Calf Pain

Common Causes and Treatment of Calf Pain

calf strain pain
Calf pain causes discomfort in the back of the leg. Jeannot Olivet\Getty Images

The body region commonly referred to as the calf is in the back of the leg, just below the knee. The calf is made of three major muscles. These muscles are the two gastrocnemius muscles (medial and lateral), and the soleus muscle. Another smaller muscle called the plantaris muscle, is also in the calf. There are two bones in the calf region, the larger tibia and the smaller fibula. Sometimes bone problems, such as stress fractures, can cause symptoms of calf pain.

While muscle injuries are the most common cause of calf pain, there are other causes of calf pain due to circulation problems, knee joint problems, and other conditions. Determining the cause of your calf pain can help guide appropriate treatment. Some of the more common causes of calf pain include:

  • Calf Muscle Strain
    A calf muscle strain is the most common cause of acute onset calf pain. Usually, this injury occurs during a sports or exercise activity. Common symptoms of a calf strain include pain, swelling, and bruising.
  • Medial Gastrocnemius Strain
    The medial gastrocnemius is the part of the calf muscle most commonly injured.  The medial head of the gastrocnemius is one of the three major calf muscles that often is the source of pain when the calf muscle is strained.
  • Plantaris Muscle Rupture
    The plantaris muscle is a thin, small muscle that is not even present in about 10% to 20% of the population. The muscle runs along the gastrocnemius muscle but is a tiny fraction of the size. The plantaris muscle can rupture, causing a sudden, snapping pain in the back of the leg. Because the muscle is of no functional importance, treatment is non-operative.
  • Baker's Cyst
    A Baker's cyst is not a true cyst, rather it is a collection of knee-joint fluid that has pooled in the back of the knee. When excessive amounts of fluid accumulate, it can cause pain in the back of the leg. Occasionally, the Baker's cyst will rupture causing the fluid to enter the calf region.
  • Blood Clots
    A blood clot needs to be considered as a cause of calf pain, especially when the calf pain is not the immediate result of an injury. Blood clots can form is the deep veins of the leg, causing a blockage in circulation. This may cause swelling and pain in the calf. Blood clots are more common in the days and weeks after injuries and surgical procedures. Knowing if you have a blood clot is important, because without treatment the clot can travel to the lungs causing difficulty breathing.
  • Leg Cramps
    Cramps in the leg muscles are a common cause of calf pain. Usually, the symptoms are intermittent (not constant pain) and relieved by stretching and heat application.

When should I see a doctor about calf pain? 

If you are unsure of the cause of your symptoms, or if you do not know the specific treatment recommendations for your condition, you should seek medical attention. Treatment of calf pain must be directed at the specific cause of your problem.

Some signs that you should be seen by a doctor include

  • Inability to walk comfortably on the affected side
  • Injury that causes deformity of the lower leg
  • Calf pain that occurs at night or while resting
  • Calf pain that persists beyond a few days
  • Swelling of the calf or ankle joint area
  • Signs of an infection, including fever, redness, warmth
  • Any other unusual symptoms

Treatments for Calf Pain

Treatment of calf pain depends entirely on the cause of the problem. Therefore, it is of utmost importance that you understand the cause of your symptoms before embarking on a treatment program. If you are unsure of your diagnosis, or how severe your condition is, you should seek medical advice before beginning any treatment plan.

Some common treatments for calf pain are listed here. Not all of these treatments are appropriate for every condition, but they may be helpful in your situation.

  • Rest: The first treatment for most common conditions that cause calf pain is to rest the muscles, and allow the acute inflammation to subside. Often this is the only step needed to relieve calf pain. If the symptoms are severe, crutches may be helpful as well.
  • Ice and Heat Application: Ice packs and heat pads are among the most commonly used treatments for calf pain. So which one is the right one to use, ice or heat? And how long should the ice or heat treatments last?
  • Stretching: Stretching the muscles and tendons of the calf can help with some causes of calf pain. A good routine should be established, and following some specific suggestions will help you on your way.
  • Physical Therapy: Physical therapy is an important aspect of treatment of almost all orthopedic conditions. Physical therapists use different techniques to increase strength, regain mobility, and help return patients to their pre-injury level of activity.
  • Anti-Inflammatory Medication: Nonsteroidal anti-inflammatory medications, commonly referred to as NSAIDs, are some of the most commonly prescribed medications, especially for patients with calf pain caused by acute inflammation.

The good news, is that most conditions that cause calf pain do not need surgical intervention. However, you should be sure you know the cause of your symptoms because some of these conditions do require acute treatment. Furthermore, conditions such as blood clots can be more serious and require urgent management to prevent systemic complications.

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