Heaviness in the legs - Causes, Symptoms and Treatment .MF .
Heaviness in the feet is a fairly common reason for treatment of the patient to the doctor.More than a third of the world population complain of "buzzing", "aching" legs "bloating drumsticks", "constant fatigue" in the lower extremities.The mechanism of heaviness in the legs is reduced to stagnation in the vessels of the lower extremities.
Causes heavy legs
Possible causes heaviness in the legs, not caused by disease
1. sedentary lifestyle, prolonged static loads.
2. Overweight.Heaviness occurs directly due to the extra weight and due to volume expansion in the body fluid and interstitial fluid.In addition, the reduction of the normal vessels prevents a significant layer of subcutaneous fat.
3. Admission drugs (some hormonal contraceptives).
5. The weather conditions (hot weather reduces the overall motor activity of man, changing the volume of the circulating fluid in the body, lower limb blood vessels dilate, their tone is reduced, which contributes to a stagnation of blood).
6. hormonal changes (in women heaviness in the legs appears or worsens during the second phase of the menstrual cycle).
However, heaviness in the legs can often become the "first sign", shows the development of serious diseases.
Diseases accompanied by heaviness in the legs
1. lower limb vascular disease .
most common pathology accompanying this symptom is varicose veins of the lower extremities.It is a multifactorial disease associated with muscle weakness of the walls of superficial veins and congenital deficiency of the valve apparatus.In the early stages, patients pay attention to the heaviness in the legs that occurs during the second half of the day, and worse in the evening, there are no visible skin changes.You must not skip this step, since in this period the most favorable treatment and conduct of preventive measures, which significantly slow down the disease.With disease progression joined complaints of pain in the legs, cramps, cosmetic defect (twisted lower limbs extended subcutaneous veins).When deterioration appears edema legs, initially not constant (in the evening), painless.In severe cases swelling become permanent, Kazha over varicose veins inflamed, appear poorly healing ulcers, bleeding from varicose veins, the disease can be complicated by acute varicothrombophlebitis.However, varicose veins of the lower extremities - rather slowly progressive disease, even with extensive varicose veins health of patients may not suffer for decades.But despite the seeming harmlessness of the disease should not forget about such dangerous complications like varikotromboflebit manifested by the appearance of blood clots in the veins, which separation and further movement in the venous system of the body, can lead to a deadly condition - pulmonary embolism.
When chronic arterial insufficiency of the lower limbs occurs narrowing of vessels of the legs and arms up to the full blockage, which is accompanied by varying degrees of circulatory disorders in the limbs.This group of diseases include atherosclerosis, thromboangiitis obliterans, nonspecific aortoarteriit, diabetic arteritis as a consequence of diabetic microangiopathy, connective tissue diseases (scleroderma, periarteritis nodosa, rheumatoid arthritis, systemic lupus erythematosus).The manifestations are varied, but usually consist of symptoms of deficiency of blood supply to the lower limbs.First symptoms appear only during exercise.Patients complain of weakness, high fatigue and heaviness in the affected limbs, paresthesia (a feeling of "pins and needles"), cold toes, pain in the legs.A typical symptom is intermittent claudication.In early disease, it only appears after a long walk, but with the progression of the pathological process, the distance that a patient can pass safely without stopping, is reduced to 100 - 150 m. On examination, the skin of the lower limb pale, sometimes with a bluish tint, there is a decrease or absence of haircover, brittle nails, come later trophic disorders (ulcers, gangrene of the toes).The temperature of the affected limb reduced pulsation of the great vessels is significantly weakened or absent.
limfostazom (lymphedema) - accumulation of lymph in the intercellular space and a complete cessation of its current through the lymphatic vessels.The disease is characterized by the appearance of swelling in the lower extremities, heaviness and fatigue in the legs, pain, trophic changes in the skin.Edema is located on the rear of the foot, or the bottom third of the leg, not constant (increasing in the summer, after exercise and decreases in autumn and winter, or after a long rest).The skin of normal color, swelling of soft, painless.It noted a tendency to inflammatory diseases of the skin of the affected limb, which contributes to the progression of the disease and the deterioration of its flow.
