Regardless of a person’s gender and age, pain in the hip joint can occur in children and adults. The right or left hip joint may occasionally hurt, but the sensations are sharp and strong, and sometimes every movement is accompanied by discomfort in both legs. Unpleasant sensations may be concentrated in the groin and upper thigh. One leg or two legs hurt at once, but the reasons for such symptoms are different.
The hip joint is the strongest joint and can withstand many repetitive movements and is durable. If the aching pain in the hip area is not the result of an injury, and is a long-term problem, the answer must be sought in the body. Finding out the cause of discomfort is the first stage in the treatment of pathology. The location of the discomfort varies; pain may occur in the upper thigh, on the outside, on the side, in the groin area, or on the inside of the thigh.
Any injury can result in a fracture. Often the femur does not break, but damage appears, which, without violating the integrity of the soft tissues, increases their length, activating pain in the left thigh or on the inner surface of the right. Such injuries refer to a tear that occurs during a sudden unnatural movement. The most common types of injuries in the right or left hip are:
Pain from a bruised tailbone can be reflected in the femoral part of the lower limb.
The consequence of a sprain is a dull pain in the hip when walking. Inflamed soft tissues that protect the joint do not fully do their job. The discomfort intensifies from the load: the leg hurts, the pain throbs, pulls and radiates to the buttock. With a fracture, the pain is much stronger, it is impossible to endure it.
A congenital dislocation occurs in the joint, which is detected in a newborn even at the examination stage. To determine the final diagnosis, an x-ray must be taken.
Abnormalities in the femur cause discomfort, sometimes causing pain in the femoral neck. Since diseases of one part of the skeleton always provoke a deterioration in the condition of another, they are combined into a group of such pathologies:
The cause of pain may be inflammation in the joint.
Pathogenic bacteria are activated in the soft tissues of the thighs, entering through open wounds after injury or spreading through the blood from other organs. This leads to activation of the immune system and the development of an inflammatory process in the bone cells of the hip and pelvis, which is accompanied by acute pain. The following infectious pathologies are distinguished:
The appearance of pain in the hips may be a consequence of the formation of a tumor: benign or malignant. The onset of the development of neoplasms does not differ in pronounced symptoms, so it is difficult to notice the pathology. Pain appears in later stages, when the size of the tumor increases and it presses on surrounding surfaces.
Pain syndrome is caused by the following situations:
When the sciatic nerve is pinched, numbness of the limb may occur.
The following types of neoplasms are distinguished:
The presence of a traumatic history will not cause difficulties in making the correct diagnosis. It is much more difficult when the causes of hip pain are unknown. In such a situation, you need to do a comprehensive examination, which consists of the following methods:
In addition, you will need to be examined by such specialists as:
Treatment with folk remedies can be used as an additional method, but not the main one.
The doctor decides how to treat separately in each individual case. The choice of therapeutic procedures depends on the diagnosis and the complexity of damage to joints and bones. After determining the cause of the pain, all treatment is aimed specifically at eliminating it. If there is no severe pain, therapeutic procedures can be performed at home. In a difficult situation, hospitalization is indicated.
Following simple recommendations will help reduce pain:
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Any reason that causes pain is accompanied by an inflammatory process. To reduce the activity of inflammation, and therefore reduce pain, the following medications are used:
How long the course of treatment will take will depend on the disease that provoked the pain syndrome. After relieving pain and eliminating the underlying pathology, physiotherapeutic procedures, massage, and manual therapy may be prescribed. Surgery is a last resort measure, which is used only when conservative therapy does not produce the desired result.
Pain in the ankle joint can occur for various reasons. Painful sensations usually appear as a result of injury, joint damage and many other factors. You cannot ignore such symptoms and self-medicate. It is very important to make a correct diagnosis and identify the true causes of the disease, because there is a high probability that the patient’s condition will worsen, due to which he will subsequently be unable to move normally.
Let's try to find out why pain in the ankle joint occurs, the causes and treatment of this pathology.
