg ulcer - a deep defect of the skin and subcutaneous tissue
      • complicated treatment and healing
    • leg pain when sitting for long periods of time
(more information in the links)
Deep vein thrombosis
  • phlebothrombosis
  • may endanger a person's health and life
  • it is characterised by a high prevalence, especially in people over 60 years of age
  • it is a process of blood clot formation in the deep venous system
  • leads to restriction of blood flow through the affected vein
  • Symptoms
    • swelling of the lower limb - characteristic is asymmetric swelling of only one lower limb
      • it is caused by stagnation of blood in the affected lower limb
    • lower limb pain
      • aggravated by movement
      • tension in limb
      • sensation of heavy legs
      • cramping in legs
    • limitation of lower limb mobility 
    • increased filling of superficial veins - for stagnation of blood in the lower extremities
    • limb colouration - red hue, later cyanotic, i.e. blue to purple limb
    • trophic changes, skin damage up to ulceration
    • the skin temperature will be normal, on the other hand pale and cold when embolizing into an artery
(more in the link to the disease) + complications:
  • thrombo-embolic disease
    • a process that arises from deep vein thrombosis and pulmonary embolism
  • post-thrombotic syndrome
    • arises as a complication of venous thrombosis
    • a serious condition that significantly reduces the affected person's quality of life
    • the onset includes:
      1. narrowing or stenosis of the veins due to thrombosis
      2. damage to the venous valves
      3. increase in blood pressure in the veins
  • superficial thrombophlebitis, is an inflammatory disease of the superficial veins
  • The characteristic symptoms of thrombophlebitis are:
    • redness during inflammation of the vein
    • pain and tenderness at the site of inflammation 
    • the vein is rigid to the touch and movable against the substrate
    • swelling at the site in case of mild course
    • transiently present hyperpigmented area - brown dark pigmented streak
    • stiffening persists for several weeks to months, after the thrombus has dissolved in the vein
    • increased skin temperature during inflammation
(more in reference to the disease) 

Rheumatic diseases and the process of degeneration

Rheumatic diseases and osteochondrosis are among the common causes of joint and lower limb pain.

It is an autoimmune process when a person's immunity attacks the body's own cells. Alternatively, the degenerative process and aging of the body contribute to the pain.

Rheumatism is generally associated with the joints. However, its action does not end here. It also attacks other soft tissues and takes many forms. 

Worldwide, about 350 million people suffer from rheumatic diseases. Rheumatism affects more women than men. They are among the most common causes of missing work and getting a fit note.

Pain in the big toe and other joints is caused by the well-known gout.

General symptoms:

  • fatigue, general weakness, inefficiency
  • loss/lack of appetite
  • weight loss
  • increase in body temperature
  • sleep disorders
  • abdominal pain
  • muscle and tendon pain
  • inflammation of blood vessels
  • inflamed and irritated eyes
  • skin rash, skin redness, skin defects to ulcers
  • anxiety and depression

A special group are joint inflammations in the form of arthritis.

Examples of diseases:

Difficulties affecting the joints are: 

  • joint stiffness
  • 3 or more joints can be affected at the same time, most commonly:
  • joint pain
  • joint swelling
  • inflammation of the joints
  • skin changes
  • restricted movement
  • joint instability and limitation of function
  • deformation of joints

Neurological causes

Peripheral neuropathy is the term used to describe constant or recurrent pain in the extremities. 

The pain can be of various types, such as burning, stinging or dull.

The condition is associated with...

Tingling and pins and needles, also known as paresthesias or other negative sensations, and affected skin sensitivity.

The cause is various diseases such as:

  • diabetes as a cause of neuropathy
  • vasculitis, i.e. inflammation of blood vessels
  • toxic factors
  • infection - HIV
  • immunosuppressive diseases - Guillian-Barré syndrome
  • tumours and cancer
  • smoking and alcoholism
  • and other diseases

Other causes of leg pain

 Already the palette of diseases and injuries listed so far is varied.

Further, for leg pain may also include:

  • mineral deficiency and imbalance
    • mainly reduced magnesium - lower limb muscle cramps
    • reduced sodium, potassium, calcium, copper
      • minerals important for muscle function
  • infection with bacteria, viruses or fungi
    • pain of the whole body, hands and feet with flu is also known
    • osteomyelitída - zápal kosti
    • erysipelas - infectious disease of the skin and subcutaneous tissue - fever, weakness and redness of the skin
    • cellulitis - skin infection
  • bloody discharge
  • chronic exertion syndrome - muscles and nerves produce symptoms such as pain, swelling and impaired function due to prolonged overuse
  • pain in the leg during a long run, marathon
  • ingrown nails and nail infections
  • being overweight and obese
  • flat feet - low arch of the foot
  • Legg–Calvé–Perthes disease (LCPD) - a childhood hip disorder
  • joint hypermobility - excessive flexibility and loose joints
  • fibromyalgia and myopathy
  • bone cancer and other structures
  • chemotherapy
  • and other diseases

Growing pains and leg pain in children

Deti rastú, samozrejme, od narodenia malička. 

The presence of growing pains is mainly reported from the age of 3 years until the period of adulthood.

