What causes pain in the abdomen and legs?

September 26, 2025 •

4 min read

According to studies on referred pain, discomfort can travel far from its source, making a diagnosis difficult. If you're experiencing pain in the abdomen and legs, this can be caused by a variety of conditions, ranging from musculoskeletal issues to more complex systemic diseases, and requires careful evaluation.

Quick Summary

Pain simultaneously affecting the abdomen and legs can result from diverse issues, including nerve compression, muscle strain, vascular problems, and internal organ conditions that radiate discomfort. Understanding associated symptoms is key to finding the root cause.

Key Points

Referred Pain: The coexistence of abdominal and leg pain often involves referred pain, where the actual source of the problem is elsewhere, like the spine, organs, or blood vessels.
Musculoskeletal vs. Vascular: Common causes include nerve issues like sciatica and muscle strains, as well as circulatory problems like Peripheral Artery Disease (PAD) or Deep Vein Thrombosis (DVT).
Internal Organ Issues: Conditions affecting abdominal organs, such as kidney stones or gynecological problems like ovarian cysts, can trigger pain that radiates to the legs.
Chronic Conditions: Systemic inflammatory diseases and disorders like fibromyalgia can cause widespread pain that affects both the abdomen and legs over the long term.
When to Worry: Seek immediate medical attention for sudden, severe, or worsening pain, especially if accompanied by fever, swelling, or dizziness, as these could signal a medical emergency.
Diagnosis is Key: Due to the wide variety of causes, a professional medical diagnosis is essential to identify the root of the pain and receive appropriate treatment.

Understanding the Connection Between Abdominal and Leg Pain

Experiencing pain in two seemingly unrelated areas, such as the abdomen and legs, can be unsettling. This discomfort is often a result of 'referred pain,' where the brain interprets pain signals from internal organs or compressed nerves as originating from a different, sometimes distant, part of the body. Pinpointing the exact cause requires a careful look at the nature of the pain, its location, and any accompanying symptoms.

Common Musculoskeletal and Nerve-Related Causes

Many instances of co-occurring abdominal and leg pain stem from problems in the back, nerves, or muscles that connect these regions.

Sciatica: Sciatica occurs when the sciatic nerve, which runs from the lower back through the hips and down each leg, is compressed or irritated. While primarily known for causing leg pain, severe cases can also present with lower abdominal discomfort due to nerve inflammation near the spine.
Hernias: An inguinal or femoral hernia occurs when tissue, such as part of the intestine, protrudes through a weak spot in the abdominal muscles. This can create a bulge and cause localized groin pain that can radiate down the leg. The pain often worsens with straining, lifting, or coughing.
Psoas Muscle Strain: The psoas muscle is a deep muscle that connects the lumbar spine to the femur. A strain or abscess in this muscle can cause significant lower back and abdominal pain. Due to its connection to the leg, the pain can also travel down the thigh.
Pinched Nerves: Nerves exiting the lumbar and sacral spine supply both the abdominal wall and the legs. If one of these nerves becomes pinched or entrapped by a disc herniation or spinal stenosis, it can cause radiating pain, numbness, or weakness in both areas.

Vascular Conditions

Problems with blood circulation can cause pain in the legs and, in severe cases, affect the abdomen.

Peripheral Artery Disease (PAD): PAD is a circulatory condition where narrowed arteries reduce blood flow to the limbs. The most common symptom is leg pain when walking (claudication), but blockages in arteries that supply the intestines can also cause abdominal pain after eating. In advanced cases, the symptoms can coexist.
Deep Vein Thrombosis (DVT): A DVT is a blood clot in a deep vein, most often in the leg. Symptoms typically include swelling, pain, warmth, and redness in the affected leg. If the clot travels to the lungs, it can cause a pulmonary embolism, a life-threatening condition that can sometimes present with severe abdominal or chest pain.
Abdominal Aortic Aneurysm (AAA): This involves a weakened and bulging area in the large artery that supplies blood to the body. A rupturing AAA is a medical emergency characterized by sudden, severe abdominal and back pain that may radiate to the legs.

Abdominal Organ-Related Issues

Certain internal organ problems can cause referred pain that is felt in the legs.

