Calf Pain: Causes and What You Should Know

By Craig Sorkin, DNP, APN
Medically reviewed checkmarkMedically reviewed
June 7, 2022

Pain in your calf is usually related to the two main muscles: the gastrocnemius and soleus, which connect to your Achilles tendon.

Strain, injury, and cramps can all cause calf pain but in some cases, calf pain is due to a problem with the blood vessels or nerves in your calf. 

This article talks about what calf pain is and why you may be experiencing it. It also covers how to diagnose the cause of your calf pain and what types of treatment are available.

Lastly, learn the signs of when it’s essential to see your medical provider about your calf pain.

What Is Calf Pain?

Calf pain is pain felt in the back of the lower leg. The pain feels different for each person.

Sometimes it’s described as a dull ache, while it may feel like sharp or stabbing pains for others.

The type of pain felt is also related to the underlying cause of the pain.

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Types of Calf Pain

Calf pain can come from your muscles, tendons, bones, or from blood flow and nerve problems.

Some pain is experienced as a dull ache, while other times it comes on suddenly and sharply.

Sometimes calf pain is accompanied by other symptoms such as swelling, bruising, or redness.

Causes

Read on to learn what may be causing your calf pain.

Muscle strains

Muscle strains are a common injury. A strain is when a muscle is stretched to the point that it partially tears or frays. Overuse, poor flexibility, or an improper warm-up can cause strains of muscles.

Other symptoms include bruising, swelling, and instability.   

Contusions

A contusion is another term for bruising. Typically, a contusion is from a blunt force hitting you and causing tiny blood vessels to break and bleed under the skin.

Usually, bruising lasts one to two weeks, but some can take longer to heal.

While they heal, they change color from purple to blue, then to green and/or yellow. Other symptoms can include pain and swelling. 

Claudication

Claudication is muscle pain in the legs experienced during exercise.

The cause of this pain is the decrease of oxygen-rich blood flow to the calf muscles. 

It’s a symptom of peripheral arterial disease (PAD), common for people with diabetes and those who smoke, amongst other conditions. 

The severity of the pain is related to how blocked the arteries are.

Resting your leg muscles usually relieves the pain; this is then diagnosed as intermittent claudication.  

Compartment syndrome

Compartment syndrome is a rare but severe condition of rising pressure in a muscle compartment.

The increased pressure from swelling can cause blood flow issues and severe damage to the muscles and nerves in that area. 

Causes of compartment syndrome include: 

  • Trauma (e.g., a crush injury or surgery)
  • Broken bone
  • Cast or bandage that is too tight

Compartment syndrome can come on quickly after the injury. 

Other symptoms include:

  • Severe pain that can’t be relieved
  • Decreased feeling in the affected area
  • Numbness, tingling, weakness
  • Pale skin
  • Swelling
  • Unable to move that part of the body

Compartment syndrome is severe and can cause lasting damage.

If you feel you are experiencing this, seek immediate in-person medical care. 

Muscle cramps

A muscle cramp is a painful, involuntary contraction of a muscle.

Usually, muscle cramps last a few seconds to a few minutes.

The cause of muscle cramps is not always known, but they are generally related to exercise and are common in pregnancy. Dehydration and inadequate electrolytes may also be a cause. 

Trauma, injury, improper footwear, and other causes could prompt leg muscle cramping.  

Blood clot

Blood clots can happen at any time to anyone. It occurs when your blood thickens, forms a clump, and lodges in a blood vessel. The calf is a common location.

Symptoms of a blood clot include swelling, pain, warmth, and redness. 

People on birth control, smokers, and those who are bed-bound are more likely to get a blood clot.

Blood clots can lead to serious complications. If you feel you are experiencing a blood clot, seek immediate medical care. 

Achilles tendonitis

The Achilles tendon is said to be the strongest tendon in the body.

It connects your calf muscles to your foot and is necessary for walking and running. 

Tendonitis happens when there is inflammation in the tendon because of trauma, overuse, or improper use. It can cause a great deal of pain and stiffness in your calf.

When this happens, your calf needs rest. 

Achilles tendon rupture

The Achilles tendon is the most common tendon to rupture in the legs; this usually happens to adults between the ages of 30 and 50.

People who are more likely to experience a rupture are not consistently physically active but occasionally go out for sports, especially tennis, basketball, and track (these people are sometimes called “weekend warriors”). 

The rupture happens with a sudden “pop” or “snapping” sound and extreme pain.

People describe it as feeling like they were kicked in the leg. 

One million athletes are estimated to be affected each year in the United States.

Initial treatment is rest, elevation, and pain control. Sometimes surgery is needed. 

Diabetic complications

Diabetes is a disease in which blood sugar levels run high.

The consistently high levels of sugar in the blood cause damage to the nerves called neuropathy which affects the arms, hands, legs, and feet. 

Other symptoms include:

  • Tingling sensations (like “pins and needles”)
  • Pain
  • Numbness
  • Weakness

Diagnosis

Your primary care provider will start with a physical exam to make a correct diagnosis.

