Leg pain is a broad category of conditions. Leg pain can range from acute soreness due to a minor sports injury to long-term chronic and severe leg pain that can be the result of a disease or disorder. Answering what causes leg pain for you will depend on how and where you’re feeling your pain.
What causes leg pain?
The main areas where people feel leg pain include:
- Leg pain behind knee
- Pain in back of leg
- Pain in both legs
- Pain in left leg
- Leg muscle and nerve pain
- Pain in right leg
- Upper leg pain
- Back of leg pain
When people ask what causes leg pain, however, the most common answers are:
- Sports injuries
- Overuse injuries
- Dehydration and other nutritional deficiencies
- Arthritis and other degenerative conditions, like degenerative disc disease
- Co-occurrence with other back and leg pain conditions, like sciatica or spinal stenosis
- Co-occurrence with other pain conditions, like fibromyalgia or diabetic neuropathy
Lifestyle injuries are among the most common leg pain causes. Nearly two million people in the U.S. seek emergency room treatments for sports injuries each year. Sports injuries are most often associated to injuries to the legs.
What causes leg pain? 5 risk factors
Specific pain conditions can lead to chronic or constant leg pain. However, risk factors that are associated with lifestyle choices can also lead to an increased risk of pain in the legs.
People who drink heavily for a decade or more are at an increased risk for neuropathy. As many as 50% of heavy alcohol users report the condition, according to the National Institutes of Health (NIH).
Researchers aren’t sure why, but believe that alcohol poisons the nerves. People who drink a lot typically don’t eat enough fruits and vegetables, which can also contribute to neuropathic leg pain. High alcohol consumption also affects the kidneys’ health, which can contribute to the development of peripheral neuropathy.
The kidneys are responsible for cleaning the blood and flushing toxins out of the body. When these important organs are not functioning properly, dangerous levels of toxins build up in the blood that can lead to nerve damage and neuropathy.
As tumors grow, they can put undue pressure on nerve fibers, leading to leg nerve pain. Tumors in the leg may result from soft-tissue cancer, known as sarcoma, bone cancer, or they could be a metastasis of a distant, primary cancer. Nerve tissues can also turn cancerous.
While cancerous tumors can lead to leg neuropathy, some lumps are benign. If they grow very large, or develop in the wrong spot, tingling or pain may develop.
One type of a benign tumor is called a neuroma. These are clumps of overgrown nerve tissue that develop after the nerve is severed from an injury, amputation, or surgery. These nerve tumors can lead to significant pain, sometimes affecting surrounding nerves and worsening the condition.
Another possible cause of leg nerve pain is chemotherapy treatment for cancer. Chemotherapy-caused neuropathy is relatively common, affecting 30-40% of patients, according to the National Cancer Institute (NCI).
The drugs that carry neuropathy as a potential side effect aren’t necessarily those used to treat cancers occurring in the leg. For example, the chemotherapy drug Taxol is used to treat cancers including breast, melanoma, and esophageal, among others, but can lead to leg and foot pain.
The severity of leg nerve pain from chemotherapy can be mild to severe. The condition is one of the most commonly cited reasons for patients stopping their treatment ahead of schedule, according to the NCI. Prognosis varies by patient. Sometimes, lowering a person’s chemotherapy dose alleviates pain. Others develop a mild case that dissipates after completing treatment. Still others experience pain that lasts for months or years later.
Leg pain during pregnancy
Many women experience leg pain during pregnancy, as well as back pain. As Parents.com explains: “Raised hormone levels cause you to retain water during pregnancy, making you feel swollen and bloated. Your body needs this extra fluid so it can do the work of carrying nutrients and oxygen to your baby.”
Since leg pain during pregnancy is often related to these fluid levels, the same Parents.com article explains some easy tips for reducing swelling and leg pain.
What causes leg pain? Common conditions
As discussed, minor sports injuries and overuse injuries are the most common leg pain causes. However, chronic pain conditions that are closely related to leg pain include:
- Leg pain and fibromyalgia
- Leg pain and sciatica
- Leg pain and diabetic neuropathy
- Leg pain and spinal stenosis
In addition to these common pain conditions that are associated with leg pain, determining what causes leg pain for you may relate to where and how you feel your pain.
