Update: October 2018
The drumstick is an anatomical region that takes up the gap from
knee to heel joint. She, like other areas of the body,
is a multi-layer formation: the skin is on top, under it –
a little subcutaneous tissue, below – the muscles, bones, between which
pass vessels and nerves. The characteristic pain of the lower leg region is
that their cause can be not only inflammatory, tumor
diseases or impaired blood supply to any of the structures
constituents. It is this area that will hurt in response to a pronounced
intoxication (for example, with leptospirosis or flu); right here
blood is the most difficult to climb through the veins against gravity that
creates prerequisites for the formation of varicose veins.
Consider why the lower leg legs are sore in relation to localization and
the nature of the pain syndrome, but first, briefly highlight
anatomy, so that later it was clear what is called.
The skin of the lower leg has nothing that distinguishes it from the integument.
other sites. Temperature, pain and tactile
its sensitivity is provided by nerves starting from
lower back and passing through the thigh.
Subcutaneous tissue of the leg is well expressed. On
the front surface in it are the subcutaneous veins – small and
large, as well as a nerve that goes to the skin. On заднюю поверхность
only their branches pass. Superficial veins communicate with
deep, lying between the muscle layers, using special
perforating (communicative) veins.
Under the fiber on the front surface is fascia –
the film covering the muscles, but here it is more dense
resembles a tendon. On the posterior surface of the fascia is not so
dense, but divided into 2 sheets, which divide the muscles into 2 layers
– superficial and deep. Under the muscles are 2 bones:
tibial – from the inside, peroneal – with
Muscles of the calf (crural muscles). They don’t cover all of it.
the front surface, leaving the “bare” part of the tibia
on its outer surface (you can easily grope it). Back muscles
the surfaces of the lower leg form the so-called “second heart”. With
walking they push blood from the veins into the systemic circulation against
gravity, and blood in these veins can be deposited
a large number of. Therefore, in situations involving blood loss
or loss of fluid, legs try to lift. When is the bloodstream
the channel is crowded, which is accompanied by an increase in arterial
pressure, the legs are lowered, and even with thermal procedures they try,
expanding the veins, remove a large amount of blood in them.
Bones. They are two: wide and large tibial, and also small,
similar to a cane, peroneal. Above and down in the tibia
The bones are recesses where the fibula is inserted. Such a
the connection is not very reliable, so the bones additionally
fixed by a membrane of dense connective tissue. Through this
the membrane is pierced through it, nerves and blood vessels.
What can hurt the legs
On голени может развиваться:
- circulatory disorders;
- damage to nerve fibers.
- muscles and their tendons;
Сразу оговоримся, что голень left foot имеет такие же
structure, as in the right. Therefore, in the following material we will
consider pain depending on their localization in the very leg –
both right and left.
Sore whole leg
Pain syndrome of such localization is typical for:
- Fracture of the bones of the leg caused by a blow, bruise,
jump from a height or a fall. Initially, the pain may be located
locally, in the place where the blow fell, but then the whole
shin. In addition, it becomes extremely difficult movement in
- Osteitis deformans characterized by predominance
processes of bone destruction over its formation. Affected bone
is deformed, which is accompanied by dull aching pains that
almost do not pass, and at rest can and amplify.
- Onрушения кровоснабжения вследствие атеросклероза или
endarteritis obliterans, when the vessels that feed the lower leg tissues,
increasingly narrowed, depriving them of food.
- Gas gangrene, when there was a leg injury, and on the injuring
the subject was the soil where there were clostridium bacteria (this may
be a nail, glass, and so on). Read lower gangrene
- Any of the tumors developing in the crural zone, which
caused squeezing of blood vessels or their blockage
tumor cells. So, squeeze blood vessels can both
benign neoplasms (osteoma, chondroma, lipoma,
fibroma) and cancer (they will be called sarcomas) tumors.
Only osteosarcoma can block blood vessels.
chondrosarcoma, leiosarcoma, melanoma, squamous cell skin cancer,
rhabdosarcoma and others.
Sore on the front of the leg
When the lower leg tissues ache in front, this can occur due to
the following reasons.
A blow to the front drop on your knee at
skating, rollerblading or cycling, which caused not
fracture, and only soft tissue damage, will be accompanied
pain of the lower leg in front.
