Muscle Strain and Pain in the Legs: Causes and Solutions

Q: Muscle Strain and Pain in the Legs: Causes and Solutions

Hello Ah Hao： Your excessive muscle use, especially engaging in intense activities without proper warm-up, can often lead to muscle strains, and this reasoning is reasonable. <br>Additionally, since you have consulted with orthopedics, rheumatology, and neurology, and have underg

Regarding leg pain, tightness, and weakness..?

I have a question regarding muscle fiber tears in the calves and thighs.
I work in the electronics industry, where I have to stand and walk briskly all day, and sometimes even run to meet deadlines.
I typically work over eight hours a day.
When I first started working after my military service, I didn't know how to protect myself and often ran or walked quickly for performance reasons.
After two to three years, I realized I could hardly walk anymore.
At times, even walking a few steps would cause tightness and pain in my leg muscles.
However, I did not seek medical attention at that time.
Now, after working for over six years, I have recently noticed that going up stairs causes extreme tightness and pain in my legs.
I now find it uncomfortable to walk on flat ground, even for short distances (like when visiting a night market), and my legs feel weak.
After slight exercise, the muscles in both my thighs and calves become extremely tight and painful for several days.
I went to an orthopedic clinic where X-rays showed no abnormalities in my bones, and I was referred to a rehabilitation department for further examination (I also had blood tests for rheumatology and immunology).
The doctor diagnosed me with muscle fiber tears in my legs and recommended electrical stimulation and infrared therapy.
However, after several weeks of treatment, I did not feel any improvement.
I was then referred to a neurology department, where I underwent an MRI of my lower back and another MRI for my intervertebral discs (the sixth and seventh discs showed slight protrusion, but the doctor said there was no significant nerve compression and it was not a major concern).
The doctor advised me to let my legs rest.
However, I have been at home for nearly a year without working, and the soreness has not subsided at all.
There are times when I feel skeptical and try to walk briskly or jog a little, but my leg muscles become incredibly tight and painful, especially in the front of my calves and the back of my thighs.
The pain and tightness are particularly pronounced in the back and sides of my calves and the front and back of my thighs.
Currently, I have turned to traditional Chinese medicine, but I have not received any definitive answers regarding my condition.
I am unsure whether this is a muscle issue or a nerve issue.
I have undergone rehabilitation in the neurology department, where I was prescribed pain relievers and muscle relaxants, but none have completely resolved the problem.
I would greatly appreciate any advice on whether there are other methods of examination or treatment options available, such as muscle biopsy or surgery.
I am truly suffering from this condition.
Thank you for your guidance.

Ahao, 20~29 year old female. Ask Date: 2008/06/20

Dr. Lin Yijun reply Orthopedics

Hello Ah Hao: Your excessive muscle use, especially engaging in intense activities without proper warm-up, can often lead to muscle strains, and this reasoning is reasonable.
Additionally, since you have consulted with orthopedics, rheumatology, and neurology, and have undergone an MRI of the spine, it can generally be concluded that the issue may not be significant.
Here are a few suggestions:
1.
To diagnose whether a herniated disc is causing nerve compression, sometimes it cannot be confirmed by MRI alone; electromyography (EMG) and nerve conduction studies may be necessary for confirmation.

2.
In rare cases of specific neuromuscular disorders, further testing may be required to rule them out, such as brain imaging studies or evoked potentials.

3.
You can start by adjusting your lifestyle, engaging in moderate exercise, and remember to warm up before exercising.
Additionally, consider physical therapy, and if there is no improvement, consult a neurologist.

Wishing you good health,
Lin Yi-Jun
Department of Internal Medicine, Taipei City Renai Hospital

Reply Date: 2008/06/20

More Info

Muscle strain and pain in the legs can be a complex issue, especially for individuals who have physically demanding jobs or lifestyles. Based on your description, it seems that you have been experiencing significant discomfort and limitations in mobility due to muscle strain, which may be exacerbated by your work environment and physical activity levels. Let's explore the potential causes, diagnostic approaches, and treatment options for your condition.

Causes of Muscle Strain and Pain
1. Overuse Injuries: Given your job requires prolonged standing and fast walking, it's likely that you have developed overuse injuries. These occur when muscles and tendons are subjected to repetitive stress without adequate rest, leading to micro-tears in muscle fibers.

2. Muscle Imbalance: If certain muscle groups are stronger than others, this imbalance can lead to strain. For instance, if your quadriceps are significantly stronger than your hamstrings, this can create tension and pain in the legs.

3. Poor Ergonomics: Standing for long periods without proper footwear or support can lead to muscle fatigue and strain. If your work environment does not allow for proper posture or movement, this can exacerbate your symptoms.

4. Previous Injuries: Past injuries, even if they seemed minor at the time, can lead to chronic pain if not properly rehabilitated. Scar tissue can form, leading to stiffness and discomfort.

5. Underlying Conditions: Conditions such as fibromyalgia, chronic fatigue syndrome, or even certain neurological disorders can manifest as muscle pain and fatigue.

Diagnostic Approaches
1. Physical Examination: A thorough physical examination by a healthcare professional can help identify areas of tenderness, swelling, or muscle weakness.

2. Imaging Studies: While X-rays can rule out bone issues, MRI scans can provide detailed images of soft tissues, including muscles, tendons, and ligaments. This can help identify any tears or inflammation.

3. Electromyography (EMG): This test can assess the electrical activity of muscles and help determine if there is any nerve damage contributing to your symptoms.

4. Blood Tests: These can help rule out inflammatory or autoimmune conditions that may be causing your symptoms.

Treatment Options
1. Rest and Recovery: Allowing your muscles to recover is crucial. This may involve taking time off work or modifying your activities to reduce strain.

2. Physical Therapy: A physical therapist can develop a personalized rehabilitation program that includes stretching, strengthening exercises, and modalities like ultrasound or electrical stimulation to promote healing.

3. Pain Management: Non-steroidal anti-inflammatory drugs (NSAIDs) can help manage pain and inflammation. Muscle relaxants may also be prescribed to alleviate muscle spasms.

4. Ergonomic Adjustments: Consider evaluating your work environment. Using supportive footwear, taking regular breaks, and incorporating stretching into your routine can help mitigate strain.

5. Alternative Therapies: Some individuals find relief through acupuncture, massage therapy, or chiropractic care. These modalities can help alleviate muscle tension and improve circulation.

6. Surgical Options: In rare cases, if conservative treatments fail and there is a significant underlying issue (like a severe tear), surgical intervention may be considered.

Conclusion
Your symptoms of leg pain and muscle tightness are likely multifactorial, stemming from overuse and possibly compounded by previous injuries and work-related stress. It is essential to work closely with healthcare professionals to develop a comprehensive treatment plan tailored to your specific needs. If conservative measures do not yield improvement, further diagnostic testing may be warranted to explore other underlying conditions. Remember, the goal is to restore function and alleviate pain, allowing you to return to your daily activities with greater ease.

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