One of the most feared complications of venous lesions of the lower extremities - a violation of the integrity of the skin, until the development of ulcers and gangrene, while showing lower limb amputation, so at the first sign of illness should be promptly seek medical attention.
2. Pathology of the locomotor apparatus .
spine pathology. lumbosacral osteochondrosis (dystrophic disease of the intervertebral discs and vertebral bodies to be) in the initial stages is manifested by pain in the lower back, spasmodic contraction of the calf muscles, heaviness in the legs.Neurologic manifestations depend on the period of the disease.During an exacerbation of pain observed (lumbalgia), backache (lumbago), radicular pain and disorders of sensation in the legs, vegetative trophic disorders, are often reduced tendon reflexes.In remission symptoms subside, or do not appear at all.
diseases of the joints of the lower extremities .
Arthrosis - degenerative-dystrophic diseases of the joints.Despite the diversity of location, formed from the symptoms of the disease of pain, stiffness feeling during movement, increased fatigue of the lower limbs, stiffness, coarse crunch.Pain dull, is not constant, worse in cold and wet weather, after a long load.Very often in the elderly arthritis occur with minimal symptoms: aches and a feeling of heaviness in the lower extremities, pain is absent.All these symptoms are caused by a violation of the relation to each other articular surfaces, changes in the joint capsule (calcification, sclerosis), tendons and muscle spasm.An important feature of arthrosis is a discrepancy between the clinical manifestations (complaints of the patient) and morphological changes in the joints observed on radiographs.Sometimes even minor changes to the X-ray observed severe pain and disturbance of function of the joint.
Arthritis - is an inflammatory disease of the joints.Their causes may be local or general infectious process, allergy, autoimmune reaction, local trauma, etc.However, the nature of certain heavy joints diseases (rheumatoid arthritis, ankylosing spondylitis, etc.) Has not yet been sufficiently clarified.The flow of arthritis can be acute, subacute and chronic.Common symptoms Cynic comes to joint pain, deformities, dysfunction, change in temperature and color of the skin over the joint.However, each disease has its own specific symptoms.For example, in rheumatoid arthritis articular manifestations except in extra-articular symptoms are present.These include rheumatoid nodules - formation of connective tissue, dense, rounded size from a few centimeters to a larger, which are often located on the forearm below the elbow;cutaneous vasculitis (necrotizing vasculitis, heart attacks the nail bed);polyneuropathy (when joint deformity occurs compression of nerves: median, ulnar, and others.).When gouty attack to the fore in most cases goes arthritis of the big toe (a sharp pain in the metatarsophalangeal joint of the first toe, foot movement difficult, joint redness, fever up to 38 ° C), which spontaneously passes after 3-5 days and tophi(uric acid deposits are limited by connective tissue), usually located on the ears, feet, fingers.Tophi small size resolve with adequate treatment.Excessive amounts of urate leads to the formation of kidney stones with renal colic attacks.
tophi in advanced gout
Flatfoot - foot disease characterized by a decrease in its vaults.Distinguish longitudinal and transverse flat depending on the reduced set.It is often combined lateral and longitudinal flat feet.With ill-defined flat feet (I degree) patients worried heaviness in the legs, fatigue of the lower limbs, pain when pressing on the foot or the middle of the sole, gait loses plasticity.With increasing severity of the disease appear more constant and intense pain in the feet and legs, swelling of feet and ankles by the end of the day, it varies considerably gait requires individual tailoring of shoes, as there is no opportunity to wear shoes of mass production.When viewed from the foot flattened, callus skin soles under the heads of the metatarsal bones, formed "halyus valgus" - deformation of the foot in the metatarsophalangeal joint of the big toe.
