Leg pain is often a symptom of serious illnesses that need to be treated at the initial stages of development, so do not ignore your legs if they feel uncomfortable sensations or pain every night.
The usual fatigue that accumulates in the legs in the evening, and passes without a trace in the morning, we will not consider. We focus on the more serious problems.
Endarteritis - inflammation of the inner membranes of arteries
Symptoms After the first 50 - 100 steps there is acute pain and numbness in the legs. If you rest, the symptoms disappear, but after resuming walking, after 20 to 30 steps, they return. Pain in the foot and calf can be even if the person is lying, but if the leg is lowered down, the pain goes away.
What to do. Stop smoking (nicotine contributes to vascular ischemia) and consult a vascular surgeon. It will be necessary to do a comprehensive examination: MRI, angiography, ultrasound of blood vessels, a blood test. With severe sudden pain - call an ambulance, this may be a sign of a blockage in a large artery. The disease is treated with conservative and surgical methods.
Symptoms Pain and cramps in the calf muscles, which intensify when walking, running, climbing stairs and can bother even at night. The feet are cold in both winter and summer. Lack of clear pulsation on the big toe. In men - the disappearance of hair on the toes and problems with potency.
What to do. Stop smoking and be sure to visit a vascular surgeon. Pass the appropriate diagnostics. Timely treatment will save you from gangrene and amputation.
Symptoms Acute "twisting" pain in the joints during walking or a long standing position. The joints are deformed. The pain intensifies when the weather changes, painful swelling and redness in the joints are observed.
What to do. Visit a rheumatologist as soon as possible, take an x-ray of the joints and take a general clinical blood test. The treatment is only complex - taking the appropriate medications, physiotherapy, diet, physiotherapy, massage.
Symptoms Constantly throbbing pain, often turning into a burning sensation in the calf muscles. Redness and swelling, painful compaction along the veins.
What to do. Go to a vascular surgeon immediately. Make angioscanning to assess the condition of the veins throughout the continuation, to determine the degree of their slagging, to identify the threat of a blood clot. Take a blood test for non-specific factors of inflammation. Most patients can be treated on an outpatient basis under the supervision of a physician.
The consequences of fractures
Symptoms Aching pain when walking at the fracture site.
What to do. Strengthen the corresponding muscles with special exercises, due to which the bone tissue will become denser, and the load on the bones will be reduced during daily activities. Wear special orthopedic appliances - orthoses. They do not interfere with the movement of the extremities, maintain muscle tone, but at the same time take on part of the load.
Symptoms Sudden sudden pain in the heel, usually while walking or running.
What to do. This is just the case when time is one of the best healers. It is useful to lose weight - reduce the load on the feet. Take an X-ray to make sure heel spur is diagnosed. For treatment, anti-inflammatory drugs, special massage, laser therapy, orthopedic insoles and heel tabs are used.
Symptoms Cramps occur in the legs (especially at night), swelling, weakness and pain, the skin on the legs becomes dry, peeling and itching appear. Often the legs are "numb" in them there is a feeling of creeping creeps, tingling.
What to do. Donate blood for analysis and continue to act on the basis of the result of the analysis.
Symptoms Leg cramps and severe calf pain are a clear sign of calcium deficiency. The problem is more typical for women after 40 years.
What to do. Make a study measuring bone density and appropriate blood tests. If calcium deficiency is detected, the doctor will prescribe the appropriate diet and special medications.
Symptoms. The pain in the muscles of the hips is twitching, pulling, or cutting. It can increase with physical overload, especially in wet or cold weather.
What to do. Seem to a neurologist. For treatment, anti-inflammatory drugs are used, as well as analgesic ointments and gels.
Symptoms A sharp throbbing pain in the big toe, regardless of the load. The finger swells to become red, hot and sensitive.
What to do. A diagnosis by a rheumatologist and a blood test from a vein are sufficient for diagnosis. Gout is treated with non-steroidal anti-inflammatory drugs and drugs that inhibit the formation of uric acid. At the initial stage of the disease and for prevention, it is necessary to limit the use of: alcohol, meat and fish dishes, rich broths, appetizers, seasonings, mushrooms, legumes, tomatoes, spinach, coffee, cocoa, chocolate.
Symptoms Drawing unpleasant pain in the legs, intensifying towards the end of the day. Legs "buzz" so that you want to lie down and throw them higher.
What to do. Wear compression hosiery - it relieves pain and inhibits the development of the disease for a while. Be sure to go to a vascular surgeon for alarming symptoms and do an ultrasound scan of the veins. Further treatment will be prescribed by a doctor. In the early stages, the disease can be successfully treated conservatively: by the injection method of sclerotherapy, special exercises.
Symptoms Sharp pain in the legs, aggravated by an increase in load and sudden movements. Rest in a lying position does not provide tangible relief. Pain usually spreads along the back and side of the leg from the heel to the buttocks.
