What is it about ?
By “calf pain” we mean any pain, whatever the cause, in the back of the leg, between the hollow of the knee and the heel. Possible causes may be: infection (erysipelas), mechanical problem (muscle tear in the calf, Achilles’ tendon, stress fracture tibia), blood supply problem (thrombophlebitis, deep vein thrombosis, poor blood circulation in the arteries) or nerve root stuck in the lower back (sciatica), for example by a hernia.
How to recognize it?
In case of infection (erysipelas), the calf is swollen, bright red and hot. In this case, you often have a high fever. There is almost always a small wound through which the infection has entered.
A tear in the calf muscle or Achilles’ tendon usually begins suddenly with severe pain (“a whiplash”) during exertion. On the side of the lesion, then it is almost impossible to stand on tiptoe. Sometimes an effusion of blood may occur in the area of the tear.
A stress fracture mainly affects athletes and people who train a lot and intensely. Pain occurs, first with exertion, then also at rest. Palpation of the fracture site is painful. A stress fracture often occurs in the area of the tibia.
If a clot forms in a deep vein (deep vein thrombosis), the leg swells (edema). When you press with your finger on the swollen leg, the finger mark remains visible. Sometimes the superficial veins in the leg are dilated.
In case of inflammation of a superficial vein (superficial thrombophlebitis), you can feel like a cord under the skin, it is the thickened inflamed vein. The area around the affected vein is red, hot, and swollen. Inflammation of a superficial vein can spread to deep veins and cause deep vein thrombosis.
In case of poor arterial circulation, the pain occurs during walking (“intermittent claudication” or “window disease”) and disappears with rest. The shorter the walking distance before the onset of pain, the poorer the blood circulation. Staining of the leg and foot is possible. The leg may feel cold to the touch.
In the presence of a hernia in the lower back, calf pain is also often associated with pain elsewhere, and sometimes also with pain in the back itself. The pain usually increases when bending over.
How is the diagnosis made?
The doctor can usually deduce the cause of the calf pain based on the complaints and physical examination.
Sometimes, in the event of a muscle tear, he feels a deep cut at the site of the tear (also called “depression” or “gap”). It will also ask you to tense your muscle. The tension thus caused triggers the pain.
In the case of thrombophlebitis, the doctor feels a thickening of the vein in the form of a cord.
To check if the arteries are “open”, he checks the “pulse” on the back of the foot and at the medial malleolus (inner side of the ankle).
Pain from a stuck nerve in the lower back can be triggered by lifting the outstretched leg while lying on your back.
If in doubt or if indicated, a blood test and other technical examinations (for example, an ultrasound of the calf) may be performed.
What can you do ?
Always clean the wound well in the event of a calf injury.
If you experience sudden severe calf pain during a workout, you should stop immediately. Applying ice to the calf decreases pain and limits possible bleeding at the site of the tear. A muscle tear heals 2 to 6 weeks after the accident, with rest and treatment with your physiotherapist.
In case of Achilles tendon rupture, it may be indicated to consult a specialist. The latter may suggest an operation.
Blockage of blood vessels can be serious and require urgent treatment. If you have poor circulation in the arteries (intermittent claudication), a healthy lifestyle is important. If necessary, stop smoking and move enough.
What can your doctor do?
An infection (erysipelas) is being treated with antibiotics. In particularly severe cases, it may be necessary to give them intravenously in the hospital during the first few days.
In case of inflammation of a superficial vein (superficial thrombophlebitis), the symptoms can be relieved with a compression stocking, cold compresses and by keeping the leg elevated. An anti-inflammatory can be administered, locally on the vein, or in tablets to be taken by mouth. In some cases, an anticoagulant is prescribed.
In case of deep vein thrombosis, an anticoagulant is necessary.
If the doctor suspects that an artery is blocked, the doctor may refer you to a blood vessel specialist.
In case of compression of a nerve in the lower back, the examination will tell if further tests are necessary, and if the treatment will be wait-and-see or surgical.
Want to know more?
- Non-steroidal anti-inflammatory drugs – CBIP – Belgian Center for Pharmacotherapeutic Information
- Non-steroidal anti-inflammatory drugs for local use – CBIP – Belgian Center for Pharmacotherapeutic Information
- Stop smoking. It’s possible – Tabacstop
- Physical activity – Eat Move – Health question
Are you looking for more specialized help?
- Smoking Assistance Center (CAF®) – FARES – Respiratory Affections Fund
- Tobacco specialists – FARES – Respiratory Affections Fund
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