Calf Pain: Muscular, Neural or Vascular?
Calf pain is often due to a problem with your muscles, vascular system or nerves.
Your calf, that bit of your leg between your knee and your ankle, is made up of two major muscles, the gastrocnemius and the soleus, which join at your Achilles tendon above your heel.
Your lower leg also contains several arteries that circulate fresh blood from your heart. There are also major nerves like your tibial nerve and your deep fibular nerve (which both originate in your sciatic nerve). These peripheral nerves allow your brain to send and receive messages from your legs and feet.
As you can see, there’s a lot happening within your calf and a few different things that can go wrong. So, what does calf pain feel like?
Symptoms of Calf Pain
Calf pain varies quite a bit from one person to another but people commonly report symptoms like:
- A dull ache in the calf
- A sharp pain
- Tightness in the calf.
You should see a doctor if you have calf pain plus more severe symptoms like:
- Tingling or numbness in your leg
- A feeling of weakness in your legs
- An unusually cool or pale calf
- Fluid retention
- A red, warm or tender calf.
Muscular Causes of Calf Pain
Remember those two major calf muscles? Well, you use them every time you move your leg or foot. That means you may, at some point, experience cramping or calf muscle pain or strain.
Cramps tend to come on suddenly and may last a few minutes. They happen when your muscle contracts unexpectedly, causing a sudden, sharp pain. Causes of calf cramps include:
- Dehydration (not drinking enough water)
- A muscle injury
- Mineral deficiencies (not having enough calcium, potassium, sodium, or magnesium in your diet).
You may be more prone to muscle cramps if you’re pregnant, diabetic, or have problems with your kidneys or thyroid.
A calf muscle strain or sprain is another common source of calf pain. It’s usually the result of overusing or misusing your muscles. A calf muscle strain will usually feel sore, tender and limit your range of movement.
At this point, you need to listen to your body and rest. Ice or heat can also help. If you have a severe strain or sprain, see your doctor or book an appointment to see us at The Brisbane Spine Clinic.
Compartment syndrome is another possible cause of calf muscle pain. Your muscle is divided into compartments and, particularly after an injury, pressure from extra blood or other fluid can build up in these compartments and stop your blood flowing easily. There are different types of compartment syndrome. Some can be treated by physiotherapy, others will need surgery.
Neural Causes of Calf Pain
‘Neural’ means something that relates to your nerves or nervous system.
The nerve that makes your calf muscle contract traces back up to your sciatic nerve, the longest and widest nerve in your body.
A pinched sciatic nerve results in pain (sometimes with weakness) down one leg. In some cases, it’s so painful that you may not be able to walk or stand. Sciatica can be caused by pregnancy, a slipped disc or spinal stenosis, where your spinal canal narrows and pinches the nerves inside. Physiotherapy can help relieve sciatica.
Peripheral neuropathy is another source of calf pain. Many things can damage the nerves in your calf, including accidents, infections, inherited conditions, alcoholism and diabetes.
Diabetic peripheral neuropathy is a common complication of diabetes, where persistently high blood sugars over many years have damaged the peripheral nerves. Your doctor may prescribe medication to treat symptoms of peripheral neuropathy along with medication or lifestyle changes to address the underlying cause.
Vascular Causes of Calf Pain
Your vascular or circulatory system is like a river system carrying blood and lymph around your body. Your arteries carry nutritious oxygen-rich blood from your heart to your cells while your veins drop off waste at your kidneys and bring used blood back to your heart.
Peripheral vascular disease affects any part of this system outside your heart, most especially extremities like your legs.
Peripheral artery disease (PAD) is one type of PVD. PAD occurs when the arteries that supply blood to your legs and feet have become narrowed (atherosclerosis). This is more common if you’re diabetic, overweight or inactive and if you smoke, have high blood pressure or high cholesterol.
You might experience intermittent pain in your legs that sometimes strikes when you’re exercising and sometimes when you’re resting. Pain caused by a lack of blood flow is called claudication. There can also be pins and needles, numbness or blackened areas of skin.
You should see a doctor if you have these symptoms. You can reduce the risk of PAD and treat its symptoms by lifestyle changes or medications.
Deep vein thrombosis (DVT) is another type of PVD that can affect your calves. DVT happens when a blood clot forms inside a deep vein. This is a serious medical condition that can cause cramping pain in your calf. It’s more common after injury, surgery or long periods of inactivity (e.g. sitting on a long flight). Some medications can also cause blood clots. DVT requires urgent medical treatment.
The right treatment for calf pain depends on the underlying cause – whether it is muscular, neural, or vascular.
Your doctor will reach a diagnosis based on examining you, reviewing your medical history, and considering the results of any relevant tests.
Once you know what’s causing your calf pain, your doctor may encourage lifestyle changes, prescribe medication, or recommend physiotherapy to treat it.
How The Brisbane Spine Clinic May Help
We see a lot of people with calf pain at The Brisbane Spine Clinic.
Our skilled physiotherapists can help you recover from calf muscle injuries or sprains. We also treat neural causes such as sciatica or spinal stenosis and vascular calf pain, communicating with your doctor to ensure coordinated care.
Treatments on your calf can include massage, mobilisation and dry needling. But, while we know you’re feeling pain in your calf, we’re aware that it may not be caused there. We seek to trace the pain back to its source (for example, your sciatic nerve), meaning we may treat your sore leg by massaging your back!
We’ll also look at your biomechanics, such as your trunk stability, hip control, muscle control and the posture of your lower limbs as these factors can all influence your calf pain. Then we’ll develop a treatment plan to help you reduce pain and increase strength and flexibility.
All information is general in nature. Patients should consider their own personal circumstances and seek a second opinion.