Leg Pain: Causes Of Leg Muscle Pain

Leg pain is a common symptom and complaint. Leg pain can be due to a muscle cramp also called a charley horse. Common causes of muscle cramps include:

1) Muscle fatigue or strain from overuse, too much exercise, or holding a muscle in the same position for a long time.
2) Dehydration or low amounts of potassium, sodium, calcium, or magnesium in the blood.
3) Medications such as:
- Diuretics, which can cause you to lose too much fluid or minerals.
- Statins, which lower cholesterol.

An injury can also cause leg pain from: (1) strain (a torn or overstretched muscle); (2) tendinitis (inflamed tendon); (3)Shin splints or the muscle pain in the front of your leg related to overuse or repetitive pounding; or (4) hairline crack in the bone (stress fracture).

Other common causes of leg pain include:

1) Blood clot (deep vein thrombosis) from prolonged bed rest.
2) Atherosclerosis (plaque buildup) that blocks blood flow in the arteries (this type of pain, called claudication, is generally felt when exercising or walking and relieved by rest).
3) Inflammation of the leg joints by arthritis or gout.
4) Nerve damage (common in diabetics, smokers and alcoholics; symptoms include numbness, tingling, or a sensation of pins-and-needles)
5) Infection of the bone (called osteomyelitis) or of skin and soft tissue (called cellulitis).
6) Varicose veins.

Less common causes of leg pain include:

1) Slipped capital femoral epiphysis (usually seen in boys and overweight children between 11 and 15 years old, this refers to a separation of the ball of the hip joint from the thigh bone. It causes pain and growth abnormalities.)
2) Legg-Calve-Perthes disease (poor blood flow to the hip that may stop or slow the normal growth of the leg. This condition usually affects boys between 4 and 10 years old.)
3) Benign tumors or cysts of the femur or tibia (osteoid ostioma).
4) Malignant bone tumors (osteosarcoma, Ewing sarcoma).
5) Drugs such as allopurinol and corticosteroids.
6) Sciatic nerve pain (radiating pain down the leg) caused by a slipped disk in the back.

Knee Pain: Treatmant and Prevention - Part 2

Although it's not always possible to prevent knee pain, the following suggestions may help forestall injuries and joint deterioration: * Keep extra pounds off. Maintaining a healthy weight is one of the best things you can do for your knees — every extra pound puts additional strain on your joints, increasing the risk of ligament and tendon injuries and even osteoarthritis.
* Get strong, stay limber. Because weak muscles are a leading cause of knee injuries, you'll benefit from building up your quadriceps and hamstrings, which support your knees. Try knee extensions, hamstring curls and leg presses to strengthen these muscles. Balance and stability training helps the muscles around your knees work together more effectively. And because tight muscles also can lead to injury, stretching is important. Try to include flexibility exercises in your workouts.
* Be smart about exercise. If you have osteoarthritis, chronic knee pain or recurring injuries, you may need to change the way you exercise. That doesn't mean you have to stop being active, but it does mean being smart about when and how you work out. If your knees ache after jogging or playing basketball or other sports that give your joints a real pounding, consider switching to swimming, water aerobics or other low-impact activities — at least for a few days a week. Sometimes simply limiting high-impact activities will provide relief.
* Make sure your shoes fit well. If the shoe fits, you'll be a lot safer. Choose footwear that's appropriate for your sport. Running shoes aren't designed for pivots and turns, for instance, but tennis and racquetball shoes are.
* Baby your knees. Wearing proper gear for knee-sensitive activities can help prevent injuries. Use kneepads when playing volleyball or laying carpet and buckle your seat belt every time you drive. Most shattered kneecaps occur in car accidents.
* Listen to your body. If your knees hurt, or you feel fatigued, don't be a hero — take a break. You're much more likely to injure yourself when you're tired.

Knee Pain: Treatmant and Prevention - Part 1

The key to treating many types of knee pain is to break the cycle of inflammation that begins right after an injury. Even minor trauma causes your body to release substances that lead to inflammation. The inflammation itself causes further damage, which in turn triggers more inflammation, and so on. But a few simple self-care measures can be remarkably effective in ending this cycle. For best results, start treating your injury right away and continue for at least 48 hours. Commonly referred to by the acronym P.R.I.C.E., self-care measures for an injured knee include:

1) Protection. The best way to protect your knee from further damage depends on the type and severity of your injury. For most minor injuries, a compression wrap is usually sufficient. More serious injuries, such as a torn ACL or high-grade collateral ligament sprain usually require crutches and sometimes also a brace to help stabilize the joint with weight bearing.