What to do. Contact a neurologist or vertebrologist. If a hernia of the intervertebral disc has formed, it can be detected by MRI. After analyzing the data and observation, the doctor will choose whether to treat the patient with a conservative or surgical method.
Symptoms Aching pain in the feet and legs, which increases in the evening. Fatigue when walking.
What to do. Do not start the disease, but consult an orthopedist. If possible, do not wear high-heeled shoes with a narrow toe. Perform special exercises in the evenings for feet and wear arch support.
Additional articles with useful information
The joints on the legs experience a constant load, which under adverse external conditions can lead to painful sensations. Comprehensive measures should be used to restore joints and it is very good if mineral water is included in this set of measures. Read more.
Often the legs bother the person due to pain in the muscles and joints. The reasons for this condition may be different, but with most of them it is possible to improve well-being with massage or self-massage of the feet. Read more.
Non-disease causes of leg pain
Pain in the lower extremities (if it is short-term and irregular) can be associated not only with the disease, but also with prolonged physical exertion, overwork, and most often occur in the calf muscle. The leg muscles begin to experience oxygen starvation, decomposition products, in particular lactic acid, cease to be excreted from them. The result of this is pain in the muscles of the legs. To eliminate them, it is recommended to relax the muscles. To do this, it is enough to lie down or sit down, thereby changing the position of the limb, and rub the muscles tightly with your hands.
Dull, aching and stitching pains in the calf muscles, cramps often occur after prolonged standing or sitting work. When, due to prolonged stagnation in the veins of the lower extremities, normal blood circulation of the venous and arterial does not occur, oxygen starvation occurs.
Diseases accompanied by pain in the lower extremities.
Quite often, pain in the legs is a manifestation of diseases of the arteries or veins of the lower extremities, but often they are caused by diseases of the spine, nervous system and metabolism. Pain can occur with diseases of bones and joints, muscles and tendons, lymph nodes and blood vessels.
Consider the possible causes of pain in the lower extremities.
1. Leg pain in injury
Leg bruises - The most frequent damage to the lower extremities. They can be both independent, and in combination with other injuries (contusion of internal organs, dislocation of joints, etc.). With a bruise, the patient notes a connection between trauma and the occurrence of pain. At the site of the bruise there is a swelling and a hematoma (bruise). Impairment of limb function depends on the localization of the contusion, its intensity and the volume of the damaged area.
Fractures of the bones of the lower extremities - This is a violation of the integrity of the bone, and sometimes the joint. Not all bone fractures are caused by injuries. So, for example, people suffering from osteoporosis, the bones are so fragile that fractures can occur with minimal load. Depending on the severity of the fracture (open or closed, with or without displacement), pain in the leg muscles will have different intensities. Two groups of signs of a fracture of the lower extremities are distinguished. Probable: pain, aggravated by any movement, edema and swelling in the injured area, limitation of movements in the leg, the occurrence of subcutaneous hemorrhage. Reliable: unnatural position of the limb, pathological leg mobility in places where there are no joints, crepitus (crunching) of rubbing bone fragments, visually detectable fragments in open fractures (in these cases, bleeding and traumatic shock are added). In addition, with a trauma to the neurovascular bundle, there will be signs of a violation of the blood supply to the lower leg and foot, and neurological disorders.
Stretching the muscles of the lower limb can occur when jogging, walking fast, practicing any active sport, and sometimes even when wearing poorly selected shoes. The first pain usually occurs immediately, or within a day after unusually intense muscle loads. The muscles look swollen, tense and heavy. Patients complain of pain, sometimes quite pronounced, that occurs when feeling muscles. In some cases, edema of muscle tissue joins it, which is manifested by a significant increase in the size of the affected area. Pain and soreness during palpation persist for several days, and sometimes weeks. Pain sensations intensify with movements, especially with flexion of the knee and ankle joint.
Muscle breaks. Typically, such damage is localized in a small area of the muscle, in the area of its connection with the tendon. However, in some cases, the occurrence of quite large gaps, sometimes even accompanied by a complete separation of the muscle from the tendon. As a rule, such damage occurs when sharp limbs are bent in the direction opposite to the acting force. An example is the moment of a sharp start or, conversely, a sudden stop during a run. Muscle rupture is always accompanied by sudden severe pain in the lower limb. The pain syndrome may subside for a while, but then it always returns, the pain becomes constant and intensifies as the hematoma builds up and muscle spasm develops. When feeling an injured limb, local pain is noted. Sometimes by touch, swelling caused by extensive hemorrhage can be determined. When a complete rupture occurs (that is, a muscle is torn off in the area of its attachment to the tendon), one even finds the gap that occurs between the ligament and muscle. Such injuries are always accompanied by severe edema in the area of the damaged muscle and a significant decrease in range of motion.
