What causes pain in the calf muscles?

The symptoms of diseases in life can have a great impact on people. Among them, muscle pain caused by diseases is the most common. For example, pain in the calf muscles can make people feel great discomfort, causing the rhythm of life of many people to be greatly affected. The symptoms of pain in the calf muscles do not appear out of thin air. Let’s take a look at the causes of pain in the calf muscles.

Pain and tenderness in the calf muscles are characteristic of venous thrombosis, an acute non-suppurative inflammation of the veins with secondary intraluminal thrombosis. The lesions mainly involve the superficial veins of the limbs or the deep veins of the lower limbs. Its clinical characteristics are local swelling and pain in the affected limb, tender cord-like objects palpable under the skin, or venous obstruction such as superficial varicose veins distal to the lesion. Occasionally, pulmonary embolism may occur due to the detachment of blood clots.

Diagnostic tests

1. Inquire about the patient's history of trauma, the time of injury and treatment, the patient's history of long-term bed rest, surgery, pregnancy, childbirth and oral contraceptives, and the patient's history of repeated venipuncture or intravenous indwelling infusion catheter. Whether the symptoms are consistent with the disease stage, the site of onset and development, the nature of the pain, whether there is fever, swelling and pain in the affected limb, etc.

2. During local examination, attention should be paid to the tenderness of the affected limb, the location of the tenderness, the swelling (the circumference must be accurately measured daily with a tape measure on the thickest plane and compared with the same plane on the healthy side), the color and temperature of the skin (compared with the contralateral side, it is best to measure with a skin thermometer), any changes in the distal pulse of the limb, whether tender cords can be felt on the body surface, the presence of infected lesions, and nutritional changes in the foot and boot area, such as desquamation, itching, pigmentation, eczema, and ulcer formation.

3. When diagnosis is difficult or to clarify the scope of the lesion, ultrasound examination, pulsed Doppler spectrum examination, and venography can be performed (which can effectively determine the presence of thrombus, the location, scope, morphology, and collateral circulation of thrombus.

4. Venous pressure measurement: perform dorsal venous puncture and connect the needle to a pressure sensor or a transparent plastic tube with a scale (filled with heparin-saline solution) to measure the venous pressure. The normal pressure is generally 12.7 kPa (130 cmH20). When the ankle joint is flexed and extended, the gastrocnemius muscle contracts and the pressure drops significantly, generally to 5.9 kPa (60 cmH20). The pressure rises after stopping the activity, and the recovery time exceeds 20 seconds. In patients with thrombosis and blockage in the main veins, the pressure increases significantly regardless of rest or activity, and the recovery time increases rapidly, generally not exceeding 12 seconds.