Calf pain

What is calf pain?

Pain in the calf (the back part of the lower leg) is usually caused by a cramp or muscle strain. However, sometimes calf pain can be a symptom of something more serious.

What causes calf pain?

Cramp

Calf pain is usually caused by cramp, when the muscles suddenly contract. This might happen if you have been doing new exercises, if you are dehydrated, or if you are deficient in some minerals. Cramps normally go away quite quickly by themselves.

Calf strain

The calf is made up of 2 muscles called the gastrocnemius and the soleus. They meet at the Achilles tendon which is attached to the heel bone.

Overstretching or tearing either of these 2 calf muscles is known as a calf strain. Normally there is a sudden pain in the calf, and you may feel a pop, snap or tear. A calf strain may also mean you experience the following symptoms:

• Sudden pain at the back of the leg.
• The calf is stiff and weak when you walk.
• You find it hard to rise up onto your toes.
• You may have bruising on your calf after 1 or 2 days.

Other possible causes of calf pain include:

• Achilles tendonitis in which the Achilles tendon becomes inflamed
• sciatica — when you have problems with the sciatic nerve which controls your lower leg
• a bruise due to injury
• diabetic peripheral neuropathy — when you have nerve damage that affects your feet, legs, arms and hand
• deep vein thrombosis (DVT) — when a blood clot forms in the deep veins of the arm or leg. This is a medical emergency. See your doctor immediately if you think you might have DVT (see below)
• compartment syndrome — a serious condition

When should I see my doctor?

See your doctor if:

• your calf is swollen
• your calf is unusually cool or pale
• your leg is tingly or numb
• your leg is weak
• you have fluid retention
• your calf is red, warm and tender
• both legs are swollen and you have breathing problems
• your calf is painful during or after walking
• the pain gets worse or doesn’t improve after a couple of days of being treated at home
• you have painful varicose veins

Seek medical attention straight away if you have the symptoms of DVT and you have recently been sitting for a long time, such as on a flight. These include if:

• your calf is swollen
• your leg is painful
• the skin of the calf is red
• your calf feels warm

How is calf pain treated?

If you have a muscle cramp, gently stretch or massage the muscle.

If you have a calf strain or Achilles tendonitis, you should first of all use the ‘RICE’ method of treatment:

• Rest the area.
• Ice the area for 20 minutes, using a covered icepack or bag of frozen peas.
• Compress the area with a bandage (but if the pain gets worse, loosen the bandage).
• Elevate the lower leg by sitting or lying down (for example with pillows), so it is above the level of the heart.

You can take anti-inflammatory medicines to relieve pain and bring down the swelling. After 48 hours, start stretching and strengthening the muscle, for example by doing heel raises and calf stretches. Don’t return to full physical activity until you can move your ankle and knee properly, the pain and tenderness have gone, and the strength has fully returned to your calf.

Can calf pain be prevented?

Always stretch before and after you exercise to repair and strengthen the calf. Don’t over exercise, and build up gradually if you are starting something new.

Drink plenty of water to avoid cramps. Magnesium supplements have been shown to prevent cramps in some people, especially pregnant women, although the evidence is not conclusive.

If you have diabetes, keep your blood sugar levels under control to prevent diabetic neuropathy.