9 Causes of Bone Pain in Legs

Bone pain, achiness or tenderness is fairly common, although less so than joint or muscle pain. It typically occurs more frequently in those who are middle-aged or older. This is usually due to lower activity levels and reduced bone density, which increases the risk of overuse and bone fractures.

Bone pain – including bone pain in legs – can, however, be a sign of a more serious underlying medical condition. These causes are often less obvious and it is important to seek out a doctor’s diagnosis to understand more about your symptoms.

Causes of Bone Pain in Legs

Bone pain is often described as a deep or penetrating pain. Below are a number of potential causes if your leg bones hurt.

Shin Splints

Inflammation of the muscle, tendons and thin layer tissue covering the shin bones is referred to as shin splints. This presents as pain and tenderness running along or just behind the tibia (large bone in the lower leg) and happens most often after intense exercise, sports or other repetitive activity.

Bone Bruise

Another reason your leg bones hurt may be a bone bruise. Also known as a bone contusion, this occurs when a traumatic injury to a bone, such as the exposed shin bone, causes micro-fractures. Damage to blood vessels and fluid build-up can cause skin discoloration as in normal bruising, although the injury runs deeper than the surface. Bone bruises usually appear within 48 hours of injury and can take as long as six months to heal.

Traumatic Injury

Breaks and fractures in the leg bones as a result of injury can lead to severe pain and discomfort that needs urgent medical attention.

Osteoporosis

This degenerative disease causes bone density to gradually reduce. Osteoporosis leads to weaker bones that can result in bone pain in legs and increase the risk of both regular and compression fractures.

Arthritis

Different types of arthritis cause degenerative joint changes that can cause inflammation and make leg bones hurt. Osteoarthritis is asymmetrical, so symptoms may appear only on the one side, whereas rheumatoid arthritis is a symmetrical disease and is likely to affect both legs.

Paget’s Disease

This bone disease disrupts the normal cycle of bone renewal, resulting in bones that become weakened and even deformed over time. It is rare in individuals under the age of 50.

Cancer

Pain brought on by bone cancer usually starts with tenderness in the affected bone, progressing to a persistent or fluctuating ache. The most common form of bone cancer is called osteosarcoma and it commonly starts in the long bones – the legs or arms.

Osteomyelitis

Osteomyelitis is an infection that typically causes pain in the long bones of the legs. Other bones such as those in the arms or back may also be infected.

Osteomalacia

This condition causes bones to become soft and weak, putting them at a higher risk of bending and breaking. Vitamin D deficiency is the most common cause, and the most typical symptom is bone pain in legs, groin, upper thighs and knees. Pain may also sometimes be felt in the feet when standing, walking or running; sitting or lying down may ease symptoms.

More Bone Pain in Legs at Night?

Often times, bone pain in legs feels more intense in the evenings. This can be due to:

Daytime activity: Busy and active daily lifestyles can distract from pain, causing bone pain in legs to be more noticeable in the evenings when movement reduces.

Hormonal changes: Hormone levels fluctuate during the day and night and can influence pain perception, causing you to notice more bone pain in legs at night.

Limited blood flow: Increased blood flow correlates with relaxed, flexible muscles and less stiffness. Blood flow to the legs decreases when lying down, which can therefore result in more pain being felt.

Infection: Healing processes in the body take place when we sleep. As the body addresses infection, inflammation levels may rise, leading to increased bone pain in legs.

Tumour: Tumours press down on surrounding structures and may therefore apply more pressure when lying down, resulting in more bone pain in legs at night. Poor nutrition and a deficiency in nutrients like calcium, vitamin D and phosphorus may contribute to bone disorders mentioned above and their resulting bone pain in legs. If your leg bones hurt and the pain worsens over time, is accompanied by intense swelling and inflammation, or continues as a constant dull throbbing, you should consult a doctor immediately.