2) Rest. Taking a break from your normal activities reduces repetitive strain on your knee, gives the injury time to heal and helps prevent further damage. Minor injuries may require only a day or two of rest, but severe damage is likely to need a longer recovery time.

3) Ice. A staple for most acute injuries, ice reduces both pain and inflammation. Some doctors recommend applying ice to your injured knee for 15 to 20 minutes three times a day. A bag of frozen peas works well because it covers your whole knee. You can also use an ice pack wrapped in thin fabric to protect your skin. Although ice therapy is generally safe and effective, don't leave ice on longer than recommended because of the risk of damage to your nerves and skin. After two days, you might try switching to heat to relax your muscles and increase blood flow.

4) Compression. This helps prevent fluid buildup (edema) in damaged tissues and maintains knee alignment and stability. Look for a compression bandage that's lightweight, breathable and self-adhesive. It should be tight enough to support your knee without interfering with circulation.

5) Elevation. Because gravity drains away fluids that might otherwise accumulate after an injury, elevating your knee can help reduce swelling. Try propping your injured leg on pillows or sitting in a recliner.

Anti-inflammatory medications
Nonsteroidal anti-inflammatory drugs (NSAIDs), including aspirin, ibuprofen (Advil, Motrin, others) and naproxen sodium (Aleve, Naprosyn), can help relieve pain. But if taken immediately after an injury, they may actually increase swelling. What's more, NSAIDs can have side effects, especially if you take them for long periods or in amounts greater than the recommended dosage. Even small doses may cause nausea, stomach pain, stomach bleeding or ulcers; and large doses can lead to kidney problems and fluid retention. NSAIDs also have a ceiling effect, which means there's a limit to how much pain they can control. If you have moderate to severe pain, exceeding the dosage limit probably won't relieve your symptoms. Taking two different NSAIDs at the same time also won't provide more relief and may increase your risk of side effects. When self-care measures aren't enough to control pain and swelling and promote healing in an injured knee, your doctor may recommend other options, including:

Physical therapy
Normally, the goal of physical therapy is to strengthen the muscles around your knee and help you regain knee stability. Depending on your injury, training is likely to focus on the muscles in the back of your thigh (hamstrings), the muscles on the front of your thigh (quadriceps), and your calf, hip and ankle. You can do some exercises at home. Others require the use of weight machines, exercise bicycles or treadmills, which may mean visits to an athletic club, fitness center or clinic.

Surgical options
If you have an injury that may require surgery, it's usually not necessary to have the operation immediately. In most cases, you'll do better if you wait until the swelling goes down and you regain strength and full range of motion in your knee.

Knee Pain: Symptoms and Causes - Part 2

In the simplest terms, a joint occurs wherever two bones come together. But that definition doesn't begin to convey the complexity of joints, which provide your body with flexibility, support and a wide range of motion.

You have four types of joints: fixed, pivot, ball-and-socket and hinge. Your knees are hinge joints, which, as the name suggests, work much like the hinge of a door, allowing the joint to move backward and forward. Your knees are the largest and heaviest hinge joints in your body. They're also the most complex. In addition to bending and straightening, they twist and rotate. This makes them especially vulnerable to damage, which is why they sustain more injuries on average than other joints.


A Closer Look at Your Knees

Your knee joint is essentially four bones held together by ligaments. Your thighbone (femur) makes up the top part of the joint, and two lower leg bones, the tibia and the fibula, comprise the lower part. The fourth bone, the patella, slides in a groove on the end of the femur.

Ligaments are large bands of tissue that connect bones to one another. In the knee joint, four main ligaments link the femur to the tibia and help stabilize your knee as it moves through its arc of motion. These include the collateral ligaments along the inner (medial) and outer (lateral) sides of your knee and the anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL), which cross each other as they stretch diagonally from the bottom of your thighbone to the top of your shinbone.