Physical exam

The physical exam includes your medical history and current medications, vitamins, and supplements.

In addition, your provider will ask you questions about your symptoms, prompt you to describe the pain, and ask you to visually demonstrate where you feel the pain. 

They will then want to look and feel where the pain is and assess the body parts around it (your knee, upper leg, and foot).

Next, they will gently press on the area and may carefully move it in different positions.

They may also ask you to show how much you can move it. 

Depending on what they believe the cause is, the medical provider may want to check your reflexes and perform some nerve and circulation tests

Blood tests

Typically, blood tests are not needed for calf pain.

However, if a blood clot is suspected, your provider may order a D-dimer blood test to check for D-dimer proteins in the blood.

Imaging

Imaging may help to see if there is damage to the bone, the muscles, or the tendons, or if there is a blood clot.

An ultrasound or MRI can look at soft tissue to help determine what is wrong with the tendons and muscles.

An x-ray is good for looking at the bone structure of the leg, knee, and ankle, but it will not help with identifying problems with soft tissues, ligaments, tendons, or blood vessels. 

Home Treatment

Treatment depends on what the underlying cause of your pain is. Before starting therapy on your own, it’s good to see your medical provider for a diagnosis. 

Rest, icing, compression, and elevating your leg can be a beneficial start for an injury. Remember the acronym: R.I.C.E.

Rest

Take all strain and pressure off the injured leg. Limit the amount of walking you do and if needed, use crutches or a walking boot.

Ice

Placing ice on the injury can help decrease swelling and pain.

Ice packs must never be placed directly on the skin but should be wrapped in a thin towel and placed on the area for 20 minutes. Ice the injury every four hours for the first two days. 

Compression

Wrap the affected area with enough tightness to support it but not cut off circulation.

A medical-grade elastic bandage works best. Keeping the injury compressed can also decrease swelling. 

Elevation

Prop the injured calf higher than your heart. This helps fluid not collect in the area but return to the heart. In addition, this can decrease pain and swelling. 

If any of these treatment remedies cause more pain, discomfort, or swelling, please seek care ASAP. 

OTC pain relievers

Over-the-counter (OTC) medications to relieve pain include ibuprofen (Advil) and acetaminophen (Tylenol).

These medications should be taken with food.

They should not be taken if there is an allergy to these medications or if you have a condition where you should not take them (such as ulcer or liver or kidney disease). 

Medical Treatment

Very rarely does calf pain require surgery.

However, in some cases, a ruptured Achilles tendon surgery may be beneficial, or a stent may be placed to open up a clogged blood vessel.

People with diabetes need to learn how to control their blood sugar to prevent complications.

Controlling blood sugar can be done through diet and lifestyle modifications and taking medications like insulin that help the body manage blood sugar. 

Prevention

One of the best ways to prevent yourself from getting injured while playing sports or doing physical activities is to warm up before you start. 

Stretching and Warm-Up

It used to be said that stretching was important before working out.

However, current research shows that stretching without warming up may put you at a higher risk of hurting yourself. 

Experts recommend you begin your workout with a warm-up that boosts your heart rate, makes you feel warm all over, and causes a light sweat. 

Specifically, the muscles you will use the most while playing your sport should be targeted, including some aspect of dynamic stretching.

For example, jump squats, high kicks, lunges, and pushups. 

To be safe, save the static stretching for after the game or exercise session.

Hydration 

Always drink plenty of water before you play sports.

While physically active, stop and drink water every 20 minutes. Afterward, continue drinking water to replace any fluids you may have sweated out. 

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When To See a Medical Provider

Contact your medical provider if you are experiencing:

  • A change in the skin color of calf and foot (pale or bluish skin)
  • Red, hot, painful skin in your calf
  • Cold skin
  • Problems walking or moving
  • Sudden or severe pain in your calf
  • Swelling in your calf

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When should I see a doctor for calf pain?
Call your medical provider about calf pain if there is severe bruising, a change in your skin color, an obvious deformity, if your skin is swollen and red hot, or when your pain is sudden or severe.
How do I get rid of calf pain?
Calf pain caused by an injury will take a few days or weeks to heal. Letting it rest and icing the injury can help decrease some of the pain and swelling. Over-the-counter medications like ibuprofen and Tylenol may also help. If an injury is not the cause of your pain, you may need to see your medical provider and find out what is going on so it can be treated properly.
Does stretching help calf pain?
Stretching can sometimes relieve calf pain, but it could do more damage in other cases. If you have persistent pain in your calf, talk to your medical provider about it to find out what is going on. Your provider can then go over a treatment plan with you and what things you can do to relieve the pain.

K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

Craig Sorkin, DNP, APN

Craig Sorkin, DNP, APN is a board certified Family Nurse Practitioner with over 15 years experience. He received his Undergraduate and Graduate degrees from William Paterson University and his doctoral degree from Drexel University. He has spent his career working in the Emergency Room and Primary Care. The last 6 years of his career have been dedicated to the field of digital medicine. He has created departments geared towards this specialized practice as well as written blogs and a book about the topic.