Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
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