Painful lower legs can show up without warning. One day, your calves feel fine, then they ache, cramp, or feel heavy by evening.
When there’s no obvious injury, it’s hard to tell what’s behind it. Muscles, veins, arteries, and nerves all run through a tight space between your knee and ankle.
When one sends distress signals, the others can feel involved too. That overlap makes painful lower legs tricky to sort out on your own.
This article explains the signs so you can spot the source and know whether rest, stretching, or medical care is needed.
- Painful lower legs usually point to problems with veins, muscles, arteries, or nerves.
- Heavy or aching legs often link to vascular circulation issues.
- Cramping during walking often signals reduced blood flow in the arteries.
- Sharp or localized pain with movement often comes from muscles, tendons, or bones.
- Wellness and Pain can identify the cause of painful lower legs and treat it at the source.
What Causes Painful Lower Legs (Without an Injury)
When painful lower legs show up without a fall or strain, the cause is usually internal. Circulation problems, overworked tissues, or irritated nerves can all trigger leg pain.
The difference is how the pain behaves. Some types worsen after prolonged standing or sitting. Others appear only during walking or specific movements.
Certain sensations feel better with elevation, while others don’t change at all.
Noticing patterns gives you useful clues. Where the pain starts, when it appears, and what relieves it often point to the source.
1. Painful Lower Legs That Feel Heavy, Achy, or Tired
Painful lower legs that worsen in the evening often point to poor circulation. This type of lower leg pain doesn’t come from an acute injury or overuse.
Veins carry blood back to the heart. They use one-way valves to push blood upward.
When those valves weaken, blood flow slows and collects in the lower extremities. That pressure leads to aching legs, swelling, and a dull ache in the calves.
This pattern is different from muscle strain or sports injuries. Those usually cause sharp pain during physical activity.
Chronic Venous Insufficiency
Chronic Venous Insufficiency (CVI) ranks among the most common causes of leg pain without trauma. It often develops after years of valve damage or untreated varicose veins.
With CVI, blood leaks backward through damaged valves. Pressure builds in the affected leg, irritating the surrounding tissue.
Common signs of CVI include:
- A dull ache in the calf muscle or lower leg
- Heaviness that increases later in the day
- Swelling that leaves sock impressions
2. Painful Lower Legs That Cramp When Walking
Painful lower legs that cramp during walking often point to an artery problem. You may walk a short distance before intense pain hits the calves.
When you stop, the pain fades. That start-stop pattern rules out most muscle cramps and overuse injuries.
Arteries are blood vessels that carry oxygen-rich blood to the lower body. When plaque narrows them, the blood moving to the leg muscles drops during physical activity.
The affected muscle reacts by tightening, which forces you to pause and rest.
Peripheral Artery Disease
Peripheral artery disease (PAD) is a chronic condition that restricts blood flow to the lower extremities. Plaque buildup narrows the arteries and limits oxygen delivery during activity.
People with PAD may notice more than leg cramps. Over time, the affected leg can show physical changes, including:
- Hair loss on the lower leg
- Cooler skin temperature
- Weak or absent pulses in the feet
- Sores that don’t heal
PAD affects blood pressure and circulation throughout the body. It also raises the risk of heart attack and stroke.
3. Painful Lower Legs That Hurt When You Move or Press on Them
When painful lower legs hurt during movement or direct pressure, the issue usually comes from muscles, tendons, or bones. This pain reacts to use. It appears when the area works and settles once you stop.
This pain stays in one place. It doesn’t travel up or down the leg. Most people can point to the exact spot on the injured leg that hurts.
Shin Splints
Shin splints, also called medial tibial stress syndrome, cause pain along the shin bone. This often starts after repeated impact, such as long hours spent walking on hard surfaces.
The pain spreads across part of the shin instead of one pinpoint spot. It usually starts as a dull pain and becomes sharper as activity continues.
Shin splints irritate the soft tissues attached to the bone. When ignored, they can develop into stress fractures.
Stress Fractures
Stress fractures are tiny cracks in the bone caused by repeated force over time. They don’t result from a single fall or broken leg.
This pain is sharp and focused. You can often locate it with one finger. Pressing on that spot triggers immediate pain.
Stress fractures don’t improve during activity. Imaging, such as magnetic resonance imaging, may be needed when X-rays don’t show the crack.
Achilles Tendon Pain
The Achilles tendon connects the calf muscle to the heel. Over time, it stiffens and tolerates strain poorly.
Pain often appears near the back of the ankle. Morning stiffness is common. Walking may reduce stiffness briefly, then pain returns later.
Muscle Cramps and Charley Horse Pain
A charley horse causes a sudden muscle spasm in the calf. The muscle tightens hard and becomes painful to touch.
Dehydration, alcohol intake, and muscle fatigue often trigger these episodes. Gentle stretching helps after the spasm releases.
If cramps keep returning, there’s often an underlying cause worth checking.
4. Painful Lower Legs That Burn, Shoot, or Tingle
When painful lower legs burn, tingle, or send sudden shocks, nerves are usually the source. This pain doesn’t depend on movement or pressure. It can appear at rest and often feels electric rather than sore.
Below are the most common nerve-related causes.
