Calf Pain: 8 Causes, When to See a Doctor & Treatment

Calf pain can be caused by intense exercise from running or cycling, or it may be a sign of a health condition, like a Baker's cyst, varicose veins, a blood blot or a ruptured Achilles tendon. 

Other symptoms that may emerge with calf pain include redness, swelling, heat in the area, difficulty moving the leg or stiffness in the area. These may be signs of a more serious condition or injury. 

If your calf pain lasts for longer than 3 days or presents with other symptoms, you should see a family doctor or orthopedic surgeon to identify the underlying cause so that appropriate treatment can be initiated. Treatment may include stretching, medication or surgery in more serious cases. 

What causes calf pain?

The most common causes of calf pain include:

1. Poor blood circulation 

Bad circulation mainly affects people who are sedentary that do no exercise regularly. It can also affect pregnant women, especially near the end of pregnancy, as well as people who are on bed rest following surgery. A sore calf, in these cases, is not a cause for concern, but it can lead to cold feet and discomfort with walking. 

What to do: Stretching can help to reduce pain and discomfort related to bad circulation, however engaging in regular exercise is vital for improving circulation and preventing varicose veins. Other tips include using compression stockings, avoiding prolonged sitting, and decreasing salt intake to prevent water retention. 

2. Deep vein thrombosis (DVT) 

A DVT is a vascular condition that is more common in older adults. You should suspect a DVT if your leg becomes painful, swollen and hard. A clot occurs when a thrombus obstructs one of the veins in the leg, blocking blood flow in this area. 

What to do: If you suspect a DVT, you should proceed to the emergency room to confirm a diagnosis and start treatment immediately. It is usually done with anticoagulants to thin the blood and destroy the clot. In some cases, surgery may be needed to place a stent in any weakened or closed veins to promote blood flow. 

3. Varicose veins

People who have may small varicose veins, or just one or two wide and long ones, will often feel calf pain frequently. In these cases, the veins will appear more swollen and calves will feel heavy or fatigued. 

What to do: Treatment for varicose veins can be done with compression stockings, medication and exercise. Exercise is recommended because it stimulates the heart to pump with more force and it allows the heart to work more efficiently over time. Other options include laser therapy, sclerotherapy and surgery. 

4. Baker's cyst 

Baker's cysts usually appear behind the knee and feel like a sore lump. It causes pain with movement of the knee, but it can radiate and be felt in the calf. 

What to do: Bakers cysts are not serious, but they can be very uncomfortable. You are advised to use compression stockings, to place cold compresses over the affected area, and participate in physiotherapy. 

5. Infectious cellulitis  

Infectious cellulitis is an infection of the deepest layers of skin. It can affect any part of the body, including the legs. This type of infection can cause strong calf pain with intense redness and swelling. 

Read more about the symptoms of cellulitis and what can cause it. 

What to do: It is important to see your doctor if you suspect infectious cellulitis to prevent bacteria from reaching the blood and spreading throughout the body. If bacteria does spread, it can cause sepsis. Treatment is completed with antibiotics. Admission to the hospital may be necessary. 

6. Achilles tendon rupture

The Achilles tendon can rupture following direct trauma to the leg or feel, or with very intense exercise. The classic symptoms include calf pain, difficulty walking, pain upon palpation of the tendon. People who suffer from a rupture will often report that they heard a pop, or that they bumped their leg. 

What to do: You should go to the hospital, as affected legs need to be casted. In some cases, surgery is necessary. 

7. Calf pain during pregnancy  

Calf pain is a normal symptom during pregnancy. It occurs due to accumulation of blood in the legs, caused by hormonal changes. Calf pain during pregnancy mostly emerges during the night, however, cramping can occur during the day. Sometimes, the cramping is related to a lack of potassium. 

What to do: Pregnant women should stretch cramping muscles regularly. Food that is rich in potassium, like bananas, can also help, as well as compression stockings during the day. Elevating your legs at night can help to improve circulation and reduce pain.

8. Calf pain while running 

When engaging in exercise, like running, calf pain is likely muscle-related. The most common causes of calf pain while running are:

• Intense exercise, especially when running uphill, in which both legs are affected at the same time 
• Muscular overstretching, contracture or distension
• Cramping, which occurs suddenly in one leg, which can also cause foot pain 
• Myofascial pain syndrome (MPS), which can cause sudden and intense pain, as if someone threw a stone to against your leg
• Lack of minerals, which can occur after long training sessions and with lack of hydration 

What to do: If you feel a strong pain in your calf while running, you should stop to stretch your legs. Sit on the floor with your legs stretched in front of you, and point your toes toward you. If the pain felt in both legs, but is tolerable and only slightly uncomfortable, the pain is likely fatigue from increased resistance. With regular training, the pain tends to resolve over time. 

When to see the doctor 

You should see the doctor or go to the emergency room if you have any of the following signs or symptoms: 

• Intense calf pain that emerges suddenly 
• Pain, swelling and rigidness only in one leg 
• Redness and a sensation of swelling or burning in one leg 

It is also important to be assessed by a doctor if you are having intense muscle pain that does not pass within 3 days. 

How to treat calf pain

Calf pain tends to decrease after physical activity, but it can be treated with physiotherapy, massage or rest in mild cases. Severe cases may require surgery for treatment. 

Some tips to relieve calf pain are:

• Apply a cold compress on the calf 
• Massage the muscle 
• Stretch the muscle 
• Drink plenty of water and eat food that is rich in sodium and potassium 
• Rest 

Treatment of calf pain can also include anti-inflammatories or muscle relaxants, like acetaminophen, diclofenac or cyclobenzaprine.