Prolonged crushing syndrome (SDR, crash syndrome) of soft tissues - this kind of pathological condition develops as a result of prolonged (4-8 hours or more) crushing of soft tissues of the extremities with fragments of destroyed buildings, structures, blocks of soil during collapses in mines, etc. Crash syndrome occurs in emergency situations (earthquake, collapse of buildings, etc.).
A variation of SDR is positional compression syndrome (ATP) of soft tissues, complicating the course of acute exogenous poisoning or other critical conditions, accompanied by the development of coma. Positional syndrome develops as a result of prolonged compression of the soft tissues of the limbs and trunk by the weight of one's own body. The most common causes of its development are poisoning with alcohol and its surrogates, drugs of narcotic and sleeping pills, poisoning with carbon monoxide or exhaust gases. The victim complains of pain and inability to make movements with a damaged limb, weakness, nausea, thirst. He is pale, sluggishly reacting to the environment. A damaged limb swells quickly, its volume increases, tissues acquire a woody density due to muscle edema. Hemorrhages, abrasions, and blisters filled with gray or bloody fluid are visible on the skin in the crushing zone. Joint movements are impossible due to pain caused by damage to muscles and nerve trunks. Sensitivity in the area of damage and below located tissues is lost. The pulsation of blood vessels in this area is weakened or not at all determined due to increasing edema. Blood pressure decreases.
Aching pain in the muscles of the legs with spontaneous hematomas. Sometimes patients who receive anticoagulant treatment may notice the appearance of sudden hemorrhages in the muscles of their lower extremities. Such a pathology is characterized by aching pain and an increase in the size of the affected area. Similar hematomas form without regard to previous injuries, or as a result of very minor injuries.
2. Pain in the muscles of the legs with pathologies of the vessels of the lower extremities.
Chronic arterial insufficiency of the lower extremities accompanied by a characteristic pain syndrome that occurs when walking a limited distance (up to 500 m). In some cases, the distance of painless walking is only tens of meters. The arising pain associated with the accumulation in the muscle tissue of under-oxidized metabolic products (lactates, pyruvates, etc.) forces the patient to stop, wait for the disappearance of pain, and only then continue to move. This symptom is called "intermittent claudication" and its identification requires only a careful examination of the patient. In some cases, ischemic pain in the lower extremities occurs at night, forcing the patient to hang his legs down. The diagnosis can be clarified by measuring the ankle-brachial index (see examination). A decrease in this indicator to 0.8 and below is characteristic of chronic arterial insufficiency. Chronic arterial insufficiency with a short distance of painless walking or pain at rest serves as an indication for hospitalization of the patient in the vascular surgical department for angiographic examination and surgical treatment.
Chronic vein disease (CVD, varicose veins) arises as a result of insufficiency of the valve apparatus of the superficial venous system. Pain with HZV is localized in the final parts of the legs, is bursting in nature and is often combined with other symptoms, such as a feeling of heat, chills and tingling. The pain appears at the end of the day, after prolonged static exertion both in a standing position and sitting. They provoke venous pain by heating (underfloor heating, a hot bath, a bath, a sauna, a hot season, etc.), a change in the hormonal background (the pain intensifies in the second phase of the menstrual cycle, as well as when using hormonal contraceptives, including intravaginal ones). A unique feature of venous pain is its reduction or disappearance as a result of active movements in the ankle joint, as well as after raising the limb above the horizontal. Varicose veins develop rather slowly - over the years, and sometimes decades. Its progress is facilitated by: prolonged static loads on the lower limbs when standing upright, a sedentary lifestyle, overweight, prolonged sitting (for example, during frequent long trips or flights), the use of hormonal contraceptives or hormone replacement therapy, pregnancy. It must be remembered that the most famous symptoms of varicose veins in the form of protrusion of venous nodes and spider veins are not the first signs of the disease. The onset of pathology in most cases is not manifested by visible skin changes. The first symptoms most often are pain, heaviness, tension in the muscles of the legs, fatigue and swelling. If such complaints occur, it is best to immediately contact a phlebologist.The detailed clinical picture of varicose veins of the lower extremities includes: swollen, nodular, protruding veins above the surface of the skin and dilated veins through it, intense pain in the muscles of the legs, inflammation of the skin over the veins, thrombophlebitis, the appearance of poorly healing ulcers and bleeding.
