Question: I am a 35-year-old woman. I have been experiencing tightness in the calf muscles of my right leg and at the back of the thigh of the same leg for two months. Most of the time, the tightness comes with pain. I do not do any strenuous exercises. Should I be worried?
Answer: Your symptoms may be due to problems with the hamstring or calf muscles themselves, such as excessive tightness or fatigue. Muscle fatigue or tightness is usually due to overuse, either from excessive activity or poor choice of footwear. For women, wearing excessively high-heeled shoes increases tension and stress in the calves and hamstrings. Your symptoms could also be due to pressure and irritation of the nerves in your leg.
These include the sciatic nerve, which begins at the base of the spine and extends down the leg; and the peroneal nerve, a branch of the sciatic nerve that supplies movement and sensation to the lower leg, foot and toes. Such irritation usually occurs in the lumbar spine – the lower back – and may be due to pressure from a degenerative intervertebral disc or joints.
An intervertebral disc is a disc of spongy material between every two vertebrae, or bones, of the spine. It is important to identify the primary cause so that the correct treatment is prescribed. A clue that suggests that the problem lies with the hamstring or calf muscles themselves is when the symptoms worsen with activities such as climbing the stairs or squatting and go away rapidly after the activities are stopped. If the symptoms persist at rest, when sleeping or with prolonged sitting or standing, the possibility of neurological irritation or compression is higher. In this case, you may also experience pain radiating down the leg, numbness or weakness.
A physical examination will help to identify the source of your symptoms and imaging such as a magnetic resonance imaging (MRI) scan may be required to visualise the intervertebral discs and canals. Besides symptom relief, treatment is also aimed at improving local muscle control, flexibility and strength, reducing excessive tension in the nerves and addressing any spinal problems.
Answered by: DR ROGER TIAN,
Associate consultant sports physician at the Singapore Sports Medicine Centre and Changi Sports Medicine Centre