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If you’ve ever experienced a sudden onset of pain in your calves, you know the debilitating effect it can have.

Sudden calf pain is often the result of a mild pull, strain, or cramp. But there are cases where it can indicate a deeper health concern that might need immediate medical treatment.

This article covers the main causes of unexpected calf pain and discusses the best steps to take if they apply to you.

If you’re experiencing intense calf pain, here are some signs you should visit the emergency room (ER) as soon as possible:

  • You have just injured your leg and notice a deep cut or exposed bone, which could lead to infection.
  • There’s skin discoloration, either pale or bluish skin, on your leg, feet, or toes.
  • You suddenly have problems moving or walking on both legs.
  • You experience severe or sudden calf pain.
  • There’s swelling in your calf or anywhere in your lower leg with no apparent cause.

  • You have pain while or immediately after walking.
  • You have swelling in both legs.
  • You have painful varicose veins.
  • The pain gets worse or symptoms don’t improve after a few days of home treatment.

  • The pain is minor or appears to be a strain or an isolated cramp.
  • The discomfort goes away after a gentle massage or some light stretching.

The following are a few of the main causes of acute calf pain.

Claudication

Claudication is a sign your legs aren’t getting enough blood flow. The narrowing of blood arteries deprives your calf muscles of oxygen, which can cause pain when you exercise or walk.

This commonly occurs in people who smoke or have diabetes. Symptoms should go away after a few minutes of rest while standing evenly on your feet.

Neurogenic claudication

Neurogenic claudication is mostly caused by spinal stenosis, a narrowing of the spaces in your spine that puts pressure on your nerves.

When you stand or walk, the pain could increase, but it should subside if you sit or lean forward.

Lower leg fracture

If your tibia or fibula — the bones that run along your shin and calf area — break or crack, your calf may be tender, swollen, or bruised, and walking may be painful. See a doctor to help set the bones or put on a cast to help your bones heal properly.

Bone infection

Although bone infections are uncommon, bacteria can enter your bones and create an infection called osteomyelitis.

Signs include noticeable redness, swelling, and warmth in your calf.

You may also have a fever and fatigue. Labs and imaging tests are the best way to confirm you have an infection, and a doctor may prescribe you antibiotics to remove parts of the infected bone.

Cramps

A muscle cramp occurs when you hold a position for too long or are dehydrated.

After you massage the area, do some light stretching, and apply some heat. The cramp should subside. If you think you’re dehydrated, have a drink with some salt or electrolytes.

Deep vein thrombosis (DVT)

In this rare case, a blood clot forms in your lower leg, which could lead to a pulmonary embolism. Your calf may ache and feel warm.

The skin may also look red. Obesity puts you at risk of DVT along with pregnancy, smoking, and sitting for long periods of time.

Strains

If you stretch your muscle too far or place too much pressure on it you can strain your calf. You may notice swelling, redness, or a bruise. It may hurt to rise onto your toes. Rest, and apply ice to the area. It may take several weeks to heal.

Tendonitis

Your Achilles tendon can get overused and cause an ache in the back of your ankle running up your calf. This should improve with rest, ice, compression, and elevation.

Baker’s cyst

A Baker’s cyst occurs when fluid builds up in the back of your knee, caused by arthritis or an injury. The swelling may go away on its own or you might need to consult a doctor to treat it.

Sciatica

If the sciatic nerve in your lower spine is pinched or inflamed you’ll feel pain shooting down one or more legs. Ice and massage, along with yoga and gentle core-strengthening movements, can help.

Chronic compartment syndrome

When you exercise excessively, pressure can build up inside your muscles from the swelling of the repeated stress on your muscles, which causes your blood flow to go down. Your calf could cramp or hurt when you move and you may see swelling or a muscle bulge.

A break from movement may help combat this condition. In some rare cases, you might need surgery if the chronic stress is too severe.

Varicose veins

If you stand up or walk for too many hours of the day, the pressure in your legs over time can cause varicose veins to form in your calves. This can cause pain, burning, swelling, or itching.

Compression stockings may help as can exercise. Propping your leg up while you sit may help temporarily alleviate symptoms.

Your doctor may also decide to treat the varicose veins with surgery if needed.

Diabetic peripheral neuropathy

Around half of all people with diabetes get nerve damage, linked to frequent high blood sugar, which induces numbness, pain, weakness, and a burning feeling in your legs, arms, or hands.

Medical treatment is based on addressing the pain with medication, and improving overall body strength to help address the nerve damage.

The following are a few signs that you’re dealing with a potentially serious situation:

  • The pain progressively gets worse.
  • Your symptoms don’t improve after a few days of home treatment.
  • If you hear a snapping sound prior to the pain.
  • The pain is accompanied by warmth, redness, fevers, or shortness of breath.

If you suspect the pain is caused by DVT, a bone infection, or a bad fracture, go to the ER immediately.

If you suspect it’s caused by one of the other issues listed above, try treating it at home for a few days. If that fails, then head to the doctor for a better treatment option.

If you’re experiencing sudden calf pain, check that you’re not at risk of any of the more serious issues that could be causing it. Watch for symptoms like an exposed broken bone, shortness of breath, a sudden loss of the ability to walk on both legs, or a snapping sound prior to the pain.

If any of these situations apply to you, go to the ER immediately.

You may still want to talk with a doctor right away if:

  • you’re at risk of diabetes
  • you smoke
  • you’re overweight

If the pain seems manageable and is more likely a strain or a cramp, try treating the injury at home. You can try raising your leg and covering the painful area with a wrapped-up ice pack to reduce swelling for 15–20 minutes.

Repeat this over the next few days a few times every day. If the pain persists, go to the doctor for help.