Thrombophlebitis - acute inflammation of the walls of the vein with the formation of a blood clot in its lumen. Symptoms depend on the location of thrombosis. There are thrombophlebitis of superficial (mainly varicose) veins and deep vein thrombophlebitis of the lower extremities. Acute thrombophlebitis of the superficial veins of the lower extremities develops, as a rule, in a varicose vein. Most often, a large saphenous vein is affected. In the course of a thrombosed vein, acute pulling pains, local temperature increase, flushing of the skin and dense painful tenderness on palpation occur, it is possible to increase body temperature to 37.5 - 38 ° C. The manifestations of acute thrombophlebitis of the deep veins of the lower leg depends on the extent and location of the thrombus, the number of veins involved in the process. The disease usually begins acutely, with pain in the calf muscles, the appearance of a feeling of fullness in the lower leg, especially when lowering it down, increasing body temperature. Edema appears in the distal parts of the lower leg, the skin acquires a slightly bluish tint, and after 2-3 days a network of dilated superficial veins appears on the lower legs, thighs, and abdomen. With the back flexion of the foot, sharp pains in the calf muscles appear. Perhaps the appearance of pain with deep palpation (palpation) of the calf muscle. Early diagnostic signs of deep thrombophlebitis are: • Homans symptom: consists in the appearance or significant intensification of pain in the calf muscles with back flexion of the foot in the ankle joint, • Moses test, which is performed in two stages: a) compression of the lower leg in the anteroposterior direction, b) compression of the lower leg from the sides. The test is considered positive if soreness occurs only at the first dose, • Lowenberg test using a sphygmomanometer. A pneumatic cuff is applied to the middle third of the lower leg and slowly bring the pressure to 150 mmHg in it. Art. The test is considered positive in case of pain in the calf muscles at a pressure below this level. A positive result of even one of the tests listed above determines the need for an ultrasound examination. The most formidable complication of this disease is the risk of a blood clot breaking off from the inner walls of a venous vessel. This clot of clotted blood can move through the bloodstream of the body, and cause blockage of vital vessels. The most common cause of pulmonary embolism, the development of myocardial infarction, or acute vascular pathology of the brain is precisely a detached blood clot during thrombophlebitis of the lower extremities.
Lymphostasis they call a congenital or acquired disease associated with a violation of the outflow of lymph from the lymphatic capillaries and peripheral lymphatic vessels of the extremities and other organs to the main lymphatic collectors and the thoracic duct. Patients complain of edema of the lower extremities, pain, heaviness and fatigue in the limbs, the appearance of trophic disorders on the skin. In children, lymphedema (lymphostasis) develops, as a rule, as a result of a congenital malformation of the lymphatic vessels. In adults, the main causes of lymphedema are infectious (streptococcal infection, causing erysipelas) and parasitic diseases (filaria, toxoplasma, etc.), the consequences of various injuries or surgical interventions.
3. Leg pain in inflammatory diseases
Drawing pains in the muscles of the legs with myoenthesitis and paratenonitis. Under these names, a group of combined inflammatory lesions of muscles and ligaments of the lower extremities is combined. These pathologies are the result of chronic overstrain of the leg muscles under high and intense loads, and are accompanied by microtraumas of muscles and ligaments. Additional risk factors are general fatigue, chronic diseases, hypothermia, etc. Myoentesitis is inflammation at the point where the muscle transitions to the tendon, parathenonitis is damage to the fiber around the tendon, and insectitis is the inflammatory process at the site of attachment of the ligament to the bone. All these pathologies are often combined with each other, and are manifested by pain in the muscles of the legs and swelling in the corresponding area. In the chronic course of these diseases and ongoing loads, muscle tears can occur, and sometimes their complete detachments from attachment sites. Muscle inflammation (myositis) manifested by local muscle pain, aggravated by pressure on the muscles or during movement. This pain causes tension in the affected muscles and limits the mobility of the joints. Sometimes myositis can be manifested by swelling or redness of the skin in a sore spot. Symptoms of myositis also include increasing muscle weakness, in which it becomes difficult for the patient to perform simple and familiar actions. The causes of myositis can be infectious diseases (acute respiratory viral infections, influenza, chronic tonsillitis), exposure to toxic substances, injuries, metabolic disorders, hypothermia, excessive muscle tension, professional activities (violators, pianists, PC operators, drivers are at risk of developing myositis), muscle convulsions, parasites (trichinosis, cysticercosis). With open injuries and getting into the wound of infection, purulent myositis can develop. It manifests itself: an increase in body temperature, a gradual increase in muscle pain, chills, swelling, tension and muscle tightening.
4. Leg pain in bone tumors
Malignant tumors have a rich clinical picture. Symptoms such as weakness and loss of appetite, fever, exhaustion, anemia (anemia) in the late stages of the disease, lethargy, adynamia, disturbing sleep can be distinguished. Local manifestations include severe pain, which can be described as stubborn, constant, aggravating over time and at night, which is poorly relieved or does not relieve painkillers at all. Joint function is impaired with a periarticular arrangement of the process, often a pathological fracture occurs (that is, not related to trauma or damage, but occurs spontaneously, when lifting weights, turns or even at rest), a symptom of a “jellyfish head” (expansion of the venous network above the tumor) ), an increase in local temperature above the tumor. Also, with the development of malignant tumors of the lower extremities, one of the symptoms may be lameness.