Leg spasms and cramps
Legs spasms can be a debilitating condition that most frequently flares up as leg pain at night. As MedlinePlus explains, leg spasms are often caused by:
- Muscle fatigue
- Medication side effects
- Nutritional deficiencies
Leg muscle pain
Musculoskeletal leg pain doesn’t always arise from a disorder or medical condition. About 33% of adults experience pain from overusing their muscles, according to the Cleveland Clinic. In the case of overuse, acute musculoskeletal leg pain could develop from a particularly intense workout. Even carrying a golf bag has been shown to cause musculoskeletal pain in the ankle, according to a study published in the American Journal of Sports Medicine.
Frequently, muscle leg pain arises from muscle sprains or strains. A sprain occurs when a ligament stretches beyond its capacity or tears. Ligaments are the tissues that connect bones to one another. A strain, meanwhile, involves injury to the muscle or tendon. A tendon is tissue that connects muscle to bone.
While sprains more commonly occur during falls or sports injuries, strains are usually the result from overuse, according to the American Academy of Orthopaedic Surgeons (AAOS). However, strains can also result from overstretching. In the leg, the hamstring muscle is easily susceptible to strains, particularly for athletes. The hamstring is actually made up of 3 separate muscles that run from the bottom of the pelvis to below the knee. Hamstring tendons connect the muscle to the bone.
Potential hamstring injuries include strains in the muscle itself. Tendonitis—inflammation or irritation—can also develop in the connective tissues. Runners sometimes report high hamstring tendonitis in the portion closest to the pelvis.
Overuse versus underuse
Although leg muscle pain is often discussed in terms of overuse, some researchers advocate reframing the issue as underuse. In the British Journal of Sports Medicine, researchers argued that muscle use was not the problem. The problem was that the muscles had not been used prior to running, jumping, or participating in some other type of activity normally avoided in a person’s mostly sedentary lifestyle. They wrote:
“Articles are often written assessing “injuries” with the implication that they were the result of movement. This explanation, although sequentially accurate, neglects to focus on the fact that a lack of previous movement is more likely the true source.”
To drive the point home, researchers reviewed several studies and found adults who maintain robust exercises regimens typically experience less musculoskeletal pain—not more. The researchers concluded that while pushing the body too hard may result in injury, not exercising at all increases the risk of injury when a person finally does exercise.
Sedentary people who begin vigorously exercising likely put themselves at risk for leg muscle pain and injuries. To avoid injury, consider easing into exercise gradually and stay mindful of your body’s physical limits.
Shooting pain in leg
Sharp or shooting pain in the leg is most commonly associated with sports injuries. MedicalNewsToday discusses some of the most common sports injuries in their post on what causes leg pain.
Leg nerve pain
Leg nerve pain that is characterized by “pins and needles” sensations may be due to a condition called diabetic neuropathy. EMedicineHealth.com explains:
“People with poorly controlled diabetes may develop diabetic neuropathy, in which the nerves to the legs and feet malfunction. Symptoms may include pain and loss of sensation in the feet as well as a pins-and-needles or tingling sensation. Diabetes is also one of the risk factors for peripheral vascular disease, which may cause narrowing of arteries in the legs, decreasing blood flow to muscles.”
Our video on this leg nerve pain condition discusses more about treatment options.
People who smoke or drink excessive amounts of alcohol have an increased risk of diabetic neuropathy. The physical effects of diabetes wear the body down over time, and people who have had the condition for 25 years or longer are most at risk for developing neuropathic leg pain.
Injuries leading to nerve damage are also a common cause of leg nerve pain, according to the National Institute of Neurological Disorders and Stroke (NINDS). Incidents ranging from car accidents to pileups on the football field may result in peripheral neuropathy.
Leg pain and fibromyalgia
Widespread, musculoskeletal pain is fibromyalgia’s defining characteristic. Researchers aren’t sure how or why the condition develops, but it’s relatively common, affecting about 2% of the total population, according to the Centers for Disease Control and Prevention (CDC). Women are at much higher risk of developing the disorder, with the CDC reporting a 7:1 ratio of women to men.
The disorder sometimes develops after a physical trauma, infection, surgery, or significant episode of stress. Other times, the onset seems random and cannot be attributed to any sort of physical or mental trigger. The condition is believed to run in families, and may have a genetic component.
Whatever the cause, fibromyalgia is believed to induce widespread leg muscle pain by interfering with the way the brain processes pain. Neurotransmitters that signal pain elevate to abnormally high levels. Meanwhile, receptors in the brain become more sensitive to pain signals, overreacting to the brain’s efforts to communicate distress.
Fibromyalgia’s musculoskeletal pain often manifests as a dull ache as opposed to a shooting or stabbing sensation. Fibromyalgia patients also experience pain above the waist.