Kidney Stones: The pain from a kidney stone moving through the urinary tract is notorious for being intense and can shift as the stone moves. The pain often starts in the flank or back and can radiate down to the groin and inner thigh.
Gynecological Issues: Conditions such as ovarian cysts, endometriosis, or uterine fibroids can cause pelvic and lower abdominal pain. This pain can sometimes be referred to the legs, particularly the thighs, often worsening during menstruation.
Gastrointestinal Problems: Severe constipation or an intestinal obstruction can cause intense abdominal cramps. The pressure and discomfort may occasionally radiate downwards, causing a heavy or aching sensation in the legs.

Chronic and Systemic Conditions

Some long-term conditions can lead to pain in both regions.

Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease and ulcerative colitis can cause severe abdominal cramping, but the chronic inflammation can also lead to joint pain and arthritis in the hips and legs.
Connective Tissue Disorders: Diseases like lupus or vasculitis can cause widespread inflammation, affecting blood vessels and joints. This can cause abdominal pain, often related to inflammation of organs, and concurrent joint and muscle pain in the legs.
Chronic Fatigue Syndrome/Fibromyalgia: These systemic conditions cause widespread, chronic pain, which can certainly manifest in both the abdomen and legs. Symptoms are often accompanied by fatigue, sleep problems, and cognitive difficulties.

Comparison of Potential Causes


Feature	Sciatica	Inguinal Hernia	Peripheral Artery Disease (PAD)
Typical Pain Location	Lower back radiating down one leg	Lower abdomen/groin, often radiating down inner thigh	Leg cramps, especially with exertion (claudication)
Other Symptoms	Numbness, tingling, or weakness in the leg	Visible bulge, sensation of fullness or pressure	Cold limbs, sores that don't heal, weakened pulses
Primary Cause	Nerve compression or irritation in the lumbar spine	Protrusion of tissue through the abdominal wall	Narrowed arteries due to atherosclerosis

When to Seek Medical Attention

While some causes are minor, others can be serious. It is crucial to seek prompt medical advice if you experience pain in your abdomen and legs, especially if you notice any of the following warning signs.

Warning Signs that Indicate a Medical Emergency

Sudden, severe, or worsening pain.
High fever, persistent vomiting, or loss of appetite.
Swelling, redness, or warmth in one leg (potential DVT).
Dizziness, fainting, or rapid heartbeat.
Difficulty breathing.

If you are experiencing any of these symptoms, do not delay seeking professional medical help. For a thorough review of cardiovascular conditions, you can consult the American Heart Association.

Conclusion

Pain that strikes both the abdomen and legs is a complex symptom with a wide range of potential causes. From straightforward issues like muscle strain to more critical conditions affecting nerves, blood vessels, or internal organs, accurate diagnosis is the first step toward effective treatment. Never ignore persistent or severe pain; consulting a healthcare professional is always the safest course of action to determine the underlying cause and get the proper care.

Frequently Asked Questions

Referred pain is when your brain misinterprets pain signals from an affected organ or nerve and projects the sensation to a different part of the body. For example, a pinched nerve in the lower back (near the abdomen) can cause pain to be felt primarily in the legs.

Yes, a severe strain in a core muscle, such as the psoas muscle, can cause pain in the abdominal area and radiate down the leg because of the muscle's extensive connections.

Serious causes include a ruptured abdominal aortic aneurysm (AAA), a deep vein thrombosis (DVT) that leads to a pulmonary embolism, or advanced internal organ disease. These require immediate medical attention.

Sciatica often presents as shooting or radiating pain from the lower back down one leg, accompanied by numbness or tingling. Abdominal pain is less common but possible. It's best to consult a doctor for a proper diagnosis.

In some cases, yes. Severe abdominal cramping or pressure from conditions like constipation or an intestinal blockage can create enough referred pain to be felt as a dull ache or heaviness in the legs.

A primary care physician is a good starting point. They can conduct an initial evaluation and refer you to a specialist, such as a gastroenterologist, vascular surgeon, or orthopedic specialist, depending on their findings.

Yes, gynecological issues like endometriosis or ovarian cysts can cause pelvic and abdominal pain that may be referred to the legs, particularly the inner thighs, often coinciding with a woman's menstrual cycle.