5. Pain in the muscles of the legs with flat feet
One of the causes of constant pain in the muscles of the lower extremities can be flat feet. With this pathology, the flattening of the arch of the foot occurs - it becomes flatter, which causes a violation of its shock-absorbing functions. Flat feet are manifested by a feeling of "lead" heaviness, pain in the muscles of the legs and fatigue when walking. Also, with this pathology, the knee joints suffer greatly, since it is they that account for the majority of the load. In addition, the load on the spine increases, since the body has to somehow compensate for shock and shock during movement. The main symptoms of flat feet are footiness and deterioration of shoes on the inside, very fast fatigue and pain in the muscles of the legs when walking and staying upright for a long time, heaviness in the legs, cramps and swelling by the end of the day, swelling of the ankles, increase in the size of the foot in width .
6. Pain in the lower extremities with bone tuberculosis
Osteoarticular tuberculosis is manifested by symptoms of tuberculous intoxication and local lesions of the osteoarticular system. The severity of tuberculous intoxication can be very different depending on the activity and prevalence of the tuberculosis process. In many ways, it depends on tuberculosis of other organs, and first of all, on pulmonary tuberculosis. Symptoms of local damage are different depending on its location and the stage of development of tuberculous inflammation. Patients are disturbed by periodic pain in the back or in the joint, fatigue, muscle tension. The main clinical forms of osteoarticular tuberculosis: tuberculosis osteitis, tuberculosis of the spine and tuberculosis of the joints.
7. Leg pain in infectious diseases
Erysipelas - An infectious disease caused by streptococci. The disease begins acutely with the appearance of chills, general weakness, headache, muscle pain, in some cases nausea and vomiting, heart palpitations, and also an increase in body temperature. A small red or pink spot appears on the skin, which within a few hours turns into a characteristic erysipelatous redness. Redness is a clearly delimited area of the skin with uneven borders in the form of teeth, “tongues”. The skin in the area of redness is tense, hot to the touch, moderately painful to feel, swollen.
Osteomyelitis. General and local symptoms of the disease can be distinguished. The general picture of the disease, caused by the presence of bacteria in the blood (bacteremia), is as follows: after a short period of malaise, chills appear, the temperature rises from 37.5 ° C to 40 ° C, the pulse quickens (above 90 beats per minute). At this stage, osteomyelitis can be mistaken for a common acute respiratory infection (e.g., flu). On day 2-3 of the disease, local signs appear in the form of local pain over the affected area, limitation of mobility and swelling of the soft tissues of the limb segment, redness of the skin. The bones of the lower extremities (femoral and tibial) are most often affected.
8. Legs ache with arthritis of the joints of the lower extremities
Since arthritis of the hip and knee joints have already been discussed in the relevant articles, let us dwell on the defeat of the ankle joint and joints of the toes. Arthritis is an inflammation of the joints that can occur both in acute (severe pain, swelling of the ankle joint and toes), and in a chronic form (prolonged non-intense pain in the joints). However, the symptoms of the disease are specific to each specific pathology. Osteoarthritis - It causes the destruction of articular cartilage, thereby causing pain and inflammation. In such patients, movements are difficult and painful. During walking, pain and swelling intensify, and after rest there is a stiffness of movements. Gouty arthritis - mainly affects the lower limbs, but inflammation can be localized on the hands. Uric acid crystals are deposited in the joint of the big toe, since it is he who exerts the most strain when walking or running. This type of arthritis causes unbearable pain that occurs during stress. Rheumatoid arthritis - A very serious chronic disease that affects all joints. After some time, due to constant inflammation, the joints are deformed, and therefore often patients become disabled. Deformation of the foot is accompanied by a change in several joints at once, which prevents people from walking, and the resulting pain does not rest.
9. Leg pain in diabetic polyneuropathy
Typical symptoms are the sensation of “goose bumps”, burning, pain in the legs and feet, night muscle cramps. A neurological examination reveals a weakening of Achilles reflexes, impaired sensitivity of the type of “socks” and “stocking”, a decrease in muscular-articular sensitivity. With untimely treatment and treatment failure, complications of diabetic polyneuropathy such as trophic foot ulcers develop, which can lead to necrosis, gangrene (diabetic foot) and often amputations. Patients with diabetes need an annual neurological and clinical examination of the foot.
10. Neurological diseases and leg pain
Pain associated with lumbosacral osteochondrosis, localized along the posterior thigh from the buttock to the popliteal fossa, that is, along the sciatic nerve. Often these pains appear suddenly and can significantly limit the patient's motor activity. Lifting weights or sudden movements of the body can act as provoking factors. It is also characteristic that the pain intensifies when moving down the stairs.
