Causes Of Musculoskeletal Leg Pain

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Causes Of Musculoskeletal Leg Pain

Musculoskeletal leg pain involves pain that develops in any of the tendons, ligaments, and muscles in the lower extremities. Conditions ranging from tendinitis to arthritis may be the source of discomfort. Although this type of pain most frequently develops in the lower back, pain in the leg, hip, knee, or ankle is also common. Causes vary from serious physical disorders to more benign stresses from daily life.

Fibromyalgia as a cause of musculoskeletal leg pain

Widespread, musculoskeletal pain is fibromyalgia’s defining characteristic. Researchers aren’t sure how or why the condition develops, but it’s relatively common, affecting about 2% of the total population, according to the Centers for Disease Control and Prevention (CDC).

Women are at much higher risk of developing the disorder, with the CDC reporting a 7:1 ratio of women to men.

The disorder sometimes develops after a physical trauma, infection, surgery, or significant episode of stress. Other times, the onset seems random and cannot be attributed to any sort of physical or mental trigger. The condition is believed to run in families, and may have a genetic component.

Whatever the cause, fibromyalgia is believed to induce widespread musculoskeletal leg pain by interfering with the way the brain processes pain. Neurotransmitters that signal pain elevate to abnormally high levels. Meanwhile, receptors in the brain become more sensitive to pain signals, overreacting to the brain’s efforts to communicate distress.

Fibromyalgia’s musculoskeletal pain often manifests as a dull ache as opposed to a shooting or stabbing sensation. Fibromyalgia patients also experience pain above the waist.

Other symptoms include fatigue, sleep apnea, cognitive difficulties such as trouble concentrating or focusing, and depression, headaches, or abdominal cramping. Although there is no cure for fibromyalgia, patients generally manage symptoms through pain relievers and lifestyle changes such as reducing stress, eating healthy, and exercising.

Some people with fibromyalgia also use alternative therapies including acupuncture, chiropractic care, and massage.

Muscle overuse and underuse

Musculoskeletal leg pain doesn’t always arise from a disorder or medical condition. About 33% of adults experience pain from overusing their muscles, according to the Cleveland Clinic.

In the case of overuse, acute musculoskeletal leg pain could develop from a particularly intense workout. Even carrying a golf bag has been shown to cause musculoskeletal distress in the ankle, according to a study published in the American Journal of Sports Medicine.

Frequently, musculoskeletal leg pain arises from muscle sprains or strains. A sprain occurs when a ligament stretches beyond its capacity or tears. Ligaments are the tissues that connect bones to one another. A strain, meanwhile, involves injury to the muscle or tendon. A tendon is tissue that connects muscle to bone.

While sprains more commonly occur during falls or sports injuries, strains are usually the result from overuse, according to the American Academy of Orthopaedic Surgeons (AAOS). However, strains can also result from overstretching. In the leg, the hamstring muscle is easily susceptible to strains, particularly for athletes. The hamstring is actually made up of 3 separate muscles that run from the bottom of the pelvis to below the knee. Hamstring tendons connect the muscle to the bone.

Potential hamstring injuries include strains in the muscle itself. Tendonitis—inflammation or irritation—can also develop in the connective tissues. Runners sometimes report high hamstring tendonitis in the portion closest to the pelvis.

Although leg musculoskeletal pain is often discussed in terms of overuse, some researchers advocate reframing the issue as underuse. In the British Journal of Sports Medicine, researchers argued that muscle use was not the problem. The problem was that the muscles had not been used prior to running, jumping, or participating in some other type of activity normally avoided in a person’s mostly sedentary lifestyle. They wrote:

“Articles are often written assessing “injuries” with the implication that they were the result of movement. This explanation, although sequentially accurate, neglects to focus on the fact that a lack of previous movement is more likely the true source.”

To drive the point home, researchers reviewed several studies and found adults who maintain robust exercises regimens typically experience less musculoskeletal pain—not more.

The researchers concluded that while pushing the body too hard may result in injury, not exercising at all increases the risk of injury when a person finally does exercise.

Researchers wrote that:

“A review of the current science implicates that too little activity over time may in fact be the primary cause of a large percentage of musculoskeletal injuries…  People are more likely to exercise too little than too much.”

Sedentary people who begin vigorously exercising likely put themselves at risk for musculoskeletal injuries. To avoid injury, consider easing into exercise gradually and stay mindful of the body’s physical limits.

Shin splints

Shin splints are characterized by pain on the shin—the bone in the front part of the lower leg. Common in athletes and dancers, shin splints often develop from overuse or changes in exercise routines. This is an acute condition that can be eased through rest and icing the affected area.

Shin splints can re-occur, but wearing supportive shoes and easing up on the exercise can help stave off this type of musculoskeletal leg pain.


Arthritis is 1 of the most common musculoskeletal disorders affecting nearly 70% of people over age 65 and thousands of younger people in the U.S., according to the Arthritis Foundation.

The most common form of arthritis is osteoarthritis, a degenerative joint disease in which the cartilage in joints breaks down, causing inflammation and pain. Rheumatoid arthritis is a systemic, autoimmune disease, which means the body’s immune system fights the body as if it were a foreign virus. Either type of arthritis may result in musculoskeletal leg pain. Common areas this discomfort affects are the hip, knee, ankle, and foot.

Arthritis in the hip can lead to trouble walking and pain in nearby areas, such as the thigh or knee. Pain in the foot or ankle is especially common in people with rheumatoid arthritis, with more than 90% of patients reporting musculoskeletal pain in those areas, according to the AAOS.

Although there is no cure for arthritis, people can manage related pain with exercise, eating a healthy, anti-inflammatory diet, and adopting joint-healthy behaviors like maintaining good posture and wearing supportive shoes.

Have you experienced musculoskeletal leg pain?

Image by rearl via Flickr


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At Holistic Pain, we have a passion for helping you and those who around you who suffer from pain find relief. Part of that passion extends to education and transparency. In our Holistic Pain blog, we focus on new research studies, along with our own tips, for maintaining and improving your quality of life, even with pain.

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