Lower Leg Pain

Usual Suspects:

  1. The muscles of the lower leg
  2. The muscles of the thigh and upper buttock

The Imbue Pain Relief Patch temporarily relieves minor aches and pains of muscles and joints. In the diagrams below, the X’s show the locations of common trigger points (localized muscle strain), and the colored shading shows the pain pattern each trigger point produces. This pain is often several inches (or more) away from the trigger point at which it originates. When a trigger point is to blame for your pain, applying the Imbue Pain Relief Patch at the site of the trigger point sometimes yields better results than applying it where you typically feel the pain.

If you experience pain at the back of the lower leg, see also the Calf Pain section.

Pain in the lower leg is usually caused by muscles in the local area, although the source could potentially be the muscles of the thigh or buttock. Following is a discussion of each of the relevant muscles. You don’t need to learn their names, just look at the diagrams to get a general sense of where their trigger points occur (shown as X’s) and the usual pain pattern each one produces (shown as colored shading). The text provides additional details of how to find these muscles and what they do. Rather than hunting on your body for the particular places where X’s are shown on the diagrams, just use the diagrams as broad guidelines, and feel the whole region with firm pressure. If you find an especially painful spot, do some massage and apply the Imbue Pain Relief Patch here.

Lower Leg Pain Due to the Muscles of the Lower Leg

There are three main muscles in the lower leg that are often implicated in pain here. They are tibialis anterior at the front, gastrocnemius at the back, and the peroneus (actually three muscles) at the side.

Tibialis Anterior:

This is the most prominent muscle of the front of the lower leg, to the outside of the shin bone. You can feel it contact when you raise your toes toward your head. Trigger points in tibialis anterior occur just to the side of the sharp crest of the shin. These points may produce a tight, achy sort of pain down the front of the leg, and also pain at the front of the ankle and the big toe. When feeling for trigger points in this muscle, start right below the knee, against the shin bone, and gradually work downward almost to the ankle. Then move slightly more outward and repeat this process.

Extensor Digitorum Longus:

This muscle runs down the front of the lower leg beneath tibialis anterior and helps raise the toes. It primarily causes pain (sometimes with a numb quality) on the top of the foot and the central three toes, but it may also produce discomfort at the lower portion of the front of the lower leg. Compared to the trigger points of tibialis anterior (above), these trigger points will be a bit more toward the side of the leg. (They usually occur about midway between the front and side surfaces of the leg.) You won’t be able to feel this muscle directly, but if you press firmly, trigger points here will feel painful and may refer pain to the lower shin and foot.

Gastrocnemius:

The gastrocnemius gives the characteristic bulge to the upper portion of the calf. This trigger point primarily causes pain in the calf and the arch of the foot, but its pain pattern may also spread over the inside of the lower leg and the inner ankle. It is usually found slightly to the inside of the calf, rather than at the very back. Press firmly, working several inches in all directions.

The Peroneus Muscles:

This is a group of three muscles at the outside of the lower leg: peroneus longus (top black X), peroneus brevis (lower black X), and peroneus tertius (white X’s). Trigger points in the peroneus muscles are especially common in pain at the outer ankle, but they may also be involved in pain of the side of the lower leg. Trigger points at the two black X’s both produce the pain indicated by the red shading around the ankle. The upper of these may also produce pain (or numbness) shown by the red shading just below it. Trigger points at the white X’s produce the pain pattern indicated by the blue shading. These trigger points are all directly on top of or against the fibula, the thin bone that runs down the outside of the lower leg. The upper end of this bone is often visible as a knobby protrusion just below the outer knee. The lower end of the fibula forms the outer ankle bone.

Lower Leg Pain Due to the Muscles of the Thigh and Buttock

There are two thigh muscles – vastus lateralis along the outside and adductor longus along the inside – and one buttock muscle – gluteus minimus – that may be involved in pain of the lower leg. Let’s examine them.

Adductor Longus:

This muscle runs from the bottom of the pelvis to the upper, rear surface of the thigh bone. As seen by the red shading, this muscle may cause pain from the groin the whole way down to the lower leg and inner ankle. If you sit with your ankle crossed over your knee, and imagine a line that divides the inside surface of your thigh in half lengthwise (see dotted line in lower diagram), you will feel adductor longus near the upper end of this line (that is, near the groin). If you raise your knee slightly toward your face while feeling your inner thigh, this muscle will stand out. Feel thoroughly in this region. If you find any points that are significantly tender, do some gentle massage here. If these points are several inches away from the groin and your skin in this area is not too sensitive, you can use the Imbue Pain Relief Patch here. If you are concerned about removal, you can try applying a thin layer of lotion or oil to the skin before putting the patch on. If irritation occurs, remove the patch promptly by soaking it in warm water.

Vastus Lateralis:

This is a large muscle that runs from the side of the pelvis down to the outside of the knee. While most of its pain pattern occurs along the side of the thigh (see colored shading in the diagram), it occasionally sends pain down to the outside of the lower leg. This is most likely to come from trigger points at the yellow X’s just above the side of the knee in the rightmost diagram. These produce pain that may run down the side of the lower leg. However, tension higher up in the muscle (seen in the other diagram) may also contribute to lower leg pain and may prevent the release of the lower trigger points, so it is important to examine this area, too, and use the Imbue Pain Relief Patch here if there are painful spots.

Gluteus Minimus:

This is the smallest of the three main buttock muscles, though its trigger points have the largest area of referred pain. There are two sets of trigger points in gluteus minimus. The inner ones, shown as blue X’s, are just below the crest of the pelvis (iliac crest) and the pain they produce in the lower leg is primarily in the back. The outer trigger points, shown as red X’s, are almost at the side of the hip, just above the hip socket and just below the iliac crest. These can produce pain and/or numbness all the way down the thigh and along the entire lower leg.

In order to examine this area, you’ll need the help of a friend who can press firmly here, or you can use a Thera Cane or a ball (tennis or lacrosse) to do it yourself. If using a ball, lie on the floor and place the ball in the region where the X’s are on the diagram. Then slowly roll around to press on the whole area, making note of any especially painful spots. You can also do this by placing the ball between your buttock and a wall (see diagram). When you find painful spots, do some massage and place the Imbue Pain Relief Patch here.

For Pain With a Numb Quality in the Lower Leg, Also Consider the Piriformis:

The piriformis is a muscular band that runs from the edge of the sacrum (the triangular bone at the base of the spine) outward to the top of the thigh bone (the greater trochanter of the femur). Active trigger points in this muscle usually produce pain in the hip, buttock, and back of the thigh (see red shading in the diagram). Also, by squeezing the sciatic nerve, it can cause intense nervy/numb pain all the way down the leg. The two primary trigger point regions of the piriformis are just against the outside edge of the sacrum (see inner X in diagram) and just inside the back of the hip joint (outer X), though it is worth examining the whole area inside the box. If you find a painful spot here that produces (or alleviates) the pain in the back of your thigh, do some massage and place the Imbue Pain Relief Patch here.

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