It may also be a sprain or rupture of ligaments that occurred.
in case of injury or enhanced training.
With переломе болеть будет вся нога.
The front surface of the leg can be burned when cooking – boiling water
or boiling oil. A red hot spot will appear in this place.
even blister with watery contents
In the anterior part, erysipelas can often occur. it
a red or pink spot of not very small diameter, looking,
like a painted flame.
Inflammation может быть вызвано не только стрептококком, как при
mug Other microbes can also trigger inflammatory
process in local soft tissues. They can get there when injured
infected material, with poor blood supply, when
trophic ulcers occur.
Inflammation не обязательно должно быть вызвано микробами. it
There may be eczema or neurodermatitis caused by various reasons
including diseases of internal organs.
Anterior Tunnel Syndrome
This is the name of the inflammation and swelling of the muscles of the anterior crural zone,
placed in a separate fascial case that limits their
The pain is severe, localized in the front, captures the foot,
worse when bending the legs.
it заболевание чаще всего развивается у людей 10-20 лет, у
which actively grows bone tissue, and at the same time they are actively
involved in sports such as football, running or basketball,
accompanied by increased load on the legs. The essence of the disease:
damage to the bone site (tuberosity) on the tibia,
to which is attached the tendon.
The pain appears gradually, his first episode – after
physical loads At first it is weak, then it becomes strong.
It is enhanced by the extension of the leg, and if the leg is to create peace,
the pain will subside.
Damage to the knee meniscus
Arises from athletes. It is characterized by severe pain and in
knee, and in the lower leg, accompanied by limitation of the motor
limb activity and joint volume increase.
Syndrome “split leg”
it состояние возникает у спортсменов, работающих с большой
load on the legs, which gave it immediately, without a good
Aching pain, mild or moderate, occurs during
training, and at rest – leaves.
it появление на коже локальных отмираний ткани связано с
diabetes mellitus, thrombophlebitis, varicose veins or
obliterating endarteritis. Characterized by the appearance of not only
skin defect, but also pressing, arching pain in this area.
His reason – pronounced physical activity. It manifests itself
local pains in the inflamed muscle, which increases with her
squeezing and certain movements. If myositis is not treated, the muscle
weakens, atrophies. Read more on the symptoms and treatment of myositis.
Sore back of the lower leg
Pain in the back of the lower leg is characteristic of such
diseases and conditions:
If a blow or fall fell on the back and did not cause
fracture, soft tissue will hurt in the damaged area.
If it hurts from behind and from the side (on the inside), it can
periostitis is inflammation of the periosteum. His reasons: long
physical exertion in untrained people, bruises, fractures. Such
pains often develop in the lower leg of the right leg, which is usually
�”Jog” and gets a big load. They appear through
short time after exercise or exercise. On месте поражения
there may be a slight swelling, which if touched, will
hurt or unpleasant. The skin is not red, not edematous.
Exactly the same processes as described for the front
surfaces may develop and hurt in this
Deep rear tunnel syndrome
If the muscles lying deeper than the triceps of the lower leg become infected, lose
normal blood supply or stretched then being
prisoners in the fascia and not being able to expand, begin to
Pain – on the posterior surface of the crural. She is sharp
bursting It increases when trying to straighten the leg. If a
do not treat the pathology, edema appears in the affected area, the skin
will turn red or become bluish, the temperature will rise above it.
The sensitivity is later disturbed, the muscles start worse
Calf Gastrointestinal Stretching
If a неудачно прыгнуть или стараться сильно быстро бежать, может
to occur sprain calf muscle. it проявляется резкой болью
in the rear crural divisions at the time of stretching. Through time cloth
swell, and pain – worse.
Inflammation ахиллова сухожилия
Strong physical exertion can lead to inflammation.
tendon attached to the calcaneus. In this case, in the lower
parts of the back of the lower leg appear aching pain. She is
increases if you need to bend the foot, for example, when walking or
Myositis одной из мышц задней группы
The muscle starts to hurt, and this pain is aggravated by extension
feet, muscle squeezing, with changing weather.
