The part of the leg known as the calf is made up primarily of two main muscles--the gastrocnemius and the soleus--as well as tendons, blood vessels, bones and nerves. This area can be associated with pain for a variety of reasons, ranging from relatively mild muscle strains to medical emergencies such as compartment syndrome.
Muscle Strains
Dr. Patrick J. McMahon and Dr. Lee D. Kaplan, writing in the medical textbook "Current Diagnosis and Treatment in Orthopedics," report that muscle strains in the legs are common injuries. Within the leg, the calf muscle, called the gastrocnemius, is a frequently strained muscle. A mild strain may cause some pain but not necessarily result in muscle spasms, while a more severe strain can lead to pain, spasm and an inability to use the leg normally. Treatment for a strained, or pulled, muscle includes placing ice on the muscle immediately after the strain, resting the affected muscle and stretching the muscle so it regains its normal strength. Drs. Stephen Landlaw and Kenneth Bauer, both of Harvard Medical School, write in the medical database Up To Date that the calf muscle in particular may pull or tear if a person does some sort of physical activity that is not usual for him.
Deep Vein Thrombosis
A blood clot in the leg is called a deep vein thrombosis, or DVT, and can occur either in the calf or the thigh. When the clot occurs in the calf, it is called a distal calf vein thrombosis. Both types of clots are dangerous because they can travel through the blood veins and lodge in the vessels of the lungs. At this point, the DVT is called a pulmonary embolism and is a life-threatening emergency. However, according to Up To Date contributor Dr. Brydon Grant of the University at Buffalo, New York, a calf DVT is less likely to become a dangerous pulmonary embolism. In addition, it is important to recognize that this is not a common reason for calf pain. A 1998 study of over 400 people with suspected DVT found that only 70 patients, or 17 percent actually had a DVT. Besides calf pain, symptoms that suggest a DVT include swelling of the calf and warmth and redness of the calf area. In addition, a distinct cord-like structure that can be easily felt when the leg is examined. This represents the vein that has the clot in it. Treatment of a DVT includes medicine that works to prevent coagulation. This medicine is taken for at least three months.
Compartment Syndrome
Muscles within the body are grouped into sections, or compartments, that are separated by membranes that are strong and rather rigid. When pressure within a muscle compartment builds up, blood cannot circulate properly, which in turn means that the muscle cannot function normally. Compartment syndrome may either occur in an acute setting--for instance, after trauma to an arm or a leg--or can occur over a long period of time. Acute compartment syndrome, abbreviated ACS, is a medical emergency. Dr. Andrea Stracciolii, instructor in medicine and orthopaedics at Harvard Medical School, writes in Up To Date that the most common reason for acute compartment syndrome is bone fracture. This accounts for 75 percent of ACS cases. Certain bone fractures are also more likely to result in ACS. For instance, when a bone in the lower leg, called the tibia, fractures, ACS will develop in up to 10 percent of cases. If calf pain is due to ACS, the treatment is immediate surgical intervention to relieve the pressure within the muscle compartment. Chronic compartment syndrome is also a potential cause of calf pain. It is more common in situations of repetitive use of certain muscle groups, such as the situation with people who run on a regular basis. Unlike the case in ACS, patients with chronic compartment syndrome will feel pain within the first 10 to 30 minutes of exercise but feel no pain, and have no change in muscle function, between exercise sessions. Similarly to ACS, the treatment is surgery, to relieve the elevated pressures. However, in such cases, it is not an emergency situation.
Varicose Veins
Varicose veins are dilated, twisting veins that are over 3mm in diameter. They are an indication of chronic vein problems and may be associated merely with psychological discomfort resulting from their unpleasant appearance. However, varicose veins may also cause pain and itching at the site of the dilated vessels. If the vessels are vessels in the calf, calf pain may result. In addition, the varicose vein may start to spontaneously bleed. This is called varicose vein hemorrhage and may be the first time a person with varicose veins gets medical attention for his chronic venous disease. Treatments for this potential cause of calf pain include laser therapy to eliminate the dilated vessels; sclerotherapy, which uses chemicals to remove the damaged vessel; and surgical removal of the damaged vessels.
References
- "Annals of Internal Medicine"; The Clinical Validity of Normal Compression Ultrasonography in Outpatients Suspected of Having Deep Venous Thrombosis; B.G. Birdwell et. al.; January 1998
- "Current Diagnosis and Treatment in Orthopedics"; Harry B. Skinner; 2006
- "UpToDate"; Denise S. Basow; 2010