A peak is described for the period between the ages of 3 and 5 years old, then between the 8th and 12th year.

The child complains of leg pain.

It's a slightly different pain than when he tells you that his feet hurt when he walks.

The intensity of pain is individual. Some children feel it every day at about the same time, others only after exertion.

It is reported that about 25-40% of children describe this pain.
During the period of intense growth, the child grows approximately 5 cm per year.

Mostly nocturnal pain is present, it can wake from sleep. This is a deep pain in the thigh, knee, calf.

Growing pain = soft tissue pain due to irritation of nerve endings by stretching during growth.

Children experience falls and other injuries. An example of another cause is flatfeet.

When it comes to pain among children, one should take note of the following:

  • when and on what basis the pain begins and ends 
  • what will make the pain worse and what will alleviate it
  • when during the day or night it appears
  • where exactly the leg hurts, whether it is a precisely localized spot or if the pain shoots to another part
  • how the pain develops
  • what its character is and what type it is - whether it is stinging, prickly, sharp, blunt
  • to note associated complaints, especially fever, enlarged lymph nodes, frequent urination, presence of vomiting, constipation, lack of appetite
  • whether the pain responds to common over-the-counter medicines
  • in young children who cannot yet describe the discomfort - noticing bruises

If you experience pain in your limbs, you must inform your doctor, as there may be another problem

Leg pain in pregnancy and due to hormonal changes

Of course, during pregnancy, any of the listed causes can occur. 

However, some changes, whether hormonal or metabolic, lead to the possible occurrence of leg pain.

First of all, it is important to mention minerals.

These are magnesium, sodium, potassium, calcium or copper and their imbalances and variations in levels. These minerals are important in the work of the muscles.

Imbalance may be behind cramps in the calves.

Leg swelling is prevalent in the third trimester.

However, these swellings can indicate pre-eclampsia, which can turn into eclampsia, which is life-threatening for both the pregnant woman and the fetus.

Increased overload is formed by changes in the distribution of intra-abdominal organs and an increase in body weight.

It is therefore important to wear appropriate clothing that is not tight and does not restrict blood flow, and comfortable shoes during this period. Comfortable footwear is important and helps to prevent foot pain from underneath - the sole of the foot.

The same goes for hormonal changes at the beginning of pregnancy and after childbirth. During menstruation and menopause, the same problem can occur.

The cause is the key to treatment

The focus should be on finding the exact cause in the first place. Only a professional examination will help.

Based on this, effective treatment is possible.

It is difficult to state what helps leg pain if the cause is not known.

Why it occurs is not known until then and so therapy cannot be targeted. It may be muscle, bone, blood vessels, nerves or joints and other reasons.

Therefore, professional medical help should be sought. Given the severity of some diseases, leg pain should not be underestimated.

What Causes Leg Pain

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Interesting resources

  • "Polyneuropathies. Medical information about polyneuropathy | Patient". Patient. Retrieved 2016-07-17.
  • MD, Dr Sara J. Cuccurullo (2014-11-25). Physical Medicine and Rehabilitation Board Review, Third Edition. Demos Medical Publishing. p. 434. ISBN 9781617052019
  • Burns, Ted M.; Mauermann, Michelle L. (15 February 2011). "The Evaluation of Polyneuropathies". Neurology76 (7 Supplement 2): S6–S13. 
  • Richard A C Hughes (23 February 2002). "Clinical review: Peripheral neuropathy". British Medical Journal324 (7335): 466–469. 
  • Janet M. Torpy; Jennifer L. Kincaid; Richard M. Glass (21 April 2010). "Patient page: Peripheral neuropathy". Journal of the American Medical Association303 (15): 1556. 
  • "Peripheral neuropathy fact sheet". National Institute of Neurological Disorders and Stroke. 19 September 2012.
  • Rakel, David; Rakel, Robert E. (2015-02-02). Textbook of Family Medicine. Elsevier Health Sciences. p. 1026. 
    • webmd.com - What’s Causing Your Leg Pain?
    • mayoclinic.org - Leg pain
    • medicalnewstoday.com - Types and causes of leg pain
    • Institute for Quality and Efficiency in Health Care (October 9, 2014). "Slipped disk: Overview". Archived from the original on 8 September 2017. Retrieved 2 July 2015.
    • Ropper, AH; Zafonte, RD (26 March 2015). "Sciatica". The New England Journal of Medicine372 (13): 1240–8. 
    • Valat, JP; Genevay, S; Marty, M; Rozenberg, S; Koes, B (April 2010). "Sciatica". Best Practice & Research. Clinical Rheumatology24 (2): 241–52. 
    • T.J. Fowler; J.W. Scadding (28 November 2003). Clinical Neurology, 3Ed. CRC. p. 59. ISBN 978-0-340-80798-9.
    • Koes, B W; van Tulder, M W; Peul, W C (2007-06-23). "Diagnosis and treatment of sciatica". BMJ: British Medical Journal334 (7607): 1313–1317. 
    • Markova, Tsvetio (2007). "Treatment of Acute Sciatica". Am Fam Physician75 (1): 99–100.
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