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Leg Pain (cont.)

Leg Pain Causes

Trauma

Trauma is the most obvious cause of leg pain. Falls, near falls, and twisting injuries can damage bones, muscles, and joints of the leg or a combination of all three. Back pain, due to injury, can inflame the sciatic nerve and cause sciatica. This is a pain that radiates down the leg that follows the path of one of the many nerve roots that leave the spinal cord and make up the sciatic nerve.

Overuse injuries may cause pain and can be thought of as multiple minor traumatic injuries that occur over a longer time span.

  • Fractures: When referring to a bone, the terms fracture, broken, and cracked all mean the same thing: The integrity of the bone has been compromised. The most common symptom is pain that occurs because the nerve endings located in the fibrous tissue lining of the bone, called the periosteum (peri=surrounding +osteum=bone) have become damaged and inflamed. As well, the muscles surrounding the bone go into spasm and intensify the pain.
  • Shin splints are an overuse injury to the tibia or shinbone. This condition is also known as tibial stress syndrome. Running, jumping, and dancing are the most common causes. Microscopic fractures occur in the tibia, causing pain and swelling. If the person continues to exercise and disregards the pain, a shin splint can progress to completely break the bone.
  • Sprains and strains: A ligament injury is called a sprain and occurs when the ligament fibers are stretched, or partially or completely torn. Muscles and tendons can also be stretched or torn, causing a strain. Both sprains and strains result in swelling and inflammation that causes pain. Sometimes a sprain or strain can occur at the location where the structures attach to bone, and a small fleck of bone can be pulled off at the insertion of the muscle, tendon, or ligament.
  • Bleeding: Injuries can also cause bleeding into tissues and joints. Since blood, like any fluid, cannot be compressed, the swelling causes a significant amount of pain as the pressure increases. Blood is also very irritating to the surrounding tissues when it leaves blood vessels and causes pain just by its presence.
  • Compartment syndrome describes the situation in which excessive swelling within the sections, or compartments, of the leg that contain muscles can cause increased pressure that is greater than the heart's ability to push blood through the compartment. Blood supply is cut off below the compartment, causing pain, numbness, and an inability to move the foot or ankle. This is a true surgical emergency, requiring opening of the compartments and relieving the pressure within to restore blood supply and prevent permanent disability. One of the hallmarks of the diagnosis is pain out of proportion to physical findings. The diagnosis is confirmed by measuring pressures within the compartment.

Picture of the muscle and nerve anatomy of the leg

Picture of the muscle and nerve anatomy of the leg

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