Other structures in your knee include:

1) Tendons. These fibrous bands of tissue connect muscles to bones. Your knee has two important tendons, which make it possible for you to straighten or extend your leg: the quadriceps tendon, which connects the long quadriceps muscle on the front of your thigh to the patella, and the patellar tendon, which connects the patella to the tibia.

2) Meniscus. This C-shaped cartilage, which curves around the inside and outside of your knee, cushions your knee joint.

3) Bursae. A number of these fluid-filled sacs surround your knee. They help cushion your knee joint so that ligaments and tendons slide across it smoothly.

Normally, all of these structures work together smoothly. But injury and disease can disrupt this balance, resulting in pain, muscle weakness and decreased function.


Knee injuries: The How's and Why's

Many knee injuries are due to overuse, problems with alignment, sports or physical activities, and failure to warm up and stretch before exercise. But they can also result from trauma, such as a car accident, a fall or a direct blow to your knee.

Common knee injuries and their causes include:

1) Ligament Injuries. You're most likely to tear your collateral ligaments in sports that require quick stops and turns, such as soccer, basketball and skiing, or in contact sports when repeated blows to the inside or outside of your knee can cause the opposing ligament to stretch or tear. Collateral ligaments can also be damaged by repeated stress, which causes them to lose their elasticity, much like an overstretched rubber band.

Most ACL injuries are sports-related. They frequently occur during activities such as football, basketball, soccer and skiing, when you slow down suddenly or cut or pivot with your foot firmly planted — movements that twist or overextend your knee. ACL tears rarely result from contact with other players, but they can develop when you land awkwardly from a jump or fall. PCL tears, on the other hand, aren't usually associated with sports. Because the PCL is a strong ligament located deep inside your knee, tears most often result from traumatic injuries, such as those you might receive in a car accident. And because a violent impact is needed to damage the PCL, you're almost certain to injure other ligaments at the same time.

2) Tendon Injuries. Inflammation of the quadriceps tendon (tendinitis) can occur in people who run, bicycle or ski. It can also result from inflammatory diseases that occur throughout your body, most notably rheumatoid arthritis. Middle-age weekend warriors are more likely to rupture their quadriceps tendon than seasoned athletes are. And patellar tendon ruptures frequently occur in active younger people who have a history of tendinitis or who have had steroid injections in their knees.

3) Meniscus Injuries. A meniscus tear can result from aggressive pivoting or sudden turns — any activity that twists or rotates your knee. Occasionally, you can tear your meniscus while lifting something heavy. Older adults sometimes tear their meniscus during repetitive movements, such as kneeling or squatting, but more often it tears because it has degenerated over time.

4) Bursitis. Sometimes called housemaid's knee or carpet layer's knee, prepatellar bursitis often occurs after an activity that requires you to kneel for long periods — scrubbing floors, gardening, or installing tile or carpet, for example. It can also result from an infection or as one of the signs of arthritis or gout.

5) Dislocated Kneecap. Kneecap (patellar) dislocations can occur in contact sports and in activities that require you to change direction while running, such as tennis, racquetball and volleyball. If your knees tend to turn inward or your kneecaps are higher than normal, you may be more prone to this injury.

6) Osgood-Schlatter Disease. This condition can develop in athletic young people during the years when their bones are growing rapidly — usually ages 10 to 15 for boys and 8 to 13 for girls. Osgood-Schlatter disease results from repeated tugging of the patellar tendon on a growth plate at the top of the tibia. This is most likely to occur during activities that involve running, jumping and bending, when the pull of the quadriceps muscle puts tension on the patellar tendon. In time, the tendon may begin to pull away from the tibia, resulting in a small bump you can see. In severe cases, the tendon may come away from the tibia completely.

7) Hyperextended Knee. This usually results from an awkward landing after a jump or from a contact injury.

8) Iliotibial Band Syndrome. This is a common cause of lateral knee pain in runners. Competitive runners are especially susceptible, but amateurs aren't exempt. You're more likely to develop iliotibial band syndrome if you have biomechanical problems such as unequal leg length or weak hip abductors, the muscles responsible for sideways leg motion. Exercising on concrete surfaces or uneven ground, increasing the intensity or duration of your exercise too quickly, wearing worn or ill-fitting shoes, and excessive uphill or downhill running also can contribute to iliotibial band syndrome.