Peripheral nerve disease can also provoke pain in the calf muscles. With neuralgia, the pains are paroxysmal and occur along the nerve fibers. In between attacks, the pain is practically absent, and the pain attack itself can last from several seconds to several minutes. In Raynaud's disease, pain in the toes after their "numbness" can be observed.
If a person has no neurological abnormalities, then inflammatory or metabolic myopathies cause painful muscle syndrome.
11. Leg pain in inflammatory or metabolic myopathies
According to the international classification, there are three types of myopathies: 1) caused by drugs and toxins, 2) idiopathic inflammatory, 3) caused by infections. 95% of idiopathic inflammatory myopathies account for polymyositis, myositis, dermatomyositis, which arise as a result of systemic diseases of the connective tissue. Myositis with intracellular inclusions and paraneoplastic myositis can also be a cause of pain. In all these cases, a consultation of a rheumatologist is necessary to prevent or determine a systemic disease, which resulted in pain in the calf of the legs. This type of myopathy, as a drug, is most often associated with the intake of fibrates and statins.
12. Pain in the muscles of the legs with metabolic disorders and pathology of adipose tissue
Water-electrolyte imbalance. With some disturbances in the water-salt balance, patients may complain of pain and cramps in the muscles of the lower extremities. A similar condition occurs when the body is dehydrated, which is caused by prolonged diarrhea, profuse vomiting, or diuretics. Since disturbances in the water-salt balance are not an independent disease, but arise as a result of any pathology, the symptoms will be different, but constant thirst and widespread edema are considered the main ones. It is also possible to lower blood pressure, the appearance of palpitations and cardiac arrhythmias.
Pathology of subcutaneous fat. Panniculitis is a progressive lesion of the subcutaneous fatty tissue of an inflammatory nature, leading to the destruction of fat cells and their replacement with connective tissue with the formation of nodes, plaques or infiltrates. The main manifestation of spontaneous panniculitis are nodular formations located in the subcutaneous fat at various depths. Most often they appear on the legs and arms. After resolving the nodes of the panniculitis, there remain foci of atrophy of adipose tissue, which look like rounded areas of skin retraction. Nodal variant of panniculitis characterized by the appearance in the subcutaneous tissue of typical separately located nodes ranging in size from 3-4 mm to 5 cm. The skin above the nodes can have a color from normal to bright pink. Plaque variant of panniculitis represents separate clusters of nodes, which, growing together, form tuberous conglomerates. The color of the skin over such formations is pink, burgundy or burgundy-cyanotic. In some cases, conglomerates of nodes extend to the entire tissue of the leg or thigh, while squeezing the vascular and nerve bundles, which leads to severe pain and swelling of the limb, leading to lymphostasis. Infiltrative Panniculitis proceeds with the fusion of nodes or their conglomerates. Moreover, in the area of the node or plaque, as a rule, a bright red or burgundy shade, a fluctuation appears, typical of an abscess or phlegmon. However, when the nodes are opened, not pus comes out of them, but an oily mass of yellow color. At the site of the opening node, a long-term non-healing ulceration forms. In addition to local manifestations with panniculitis, there may be general ones, such as weakness, malaise, loss of appetite, fever, nausea and vomiting.
Pain in the muscles of the legs in obese people. Obesity may also be the cause of pain in the muscles of the lower extremities. If a person is overweight, then an additional load is placed on the lower limbs, and they experience increased pressure. This inevitably leads to pain in the muscles of the legs, especially with small foot sizes.
Diagnosis of leg pain
Analysis of clinical data is the first step in the diagnostic process in patients with complaints of pain in the lower extremities, on which its further algorithm, aimed at establishing a diagnosis and determining treatment tactics, depends.
Laboratory and instrumental examination methods
1. общий анализ крови (умеренный нейтрофильный лейкоцитоз со сдвигом влево, анэозинофилия, умеренно повышенная скорость оседания эритроцитов при роже и других инфекционно-воспалительных заболеваниях), 2. электролиты, мочевина, креатинин (оценка водно-электролитных нарушений), 3. глюкоза крови (нормальные показатели 3,3-5,5 ммоль/л, повышение уровня глюкозы говорит о вероятности сахарного диабета), four.Biochemical blood test: an increase in uric acid with gout, an increase in cholesterol with atherosclerotic vascular damage, 5. Microbiological examination (for example, scraping from the urethra on chlamydia with suspected reactive arthritis), 6. X-ray examination - specific changes that are characteristic of a particular pathology are revealed, 7. Research on cancer markers with suspected malignant neoplasm, 8. Serological analysis: rheumatoid factor in rheumatoid arthritis, 9. Puncture biopsy of a bone in case of suspected bone tuberculosis and osteomyelitis: material for sowing is obtained by aspiration of pus from bone or soft tissues or a bone biopsy is performed, 10. UZDG (duplex scanning) of the vessels of the lower extremities allows you to detect vascular disease at a preclinical level, 11. Angiography of the vessels of the lower extremities is carried out with suspicion of chronic venous insufficiency, atherosclerosis of the vessels of the lower extremities, etc., 12. Magnetic resonance imaging and computed tomography (a disease of the nervous system, lymphostasis, etc.), 13. Reovasography of arteries of the lower extremities (chronic arterial insufficiency of the lower extremities), 14. Skeleton scintigraphy - when searching for metastatic foci of cancer, 15. Ankle pressure index (LID, the ratio of pressure in the arteries on the ankle to pressure in the brachial artery, normal 1 - 1.2) a decrease in this indicator indicates the presence of narrowing in the arteries of the lower limb.