Baker’s cyst rupture
Some people have holes in the back of the knee
there may be a connective tissue capsule with a liquid – a cyst
Baker If a она разрывается, и жидкость попадает в межмышечные
space, it is manifested by pain, tenderness, increase
Sore shin on the inner surface
Pain in the lower leg can be caused by:
- периоститом большеберцовой bones;
- trauma to this area;
- erysipelas developed in this area;
- the syndrome of “split leg”;
- tumor formations localized in this zone;
- subcutaneous neuropathy.
The shin hurts on the outside
Pain in the outer side occurs when:
- osteochondrosis of the spine;
- intervertebral hernia lumbar;
- if squamous cell carcinoma of the skin is located in this zone.
Sore bones of the lower leg
When pain is noted in the bones of the calf
- periostitis. Caused by pain syndrome a heavy load of legs,
especially often observed in the soldiers of the first month of service or those
who decided to quickly “pump up” legs. Onд воспаленной надкостницей
there is a slight swelling of the skin of unchanged color, the bone in this
the place is painful. On рентгене первые 20 суток ничего не видно;
- Osgood-Schlatter disease;
- deforming osteitis. it процесс характеризуется нарушением
normal processes occurring in the bones of the leg. Instead of,
so that the process of bone renewal (its destruction and creation)
occurred gradually and balanced, begins to prevail
destruction. The bones try to recover, but it happens.
slower, so they tend to break;
- osteomyelitis – inflammation of the bone marrow located in
tibia. Pain arching, strong, accompanied
fever, drowsiness, weakness, and sometimes nausea.
Read more on osteomyelitis symptoms.
If a боль – в мышцах голени, это может быть:
- muscular “krepatura” arising due to overload
muscle tissue during exercise or work. Pain may be
quite strong; it passes after a short period
- varicose veins when visible on the back of the leg
- leptospirosis. This disease often occurs in hunters and fishermen,
characterized by severe course with damage to the liver and kidneys.
Both lower legs hurt, it is also accompanied by weakness, an increase in
temperature After a while, a person may notice a wish.
own skin, and then – reducing the amount of urine;
- pain in the leg muscle can be noted after her cramps,
arising on the background of dehydration, during pregnancy, while
in cold water;
- innervation disorder that occurs with osteochondrosis or
intervertebral hernia localized in the lumbar spine
- tunnel syndrome – anterior, posterior or lateral.
Pain in the skin of the leg is marked with:
- Trauma (bruise, squeezing, crushing) tissue. In this case
there will be a bruise or a bruise on the skin; also man must remember
the fact of injury.
- Burn: solar, chemical or physical. Skin reddened
swollen, there may be bubbles on it. A person can specify himself
- Inflammation (for example, erysipelas or herpes). Such a
inflammation is a noticeable phenomenon. So, the erysipelas process looks like
hot pink spot on the skin, hot to the touch, having a clear,
flames-like borders. Herpes zoster is a group
vesicles located along the nerve trunk, the skin under which
- Cellulitis, i.e., fusion caused by pyogenic bacteria
subcutaneous tissue. She is возникает после проникающего ранения или
against trophic ulcers, when staphylococci get under the skin,
streptococci, Pseudomonas aeruginosa and other bacteria.
Withблизительный диагноз по характеру боли
The lower leg hurts a lot when:
- Osgood-Schlatter disease;
- gas gangrene associated with falling into the wound on the foot of the earth,
dust (by themselves or with a hurting object), which contain
Clostridia – anaerobic bacteria;
- tumors developing from the bones of this anatomical zone. Pain
sharp, stabbing, increases with physical exertion;
- tunnel syndromes.
Резкие боли характерны для остеомиелита –
purulent inflammation of bones that contain red bone
brain. Pain распирающая, постоянная, выматывающая. She is
accompanied by deterioration (weakness, drowsiness,
снижением аппетита), повышением temperature Getting hurt
walk, and when tapping on the affected bone pain syndrome
If a боль ноющая, это может говорить about:
- tendonitis (inflammation of the tendons of the lower leg). It often develops
injured tendons, frequent or intense physical
loads, when an attachment occurs at the site of attachment to the bone.
Pain локализуется в области надрыва, кожа в этом месте припухает,
may blush slightly, shows increased tactile and pain
- herniated disc;
- deforming osteitis.