Other symptoms include fatigue, sleep apnea, cognitive difficulties such as trouble concentrating or focusing, and depression, headaches, or abdominal cramping.
Leg and foot pain
One condition that’s related to leg and foot pain is plantar fasciitis. Our infographic gives a brief overview of this condition.
Spine-Health.com also discusses some of the major causes of leg and foot pain. These include lumbar degenerative disc disease, spinal stenosis, and spondylolisthesis.
Lower back and leg pain
Pain that is felt in the lower back and leg may be caused by a number of conditions, including:
- Degenerative disc disease
- Herniated discs
- Failed back surgery syndrome
Medtronic explains the common symptoms of these lower back and leg pain conditions, as well as how you can get treatment.
Another cluster of pain symptoms that can often cause lower back and leg pain is known as sciatica. You can learn more about this type of pain in our video below.
Pain in lower leg
As verywell.com explains, there are many causes for pain in lower leg. Their list of the most common causes includes:
- Muscle strain or fatigue
- Exercise-related injuries
- Lower leg pain from tendonitis
- Vein problems, such as peripheral artery disease
Hip and leg pain
Since the hip is a joint, hip and leg pain is often related to arthritis. It’s also the cause for most kinds of knee and ankle pain, as MedicineNet.com explains. Treatment options may range from lifestyle management strategies to more interventional procedures like surgery.
As patients are diagnosed younger and live longer, hip and leg pain treatment has become a long-term proposition that may require multiple surgical interventions throughout a patient’s life. Approximately 4.7 million people in the U.S. have a prosthetic knee and 2.5 million have a prosthetic hip.
This reflects a rise in the incidence of these operations, with total knee replacements (TKR) increasing:
- 120% overall from 2000 to 2009
- 188% for patients ages 45 to 64
- 89% for patients ages 65 to 84
Likewise, total hip replacements (THR) treatments have increased:
- 73% overall from 2000 to 2009
- 123% for patients ages 45 to 64
- 54% for patients ages 65 to 84
Our infographic shows more of the stats related to hip and leg pain.
Living with hip and leg pain
The good news is that the aging population of the United States is able to stay active and mobile even with severe hip and leg pain caused by arthritis or other chronic conditions or injuries.
The bad news, or at least the very challenging news, however is that this has implications for not only increased mobility as the population ages, but also long-term care that can be complicated by other health conditions. More women than men are living with THR and TKR, but both populations can expect to live longer with their prosthetic knees and hips, and possibly still experience hip and leg pain. The economic impact of patients with these conditions cannot be underestimated and is an important part of a family’s long-term care planning for elderly family members, but it also comes into play for the younger generation as well.
With the increase in younger people getting TJR surgeries and an increase in life expectancy and care options for older patients, it seems that the upward trend of TKR and TKR for hip and leg pain will continue. THR and TKR as a treatment option for hip and leg pain is a relatively new technology, beginning only in the mid-20th century, and with the increased need has come advances in treatments.
Although surgery will always remain an option, some doctors are looking at complementary treatments such as chiropractic care, acupuncture, and physical therapy to minimize surgical procedures and downtime. With life expectancies continuing to climb, the focus has changed to sustainable, long-term treatment instead of a quick fix.
Constant leg pain
Spine-Health.com notes that constant leg pain is often felt as upper leg pain or leg and back pain. It is often related to sciatica or radiculopathy. Read more about how to relieve sciatica leg pain in our post “10 Sciatica Stretches You Can Do Anytime, Anywhere.”
More serious conditions related to severe leg pain
HealthLine.com discusses 25 conditions that are related to leg pain. They also touch on some of the more serious conditions that can lead to severe leg pain. These include:
- Deep vein thrombosis
- Pulmonary embolisms
- Arterial embolisms
- Compartment syndrome
- Necrotizing vasculitis
As they explain on their site, if you suffer from symptoms associated with any of these conditions, seek medical attention fast. EverydayHealth also offers a symptom checker where you can learn more about the conditions that could be leading to your leg pain.
Finding leg pain relief
Because of the varying causes of leg pain there are a number of possible treatments as well, all dependent on the cause and severity of the condition. Our post “31 Tips For How To Get Rid Of Leg Pain” discusses many lifestyle and home remedies you can try for treating your leg pain.
However, as with all chronic pain conditions, a diagnosis is always the right first step. By knowing what type of pain you’re suffering from, you’ll be able to find better treatments for it. Find a certified pain doctor to find out what causes leg pain for you. Schedule an appointment with one of our pain doctors today to get the right diagnosis, so you can get back to a life without pain.