- Sciatica from nerve compression: Sciatica starts in the lower back. Pressure on a nerve sends pain down the back of the leg and into the calf. Sitting often makes it worse, even pressing on the leg doesn’t change the pain.
- Peripheral neuropathy: Peripheral neuropathy affects nerves that carry signals to the legs. It often causes burning, tingling, or numbness in the lower legs. Muscles may weaken as nerve signals fail to reach them.
- Diabetic neuropathy: Diabetic neuropathy develops after long-term high blood sugar. Pain often starts in the feet and spreads upward. Light touch can hurt, especially at night when symptoms tend to worsen.
Nerve pain doesn’t respond to rest, compression stockings, or anti-inflammatory medications.
Treatment options often include physical therapy to reduce nerve compression and help nerves function properly.
5. Painful Lower Legs Causes You Can’t Ignore
Some causes of painful lower legs require urgent care. Deep vein thrombosis is one of them.
Deep vein thrombosis (DVT) occurs when a blood clot forms in a deep vein. This usually affects one leg, not both. If that clot breaks loose, it can travel to the lungs and block blood flow.
That’s a medical emergency.
DVT pain often appears suddenly. It doesn’t follow the patterns seen with muscle strain, nerve pain, or overuse injuries. It also doesn’t respond to rest, stretching, or position changes.
It usually affects the calf or thigh. The affected leg may look different from the other one.
Common warning signs include:
- Sudden swelling in one leg
- Warmth over the area
- Red or discolored skin
- Severe pain or tenderness
Some people describe stabbing pain or deep pressure in the calf muscle. Others notice visible veins near the surface. In some cases, there are no early symptoms at all.
Several risk factors raise the chance of DVT. These include recent surgery, long periods of sitting, pregnancy, smoking, certain medications, and a history of blood clots.
If you notice sudden swelling, warmth, or severe pain in one leg, seek medical attention right away. Don’t wait to see if it passes.
How Doctors Figure Out the Cause of Painful Lower Legs
When painful lower legs don’t improve, doctors identify the source of the pain. They start by reviewing your symptoms.
When the pain appears, what triggers it, and whether it affects one leg or both, all provide useful clues. Swelling, weakness, or skin changes can also signal where the problem starts.
Next comes a physical exam. Doctors check pulses, joint motion, and strength in the surrounding muscles.
They test sensation to see if nerve problems are involved. If symptoms suggest an issue higher up, they also look at the spine and spinal cord.
Imaging helps confirm findings. X-rays can rule out a bone fracture or damage to an affected joint. Other scans may help when nerve involvement or deeper tissue issues are suspected.
This process helps doctors pinpoint the cause of painful lower legs and decide on the right care for your symptoms.
What You Can Do to Manage Painful Lower Legs
If painful lower legs flare up during the day, a few remedies can reduce discomfort while you figure out the cause.
Raise your legs above heart level for 15 minutes if swelling or heaviness shows up. This helps blood drain from the lower legs instead of pooling around the ankles.
If tight muscles drive the pain, gently stretching the calves can help loosen them. Keep movements slow. Stop if sharp pain appears.
Hydration affects muscle function. Low fluids or skipped minerals often cause leg cramps. A balanced diet helps muscles contract and release the way they should.
Keeping a healthy weight also reduces daily strain on the lower legs.
An elastic bandage can also help with mild swelling. It should feel supportive, not tight. If pain keeps returning, worsens, or brings new symptoms, seek immediate medical care.
Get Treatment for Painful Lower Legs at Wellness and Pain
Do painful lower legs interrupt your sleep, walking, or daily routines? Doctors at Wellness and Pain focus on identifying the cause rather than masking symptoms.
They start by asking when pain begins and how it behaves. Swelling, cramping, burning, or heaviness each points to a different issue. Location and timing help narrow the source.
Doctors then order targeted tests. Circulation tests show how blood travels through the legs. Imaging checks joints and surrounding tissues.
When symptoms suggest nerve involvement, doctors evaluate neurological disorders that affect the lower legs.
After doctors identify the cause, they select care that targets it. Vein-related pain leads to circulation-focused treatment, and nerve-related pain leads to care that reduces irritation or pressure.
Doctors also review your medical history. Medications such as blood thinners or conditions tied to uric acid can affect both symptoms and care decisions.
Request an appointment with Wellness and Pain to get answers based on what’s happening in your legs.
FAQs About Painful Lower Legs
What causes leg pain in both legs?
Pain in both legs often links to circulation issues, nerve conditions, or muscle fatigue rather than a single injury. Problems like poor blood flow or nerve damage can affect both legs at the same time.
What disease starts with leg pain?
Several conditions can start with leg pain, including peripheral artery disease, diabetic neuropathy, and chronic venous insufficiency.
In many cases, leg pain shows up before other signs become noticeable.
What can I do to stop my legs from hurting?
Start by noting when the pain appears and what makes it better or worse. Elevation, supportive shoes, hydration, and gentle stretching often help.
If pain keeps returning, it may signal a problem that needs medical evaluation.
How to cure leg pain in old age?
Doctors don’t rely on one cure, since leg pain often comes from circulation changes, nerve damage, or joint wear.
They identify the cause and treat it directly. That strategy usually reduces pain and improves daily comfort.