On что могут указывать дополнительные the symptoms
Pain при беге в голени – это симптом, говорящий
about the violation of the blood supply to tissues. it характерно для двух
diseases: obliterating (that is, narrowing the lumen of blood vessels)
atherosclerosis and endarteritis obliterans. In the initial stages
diseases will hurt the whole leg only with long walking or
significant physical exertion. When does the pain in the legs arise
already when walking or at all alone, it means that the disease has gone
far away and without taking appropriate action
dying tissue (gangrene).
A similar symptom can also be observed in tumors when
the newly formed tissue squeezed the vessels that feed all the rest
tissue. it не обязательно должна быть злокачественная tumor;
lipoma or chondroma may well cause this clinical
Also, pain when walking will occur when:
- muscle sprains. it возникает немного спустя травмы,
accident or inconvenient movement;
- bone fractures or microcracks. it состояние также
provoked by trauma, unlike arterial diseases,
appearing “from scratch”;
- varicose veins of the leg.
If a нога опухла, это может быть:
- Periostitis. In this case отек небольшой, но трогать его
painful. Skin color is not changed. There is pain in 2-3 days
after an exhausting workout, bruise or fracture.
- Osteomyelitis. It is characterized by fever, redness and swelling.
in the local area, pain when walking.
- Phlegmon. The temperature rises, the appetite decreases, it can
feel sick. Swelling and tenderness in the crural region spread
over a large area.
- Gas gangrene. There is always a wound present,
which bacteria are carried under the skin and do not tolerate
- Swelling and discoloration of the legs to bluish, talking about overlapping
large vein thrombus. it требует срочного хирургического
- A slight swelling without discoloration of the skin may indicate
development of venous insufficiency with varicose veins.
- Tunnel syndrome.
If a голень болит у ребенка
Pain в голени у ребенка может возникать вследствие рассмотренных
- fracture, contusion or prolonged compression of the tissue of the cranial
- muscle cramps when in cold water or developed
with diarrhea when dehydration and deprivation of the body occur
calcium or magnesium, other conditions accompanied by a decrease
blood calcium / magnesium concentrations;
- Schlatter’s disease;
- gas gangrene.
Tumors in childhood develop extremely rarely, but with
exclusion of the above reasons should be examined and about
oncological pathologies, including.
Actions for crural pain
What to do with such a symptom before consulting a doctor depends
from the cause of the disease:
- If a накануне была травма или интенсивная тренировка, можно
drink anesthetic drug: Nimid, Ibuprofen or
�”Dexalgin”. Limbs need to be rest, muscles are bandaged
elastic bandage. To reduce pain can be 15-20
minutes 3-4 times a day apply ice wrapped in a dry diaper to
sore spot. Onрушение движения в ноге, увеличение отека после
injuries – a reason to turn to a traumatologist.
- If a боли появились спонтанно, при том, что у человека нет
varicose veins is also a reason to visit a traumatologist.
- Pain syndrome, fever and deterioration of the overall
states says you need to visit a traumatologist (if you are sick
bones) or infectious diseases (when the muscles hurt). Call the ambulance and
except to go to infectious or any other hospital
kruralnogo pain syndrome, there is one of these symptoms:
- decrease in the amount of urine;
- yellowing of the skin;
- high temperature, especially when it is badly reduced when
taking antipyretic drugs;
- feeling of “lack of air”;
- pain in the right hypochondrium.
- When you notice that it hurts to walk, but only hurts
shin, not back, dopplerography is necessary (triplex or
duplex scanning) of the arteries of the lower limbs, and then
visit a vascular surgeon.
- When the calf is worried due to frequent muscle cramps, turn in
blood for calcium and magnesium in it, refer to
family doctor, general practitioner or pediatrician.
- Edema, arching pain, crunching of tissue in the place where there are several
once there was an injury, it says about the likely development of gas gangrene,
life threatening. She is лечится только в хирургическом стационаре
by operation and constant washing of the wound with hydrogen peroxide,
potassium permanganate and other tissue-bearing solutions
oxygen, detrimental to clostridia.
Автор: Кривега Мария Салаватовна врач-реаниматолог