Leg Pain

Leg Pain

Alternate Names

  • pain in the leg
  • Fracture of the leg

Definition

Most people, including healthcare professionals, use the term "leg" to mean the entire area between the top of the thigh and the ankle. Pain can occur in this part of the body for many reasons.

What is going on in the body?

Pain may occur in one or both legs. There are many different causes, ranging from unimportant to life-threatening.

Risks

What are the causes and risks of the condition?

There are many possible causes of leg pain, including:
  • trauma or injury, ranging from a bruise to a broken bone. Sometimes, old injuries can cause pain for years after the injury.
  • arthritis, which is inflammation of the joints. The hip and knee joints are commonly affected.
  • blood clots, such as a deep venous thrombosis, which is a clot deep inside the leg
  • varicose veins, which are abnormally widened veins
  • nerve damage, also called neuropathy. Nerve damage has many possible causes, such as diabetes and vitamin deficiencies. Sciatica, which is an irritation of the sciatic nerve, may cause pain radiating down the back of the leg.
  • poor blood flow or circulation, such as that caused by atherosclerosis, or clogging of the arteries with cholesterol
  • cancer or a tumor, usually involving the bone, muscles, or skin
  • infection, usually involving the bone, muscles, or skin. For example, osteomyelitis, a serious bone infection, and cellulitis, a skin infection, commonly occur in the skin of the lower leg.
There are other causes of leg pain. Sometimes, a cause cannot be found.

Prevention

What can be done to prevent the condition?

Many cases of leg pain cannot be prevented, but prevention is related to the cause. Proper stretching and conditioning prior to participation in athletic activity may prevent some pains. The development of atherosclerosis may be reduced by not smoking, eating a good diet, and exercising regularly. Controlling blood sugar levels with diet, exercise, and medications can sometimes prevent diabetic neuropathy.

Diagnosed

How is the condition diagnosed?

Diagnosis of the cause of leg pain begins with a history and physical exam. Blood tests may be helpful in some cases. For example, a blood test called a complete blood count (CBC) may help diagnose an infection. Imaging tests, such as an ultrasound, can help diagnose blood clots and poor blood flow. X-rays can help diagnose a bone fracture, tumor, or infection.

Long Term Effects

What are the long-term effects of the condition?

Long-term effects are related to the cause of the pain. Pain can be severe and make a person unable to perform normal activities. Chronic pain can also cause stress, sleep disorders, and depression.
Infections can often be treated with antibiotics and may have no long-term effects. A deep venous thrombosis in the leg can break off and travel through the bloodstream to the lungs, a condition called pulmonary embolus.

Other Risks

What are the risks to others?

Leg pain is not contagious and poses no risk to others.

Treatments

What are the treatments for the condition?

Leg pain can be treated in a number of ways. The treatment depends on the cause if it is known, although it can be given simply to relieve the pain. The most commonly used pain relievers include nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (i.e., Advil, Motrin) or naproxen (i.e., Aleve, Anaprox, Naprosyn). These can help with many types of pain, such as that due to injury or arthritis. Medications such as gabapentin (i.e., Neurontin) and amitriptyline (i.e., Elavil) may help treat pain due to nerve damage. Cancer pain can often be treated with medications like morphine or meperidine (i.e., Demerol).
The underlying cause of the leg pain may need to be treated as well. For example, someone with a broken leg may need a cast or surgery. Someone with deep blood clots may need to be treated with blood thinners like heparin or warfarin. An infection may need treatment with antibiotics. A person with a bone tumor or cancer may need surgery, chemotherapy, or radiation treatment.

Side Effects

What are the side effects of the treatments?

Side effects depend on the treatments used. NSAIDs may cause allergic reactions or stomach upset. Blood thinners may cause abnormal bleeding if the blood gets too thin. Surgery can be complicated by bleeding, infection, or an allergic reaction to the anesthetic.

After Treatment

What happens after treatment for the condition?

Arthritis is often a lifelong condition requiring long-term treatment. An infection may be "cured" by treatment and the person may be able to return to normal activities right away. Cancer may result in death if treatment is not successful.

Monitor

How is the condition monitored?

Monitoring is related to the cause of the pain. For example, those with nerve damage from diabetes need to check their blood sugar levels often. Any new or worsening symptoms should be reported to the healthcare professional.

Sources

Harrison's Principles of Internal Medicine, Fauci et al., 1998

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