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What is Chronic Leg Pain?

Usually affecting athletes (particularly runners), chronic leg pain can be a dull, nagging pain or a sharp, intense pain. The most likely causes of leg pain are stress fractures, chronic compartment syndrome (when bleeding and swelling get in the way of proper circulation of the muscle and nerve tissues), medial tibial stress syndrome ("shin splints"– inflammation of muscle near the tibia), and nerve entrapments. Chronic leg pain can also be called "shin splints," "periostitis," "stress fracture," and "acute compartment syndrome".

Leg Pain Causes

Back and leg pain are often related. Severe leg pain can be caused by overuse or stress of the leg and back. Physicians will often tell sufferers of chronic leg pain to take nonsteroidal anti-inflammatories (NSAIDs) like Acetylsalicylic acid (aspirin) or Ibuprofen and to stop running for a while. Physicians should also ask the runner to provide an accurate history of his or her exercise regimen to better evaluate his or her injury. The physician should ask whether or not the sufferer has had past leg problems, and ask the runner if his or her running workout has changed recently.

Additional questions should include:

  • How often does the patient run and how many miles?
  • Any recent changes in the running pattern?
  • When does the pain occur?
  • What effect does the running have on the pain?
  • On what sort of surface does the running take place?
  • Does the runner do any stretching before running?
  • What kind of shoe is used?

Symptoms of Chronic Leg Pain

The pain that comes with chronic leg pain varies. With stress fractures, pain occurs immediately. Stress fractures usually develop in response to a sudden increase in the stress applied to a weight-bearing bone. They are more likely to occur to those who are new to running, or the runner who suddenly increases his or her mileage. The proximal medial tibial border and the lower portion of the fibula are the most commonly affected areas in the lower leg. With stress fractures, walking is uncomfortable, but running and jumping are very painful. With exercise-induced compartment syndrome, vigorous exercise may lead to swelling and mild ischemia (a lack of blood in a given body area or organ) in the four "compartments" of the calf. The anterior and lateral compartments are the most affected in chronic leg pain. The pain can last anywhere from a few minutes to several hours after exercising.

With shin splints (medial tibial stress syndrome), pain in the shin (tibia) often develops in runners who run on hard surfaces, or in runners who are poorly-conditioned. The pain remains tender even after exercise.

With nerve entrapment, there is burning pain and dysesthesias, peculiar painful sensations in the skin, over the ankle and top of the foot.

In the older patients prolonged walking can produce a pain in the leg muscles that becomes so severe that walking stops. After time the pain leaves and walking can again begin. This is called intermittent claudication and is a sign of poor circulation. Pulses in the ankle and foot may be difficult to feel and will lead your physician to investigate the vascular supply.

Treatment of Chronic Leg Pain

Physicians will generally want runners with chronic leg pain to stop running for about 4-to-6 weeks, or until the pain goes away. Swimming may be substituted for running during the healing stage. Other forms of treatment include anti-inflammatory drugs, local heat, stretching exercises, ice massaging, orthotics (supports or insoles in shoes), corticosteroid injections. Once the pain has subsided, the runner 's level of training can increase as long as the runner is pain free.

Stress fractures, if unrecognized and untreated, can sometimes turn into a displaced fracture of the fibula or tibia. Crutches for stress fractures are only used if the pain is unbearable.

The information provided herein is not intended to be a substitute for professional medical advice. You should not use this information to diagnose or treat a health problem or disease without consulting a licensed physician.

©2000, LLC, Indianapolis, IN

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