How to diagnose and
treat leg pain

How do clinicians diagnose leg pain?

Clinicians start by asking about your story. They will want to know exactly where your leg hurts, what the pain feels like, when it started, and what makes it better or worse. ^{1 2 4} They will ask about recent travel, surgery, illness, injuries, exercise habits, and long periods of sitting or standing. ^{1 2 8 9} They may also ask about smoking, diabetes, blood pressure, and cholesterol, because these affect blood vessel health. ^{2 5 6 7}

A physical exam helps narrow down the cause. Your clinician will compare both legs, looking for differences in size, color, temperature, swelling, and visible veins. ^{1 2 5} They may feel for pulses in your feet and behind your knee to check blood flow, and gently press along muscles and bones to find tender spots. ^{2 5 11} Range of motion, strength, and simple walking tests can show how your leg behaves under load. ^{4 11 19}

If a blood clot is possible, clinicians often use the Wells score. This is a checklist that looks at risk factors and signs like swelling, tenderness, and recent surgery. ^{1 8 9} Depending on the score, they may order a blood test called a D-dimer and an ultrasound scan of the leg veins to confirm or rule out deep vein thrombosis. ^{1 8 9 10}

If circulation problems are suspected, such as calf pain when walking that eases with rest, an ankle-brachial index test may be done. This compares blood pressure at your ankle and arm to see if arteries are narrowed. ^{2 6 7} Ultrasound of the arteries or more detailed imaging can be used if procedures are being considered. ^{2 3 5}

When leg pain seems related to the spine or nerves, your clinician will check sensation, muscle strength, reflexes (involuntary movements in response to a stimulus), and nerve stretch tests such as the straight leg raise.^{4 17 18} This helps tell the difference between sciatica, focal nerve entrapments, and other causes. ^{4 17 18}

For bone stress injuries and shin pain, careful palpation along the bone and questions about training volume, surfaces, and nutrition are key. ^{11 19 20} X-rays may be done first, but an MRI is often more sensitive for early stress injuries and helps grade severity and estimate recovery time. ^{11 12 13}

Most of the time, diagnosis combines your story, the exam, and selected tests. The goal is to quickly pick up serious conditions like acute limb ischaemia (sudden, severe reduction in blood flow to a limb), deep vein thrombosis, or acute compartment syndrome (high pressure inside the leg that blocks blood flow and can damage nerves and muscles), while guiding sensible care for common musculoskeletal and nerve-related problems. ^{1 2 4 5}

Clinical insight

High quality evidence shows that walking programs that use repeated short bouts to a moderate level of leg discomfort, several times a week over about twelve weeks, can significantly improve walking distance and daily function.^{2 15 16}

What are the treatment options for leg pain?

Treatment for leg pain depends on the cause. Some conditions, such as acute limb ischaemia, deep vein thrombosis, or acute compartment syndrome, need urgent medical or surgical care.^{1 2 5 8} Many other causes, such as bone stress injuries, shin pain, and nerve related leg pain, often improve with movement, exercise, and lifestyle changes. ^{4 11 19 20} The main aim is to protect your overall health, lower risk, and help you return safely to the activities that matter to you.

• Education and activity changes.
• Exercise based rehabilitation
• Medications and medical therapy
• Injections and procedures

Sword's approach

Sword Health helps people manage pain and movement issues with expert-guided AI care you can use from home. Our model combines clinical support with modern technology, designed to work around your life.

Sword makes recovery easier and more accessible. You get high-quality care at home, guided by clinicians and supported by smart technology.

• Care that adapts to your progress in real time
• Licensed experts guiding every step
• Simple, non-invasive, evidence-based programs
• Proven results for pain relief, movement, and satisfaction

How can I find pain relief for leg pain?

What you can safely try at home depends on the cause of your leg pain, so it is important to seek medical advice if you have warning signs or are unsure. In general, once serious causes are ruled out, many people can start with gentle, regular movement rather than strict rest. ^{2 4 11} Short walks on level ground, light cycling, or pool based exercise can keep your joints and muscles working without overloading them. ^{4 11 16}

For bone stress injuries and shin pain, it often helps to switch to non impact activities for a time, such as cycling or deep water running, while you work on calf and hip strengthening and foot control. ^{11 19 20} As symptoms improve, you can follow a phased return to running program that increases distance and intensity slowly. ^{11 19 20}

For sciatica and other nerve related leg pain, simple strategies like changing positions often, breaking up long periods of sitting or standing, and using short walks across the day can reduce stiffness and worry.⁴ Many people benefit from basic trunk and hip exercises, gentle nerve gliding, and paced activity, ideally with support from a clinician who can coach you through flare ups and setbacks.⁴

If you have artery related leg pain from peripheral artery disease, walking to the point of moderate, tolerable leg discomfort, resting, and repeating under guidance is a key treatment, not a sign you are doing harm. ^{2 15 16} Your clinician can help you find a safe starting point and watch for signs of more serious disease. ^{2 3 16}

Simple pain relief such as paracetamol or topical anti-inflammatory gels may help some people, but any medicine plan should fit your other health conditions and be reviewed regularly. ^{1 2 4} Lifestyle steps like not smoking, managing blood pressure, cholesterol, and blood sugar, staying hydrated, and supporting healthy nutrition and energy intake also play a big role in long term leg health. ^{2 8 15 19 20}

You should seek urgent help if symptoms suggest a clot, severe circulation problem, acute compartment syndrome, or infection. ^{1 2 5 8} If leg pain has lasted more than two to four weeks, limits your walking distance, or stops you from important daily activities, it is also a good time to see a doctor or physical therapist for a tailored plan.^{1 2 4 11}