Knee Pain: Symptoms and Causes- Part 1

A knee injury can affect any of the ligaments, tendons or fluid-filled sacs (bursa) that surround your knee joint as well as the bones, cartilage and ligaments that form the joint itself. Because of the knee's complexity, the number of structures involved, the amount of use it gets over a lifetime, and the range of injuries and diseases that can cause knee pain, the signs and symptoms of knee problems can vary widely.


Acute Knee Pain
Severe knee pain that comes on suddenly (acute knee pain) is often the result of injury. Some of the more common knee injuries and their signs and symptoms include the following:

1) Ligament Injuries. Your knee contains four ligaments — tough bands of tissue that connect your thighbone (femur) to your lower leg bones (tibia and fibula). You have two collateral ligaments — one on the inside (medial collateral ligament) and one on the outside (lateral collateral ligament) of each knee. A tear in one of these ligaments is usually the result of a fall or contact trauma, especially in sports like football, and is likely to cause immediate pain in the injured area. The discomfort, which can range from mild to severe, is usually worse when you walk or bend your knee. If the collateral ligament on the inside of your knee sprains or tears, you may feel a ripping sensation. In some cases, this ligament may become calcified after repeated injuries (Pellegrini-Stieda syndrome).

The other two ligaments are inside your knee and cross each other as they stretch diagonally from the bottom of your thighbone to the top of your shinbone (tibia). The posterior cruciate ligament (PCL) connects to the back of your shinbone, and the anterior cruciate ligament (ACL) connects near the front of your shinbone. If you tear the ACL, either partially or completely, you're likely to know it right away. You may feel or hear a pop in your knee and have intense pain and immediate swelling. When you try to stand and put weight on your injured leg, your knee may "buckle" or at least feel as if it might give way. In most cases, you'll have to stop all activity, either because the pain is too severe or because your knee isn't stable enough to support your weight.

2) Tendon Injuries (tendinitis). Tendinitis is irritation and inflammation of one or more tendons — the thick, fibrous cords that attach muscles to bone. Athletes — especially runners, skiers and cyclists — are prone to develop inflammation in the patellar tendon, which connects the quadriceps muscle on the front of the thigh to the larger lower leg bone (tibia). Tendinitis can occur in one or both knees and often causes pain and swelling at the front of your knee and just below your kneecap. The discomfort usually isn't constant but tends to occur when you jump, run, squat or climb stairs. The quadriceps or patellar tendons may also rupture, either partially or completely. In that case, the pain is likely to be most intense when you try to extend your knee. If the tendon is completely ruptured, you won't be able to extend or straighten your knee at all.

3) Meniscus Injuries. The meniscus is a C-shaped cartilage that curves within your knee joint. Meniscus injuries involve tears in the cartilage, which can occur in various places and configurations. For example, the cartilage may tear lengthwise or from the inside to the outside rim of the meniscus (radial tear). Although you may not notice small tears, in most cases, you'll have pain and mild to moderate swelling that develops over 24 to 48 hours. Occasionally, a lengthwise tear flips into the knee joint instead of staying around the joint's edge, an injury called a bucket-handle tear. A flap of the torn cartilage can interfere with knee movement and cause your knee joint to lock so that you can't straighten it completely. Meniscal injuries that cause locking of your knee should be surgically treated. Meniscal tears that don't cause locking, including those of a degenerative nature, can usually be managed nonsurgically.

4) Bursitis. Some knee injuries cause inflammation in the bursae, the small sacs of fluid that cushion the outside of your knee joint so that tendons and ligaments glide smoothly over the joint. Bursitis can lead to warmth, swelling and redness over the inflamed area, aching or stiffness when you walk, and considerable pain when you kneel. Sometimes the bursa located over your kneecap bone (prepatellar bursa) can become infected, leading to fever, pain and swelling. When the pes anserine bursa on the lower inner side of your knee is affected, you're likely to have pain when you go up or down stairs.