Hallux valgus - pronounced flatfoot stage
3. heart disease .Severe cardiac disease (cardiomyopathy, myocardial dystrophy, heart disease and other diseases that lead to the development of congestive heart failure) may be associated with heavy legs and edema.However, to the fore the complaints of the heart: heart pain, tachycardia (rapid heartbeat) or bradycardia (slowing of heart rate), disruptions in heart, shortness of breath.On examination attracts attention pallor of the skin, "mitral flush" with mitral stenosis, capillary pulse in aortic insufficiency, swelling of the neck and the peripheral veins, akrotsianoz (blue course).Edema heart failure symmetrical, cold predominantly on the shins and ankles from walking patients and in the tissues of the lumbar and sacral region in bedridden.In a study of patients identify clinical and laboratory signs of heart disease.It is also necessary to remember that the complication of chronic venous insufficiency of the lower limbs can be thrombophlebitis with a margin of thrombus and its migration through the body.
4. When kidney disease , such as acute and chronic glomerulonephritis, diabetic glomerulosclerosis , chronic renal failure, heaviness in the legs occurs during the initial stages of development of edema.Edematous skin is pale, rather compact, normal temperature.Dyspnea usually does not happen.Patients complain of itching, weakness, loss of appetite, thirst, increased blood pressure.The examination of such patients reveal anemia, edema up to anasarca (total swelling of the subcutaneous tissue), and damage to other organs and systems (uremic gastritis, pericarditis, uremic encephalopathy) in the terminal stage.Disturbed blood coagulation, reduced immunity.
Diagnostics for heavy legs
Laboratory and instrumental examination.
1. CBC (decreased hemoglobin and red blood cells, a decrease in platelet count, accelerated ESR, leukocytosis in renal disease);
2. Biochemical analysis of blood: increase in uric acid in gout, increased levels of cholesterol in atherosclerotic lesions of vessels;electrolytes, urea, creatinine (kidney disease);
3. Urinalysis - the appearance of protein (proteinuria), red blood cells (haematuria), kidney disease;
4. Rehberg test - Toreeva - assessment of renal excretory function, calculated glomerular filtration rate (GFR);
5. Blood glucose (normal 3,3-5,5 mmol / L increase in glucose level indicates a possible diabetes);
6. serological testing for rheumatoid factor for rheumatoid arthritis;
7. X-ray - reveals specific changes characteristic of a particular pathology of the musculoskeletal system;
8. Computer plantography - foot examinations for suspected flat;
9. ECG - evaluation of the heart;
10. biochemical markers of myocardial damage (troponin, CK-MB) with suspected myocardial infarction;
11. Doppler ultrasound (duplex scanning) vessels of the lower extremities is carried out to detect pathology of blood vessels in the early stages;
12. Ultrasound of the heart;
13. PCG (phonocardiography) - conducted at a valvular pathology;
14. coronary angiography - assessment of the coronary arteries;
15. lower extremities angiography - allows us to estimate the degree of narrowing of the arteries in atherosclerosis of the lower limbs, to specify the location and size of floating thrombus in thrombophlebitis, etc .;
16. Magnetic resonance imaging (MRI) and computed tomography (CT) allows you to quickly and reliably identify zabalevaniya nervous system, heart, kidneys, etc .;
17. rheovasography arteries of the lower extremities is carried out in suspected atherosclerosis of the lower extremities, obliterating trombangeit etc .;
18. Shoulder-ankle index (ABI, the ratio of pressure in the arteries at the ankle to the pressure in the brachial artery, at a rate of 1 - 1.2) decrease in this indicator indicates the presence of narrowing of the arteries in the lower limbs.
Treatment of heavy legs
Since heaviness in the legs is a symptom of a large number of diseases that affect different organ systems, disparate origin and manifestations, consequently, their treatments are different.Only a physician, considering all the manifestations of the disease and the results of laboratory and instrumental examinations, can make an accurate diagnosis and appropriate treatment.
However, on their own, you can normalize your body weight, to comply with a set of exercises designed to combat physical inactivity, to massage legs, to evaluate the nature of the food and try to avoid foods high in cholesterol, stop wearing shoes with high heels, wear orthotics andcomfortable shoes for the prevention of flatfoot.
To what doctor to treat the appearance of heaviness in the legs
therapist.You may need medical assistance: a cardiologist, vascular surgeon, orthopedic surgeon, nephrologist.
therapists Kletkina Y.