Foot pain treatment
Since pain in the lower extremities is a symptom of a large number of diseases that are diverse in nature and symptoms, the treatment method depends on the cause that caused it. However, to timely prevent the appearance of pain in the muscles of the legs, you need to follow some rules:
1. With vascular pathologies, it is necessary to limit the content of fatty, cholesterol-rich foods in your diet. It will be useful to lose weight, and also regularly perform a special set of exercises aimed at preventing the development of varicose veins. For example:
- Complete alternate flexion and extension of the legs in the ankle joint until a sensation of sufficient tension of the muscles of the leg 10-20 times. - Circular motion of the foot in the ankle joint 10-20 times. - Lateral turns of the foot 10-20 times. - Flexion and extension of the toes of the feet 10-20 times. Try to avoid being in a static, seated or upright position for extended periods. If this is required by your type of activity, it is necessary to regularly take breaks, warm-ups, and change the position of the body, during the working break, perform the following exercises: - standing, 8-12 times rolls from heel to toe, - for 30-60 seconds, walking in place with a high raising of the lower leg.
2. For diseases of the spine or joints, you need to pay attention to the timely treatment of these pathologies, and the implementation of the doctor's recommendations.
3. Periodic exercises aimed at strengthening the muscles of the abdomen will lead to relieve muscle tension in the lower back, which will reduce the likelihood of radiating pain from the lower back.
In all cases of prolonged or periodically recurring pain in the lower extremities, you should consult a doctor to undergo the necessary examination to identify the disease that caused this condition.
Complications of diseases associated with leg pain
In the absence of timely diagnosis and treatment under the supervision of a physician, the disease progresses and complications develop. One of the most formidable complications of damage to arteries and veins: the development of gangrene, in which amputation of the lower limb is indicated. With untreated deep vein thrombosis, pulmonary embolism may develop.
The causes of the disease
The pain in the legs may have various causes, while additional symptoms are observed:
Lack of trace elements in the body as a result of a diet or a violation of the digestive tract. Legs quickly get tired, twists and brings them together.
Physical overwork, prolonged stay in one position, playing sports.
Prolonged use of glucocorticoids, diuretics, as well as those that lower cholesterol.
Injury to limbs.
The presence of an inflammatory process in the muscles of the lower extremities, in which there is not only aching in the legs (we consider the causes and treatment in this material), but also redness, rash and age spots.
Pathologies of the vessels of the legs: the development of atherosclerosis, thrombosis, varicose veins, osteoporosis, vasculitis or periarteritis nodosa, lymphostasis. In this case, a rash, redness of the skin, bruises, vascular networks, age spots, burning sensation can be observed.
The occurrence of osteomyelitis in children, arthrosis or arthritis in adults.
Pathologies of nerve fibers in diabetes mellitus (polyneuropathy), osteochondrosis or intervertebral hernia, as well as in smokers and alcoholics. At the same time, aches in the arms and legs, redness of the skin, the formation of dents, etc. are observed.
Rheumatic tissue lesions, their compression or cramps.
The presence of benign or malignant tumors, Paget's disease.
The appearance of allergic reactions, accompanied by a rash, burning and redness.
Night aches in the lower limbs
At night, aches in the limbs can be the cause of restless legs syndrome, strong physical exertion throughout the day. Inconvenient shoes or the same pose for a long time provokes the appearance of pain in the legs at night. The pathological cause may be the presence of fibromyalgia, flat feet or lymphostasis.
Ache when walking
Some people seem to “twist” their legs when walking. Especially the syndrome worsens when a change in weather conditions occurs. At serious stages, the ailment can become permanent, in which the ache will seem just painful for a person. This especially applies to bouts of pain with gout.
Caution - danger!
Doctors distinguish several dangerous diseases in which there is a strong pain in the legs. Therefore, it is necessary to immediately consult a doctor to make an accurate diagnosis and prescribe effective treatment, since the consequences can be very serious, up to amputation of the limbs. These diseases include:
Varicose veins, which manifests itself in the form of dilated veins, swelling of the legs, heaviness, monotonous pain, seizures. If the ailment is started, then bruises appear on the skin, burning and so on.
