The most common cause of chronic calf pain is a muscle injury, which can cause inflammation, strains, or tears in any of the three main calf muscles. An injury to those muscles can in turn cause other injuries, causing chronic calf pain that can recur multiple times. Tendinitis, or swelling of a tendon, is another common cause of chronic calf pain, as are common cramps during physical activity. More serious causes of chronic calf pain can include cysts in or around the calf muscles and blood clots, which is a condition that will require medical attention.
A calf strain occurs when too much force is applied to the calf muscles. The muscles are not prepared to handle the load and may contract beyond their normal capabilities. A muscle strain causes a dull ache, pain, tenderness, and general weakness in the calf area. It is usually treated with the RICE system: rest, ice, compression, elevation, as well as light stretching and exercise after several days of rest. Medical attention is generally not necessary for the treatment of a calf strain, although some more serious strains may require physical therapy. A more serious muscle tear will require much more rest and attention as the muscle rejoins. In some severe cases, the muscle may need surgical repair.
Chronic calf pain can also be due to muscle cramps or overuse. Runners will often get chronic calf pain after too much running, especially if the runner's shoes are old, worn, or not supportive enough. Corrective footwear or new running shoes can solve the problem, as can getting enough rest between running activities. Cramps can be caused by dehydration or overuse of the muscles, as well as lactic acid buildup in the muscles, and a runner or other athlete should make sure to drink plenty of fluids before, during, and after exercise.
More serious conditions that can cause chronic calf pain include cysts and blood clots. If the pain is not the result of an injury or persistent exercise, the cause may be a blood clot. The clot restricts blood flow through the calf, and swelling and pain usually accompany the presence of a clot. If pain persists after surgery, the start of a medication regimen, or other unusual practice, a doctor should be consulted immediately. If the pain is behind the knee, a Baker's cyst may be the culprit; This cyst is caused by fluid buildup above the calf muscles. The fluid will need to be drained to relieve the pain.