5) Loose Body. Sometimes injury or degeneration of bone or cartilage can cause a piece of bone or cartilage to break off and float in the joint space. This may not create any problems unless the loose body interferes with knee joint movement — the effect is something like a pencil caught in a door hinge — leading to knee pain and a locked joint.

6) Dislocated Kneecap. This occurs when the triangular bone that covers the front of your knee (patella) slips out of place, usually to the outside of your knee. You'll be able to see the dislocation, and your kneecap is likely to move excessively from side to side. You're also likely to have intense pain and swelling in the affected area and difficulty walking or straightening your knee. Unfortunately, once you've had a dislocated kneecap, you're at increased risk of having it happen again. Although you may not experience as much swelling or discomfort with subsequent episodes, repeated dislocations can lead to chronic knee pain. But good rehabilitation, with a focus on strength training of the muscles that control your kneecap, can help prevent dislocation.

7) Osgood-Schlatter Disease. Primarily affecting athletic teens and preteens, this overuse syndrome causes pain, swelling and tenderness at the bony prominence (tibial tuberosity) just below the kneecap. The pain, which can range from mild to debilitating, is usually worse with activity, especially running and jumping, and improves with rest. Osgood-Schlatter disease frequently affects just one knee, but sometimes develops in both knees. The discomfort can last from weeks to months and may continue to recur until your child stops growing.

8) Iliotibial Band Syndrome. This occurs when the ligament that extends from the outside of your pelvic bone to the outside of your tibia (iliotibial band) becomes so tight that it rubs against the outer portion of your femur. Distance runners are especially susceptible to iliotibial band syndrome, which generally causes a sharp, burning pain in the knee that often begins 10 to 15 minutes into a run. Initially, the pain goes away with rest, but in time it may persist when you walk or go up and down stairs.

9) Hyperextended Knee. In this injury, your knee extends beyond its normally straightened position so that it bends back on itself. Sometimes the damage is relatively minor, with pain and swelling when you try to extend your knee. But a hyperextended knee may also lead to a partial or complete ligament tear, especially in your ACL.

10) Septic Arthritis. Sometimes your knee joint can become infected, leading to swelling, pain and redness. Septic arthritis often occurs with a fever.


Chronic Knee Pain

Sometimes an injury can lead to ongoing (chronic) knee pain. Often, chronic pain results from a medical condition such as:

1) Rheumatoid Arthritis. The most debilitating of the more than 100 types of arthritis, rheumatoid arthritis can affect almost any joint in your body, including your knees. In addition to pain and swelling, you're likely to have aching and stiffness, especially when you get up in the morning or after periods of inactivity; loss of motion in your knees and eventually deformity of the knee joints; and sometimes a low-grade fever and a general sense of not feeling well (malaise). Rheumatoid arthritis usually affects both knees at the same time. And although it's a chronic disease, it tends to vary in severity and may even come and go. Periods of increased disease activity — called flare-ups or flares — often alternate with periods of remission.

2) Osteoarthritis. Sometimes called degenerative arthritis, this is the most common type of arthritis. It's a wear-and-tear condition that occurs when the cartilage in your knee deteriorates with use and age. Osteoarthritis usually develops gradually and tends to cause varying degrees of knee pain and swelling when you stand or walk and before a change in the weather. It also can lead to stiffness, especially in the morning and after you've been active, and to a loss of flexibility in your knee joints.

3) Gout. With this type of arthritis, you're likely to experience redness, swelling and intense pain in your knee that comes on suddenly — often at night — and without warning. The knee pain typically lasts five to 10 days and then stops. The discomfort subsides gradually over one to two weeks, leaving your knee joints apparently normal and pain-free. Another condition, pseudogout (chondrocalcinosis), which mainly occurs in older adults, can cause severe inflammation and intermittent attacks of pain and swelling in large joints, especially the knees.

4) Chondromalacia of the patella, or Patellofemoral Pain. This is a general term that refers to pain arising between your patella and the underlying thighbone (femur). It's common in young women, especially those who have a slight misalignment of the kneecap, in athletes, and in older adults, who usually develop the condition as a result of arthritis of the kneecap. Chondromalacia of the patella causes pain and tenderness in the front of your knee that's worse when you sit for long periods, when you get up from a chair and when you climb stairs. You may also notice a grating or grinding sensation when you extend your knee.