Vascular thrombosis (venous or arterial), which tends to develop rapidly. In this case, it is recommended to immediately consult a specialist, since in four days necrosis and gangrene can begin. The disease is accompanied by swelling and redness of the limbs, the appearance of age spots, there is an ache in the legs. Arterial thrombosis develops over several hours and is characterized by pain, paleness and numbness of the legs, gangrene can develop after four hours.
Atherosclerosis, which is characterized by the appearance of constant pain, dents and bruises on the skin of the limbs, a rash forms. If the disease is not treated on time, necrosis and gangrene are formed, which will lead to amputation of the legs.
If the aches appear regardless of physical activity, specialist advice is required. To do this, first of all, you need to contact a family doctor, who after conducting research will give a referral to a specialist of a narrow profile (endocrinologist, surgeon, neurologist or traumatologist).
If patients complain of aches and pain in the lower extremities, the doctor must analyze the clinical data, the results of which will determine the action plan for the diagnosis and treatment. For this, laboratory diagnostic methods are used. The patient must have blood tests (general, biochemical, water-electrolyte, glucose). Then microbiological examination, serological analysis and fluoroscopy are carried out. If cancer, tuberculosis, or osteomyelitis is suspected, tumor markers, puncture biopsy, or bone biopsy are used. Also, the doctor can prescribe ultrasound scan, MRI and CT, angiography of the vessels and rheovasography of the arteries of the legs, LID and scintigraphy of the skeleton. Thus, if a person is bothered by leg aches at night, accompanied by various additional symptoms, it is necessary to undergo a medical examination to make an accurate diagnosis and only then proceed with the treatment prescribed by a specialist.
The methods of treatment depend on the causes that caused aches in the limbs. Therapy is carried out based on the results of the examination and diagnosis. If a person has vascular pathologies, he is recommended to exercise (walking, swimming, etc.) to prevent the occurrence of varicose veins, fatty foods, alcohol should be excluded from the diet, long loads on the lower extremities, overwork, hypothermia should be avoided. With pathologies of the spine and joints, it is recommended to treat the underlying diseases. Doctors often prescribe antidepressants to relieve tension, anti-inflammatory drugs, steroids. It helps to remove unpleasant sensations from massage, gymnastics, acupuncture, etc. Thus, the treatment of aches in the legs is carried out in accordance with the main ailment. As a separate symptom, it is not treated, the main therapy is reduced to three parameters:
Taking medications, which is aimed at eliminating the cause of the disease. The patient is prescribed the necessary medications, as well as vitamins, minerals and anti-inflammatory drugs. It can be, for example, Actovegin, Cavinton, Ibuprofen and others.
Physiotherapy, which also includes massage, therapeutic exercises, weight control.
Surgical intervention. It is carried out in emergency and advanced cases of the disease.
Of course, as mentioned above, treatment should be carried out by an experienced specialist. At home, alternative methods can be used if leg aches arise from physical exertion. So, when the legs get tired, traditional medicine recommends cutting seven large bulbs into a large bowl (basin) and trampling on them for about twenty minutes, then rinse the legs with water and rub with vegetable oil, massaging. Such procedures must be carried out twice a week.
Some advise making compresses from dandelion. They push it and apply the resulting slurry to the limbs, rewinding them with a bandage or gauze bandage. Instead, rub your feet with castor oil overnight. It is also effective to use mixtures of herbs such as St. John's wort, bearberry, immortelle, carrot seeds, cherry stalks, and birch leaves. One spoonful of the composition is poured with boiling water and insisted one night in a thermos. Use an infusion of one tablespoon three times a day.
If you do not diagnose the disease in a timely manner and do not undergo a course of appropriate treatment, the progression of the disease and the appearance of negative consequences are possible. One of the dangerous complications is gangrene in the pathology of veins and arteries, which threatens to amputate the limb. If thrombosis is observed, it must be treated, since there is a risk of developing thromboembolism of the pulmonary artery.
Prevention methods should be different for aches in the limbs. First of all, it is recommended to lead a correct lifestyle in order to avoid the appearance of cardiovascular pathologies. To normalize blood circulation in the legs, physical activity is needed. With diseases of the spine, it is recommended to strengthen the abdominal muscles with the help of physiotherapy exercises.
It is necessary to eat properly, monitor the condition of the legs, do not overload the body, control weight. The main thing is not to miss the moment when you need to seek help from a doctor so that there are no health complications. The important thing here is the correct diagnosis, on which the method of treatment and the further prognosis depend. Doctors recommend monitoring your health. If there is pain in the legs, the causes and treatment of which are described in this material, it is necessary to undergo an examination.