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Various injuries to the ankle joint negatively affect not only motor activity, but also the general health of the patient, and in the absence of timely treatment can cause disability. This is explained by the fact that the ankle joint surrounds the ankle ligaments, strengthens it, makes it denser and stronger, and also protects it from various injuries. The ankle is formed as a result of the connection of the talus bones of the foot with the area of the lower leg and with its help the inclination of the foot, its rotational movements and flexion are performed.
The causes of pain in the ankle joint can be various factors, both external and internal. In order for treatment to be effective, the specific cause of the disease must be determined. Most often, joint pain occurs due to injuries, various diseases, inflammatory processes, etc. The following factors can be identified that can cause ankle pain:
Let's look at the most common of these diseases that cause pain in the ankle joint.
Arthrosis is an inflammatory disease that affects the limbs, their joint and cartilage tissues. The following symptoms are characteristic of this pathology:
Achillitis is an inflammatory process that affects the Achilles tendon. The causes of this pathology are long walking and shortening of the calf muscle.
The main symptoms due to which achillesitis is diagnosed at the very beginning of its development are swelling and pain that occurs during physical activity on the limb. Therefore, if the ankle begins to hurt when playing sports or walking, then you can be sure that it is achillesitis.
Arthritis is an autoimmune disease that can affect all joints, including the ankle. The localization of the pathological process is in the area of the inner shell of the ankle joint. The signs of arthritis are:
In addition, the ankle can also hurt when the ligaments are sprained. This injury is quite common and is easy to get even due to careless movement while walking. Sprains have three levels of severity and each has its own specific symptoms.
In mild cases, skin redness and pain occur in the ankle area. usually happens during physical activity . Moderate severity of sprain is characterized by increased pain in the ankle area, motor activity is impaired, and the person is unable to step on the injured leg. An extreme degree of sprain is accompanied by severe pain as the ligaments rupture. There is an increase in the size of the ankle and its swelling, the skin begins to turn red.
Gout is an inflammatory disease that affects the big toe. It occurs due to the deposition of uric acid crystals and salts in the joint area. The pathology is characterized by severe pain in the ankle and foot area.
Osteoarthritis is a disease that causes wear and tear of cartilage tissue, which contributes to joint dysfunction. With this pathology, the characteristic symptoms are severe pain in the ankle area and weakening of ligamentous and muscle tissues.
The most common cause of ankle pain is a sprain. Characteristic signs of such an injury are hematomas and swelling. If the joint is very swollen, and any movement causes severe pain, then we can safely say that we are talking about a dislocation.
A calcaneal fracture manifests itself as follows:
The ankle joint can hurt as a result of circulatory disorders and microcirculation of blood in the peripheral vessels. This condition is accompanied by enlarged veins and swelling. The occurrence of peripheral swelling is associated with varicose veins, pregnancy, excess weight and other reasons.
Vascular obstruction of the ankle area occurs due to a blood clot formed in one of the patient’s legs. This causes disruption of blood circulation, swelling and severe pain.
The ankle joint can also hurt due to an infection of the soft tissues of the ankle. This causes swelling and redness of the skin. Most often, the cause of this pathology is the negative activity of pathogenic viruses, bacteria and microorganisms.
Synovitis is an inflammatory disease that affects the synovium. In this case, an accumulation of inflammatory effusion occurs in the cavity of the membrane, causing swelling and pain in the ankle area. In this case, a person experiences rapid fatigue when walking and the motor activity of the affected limb is impaired.
It is not difficult to completely restore JOINTS! The most important thing is to rub this into the sore spot 2-3 times a day.
If the pain syndrome is a consequence of injury , then the doctor prescribes the following treatment:
If the ankle joint begins to hurt as a result of a certain pathological process, then successful treatment is only possible if the underlying disease is eliminated. For this purpose, the doctor prescribes drug treatment to the patient, which consists of taking anti-inflammatory and painkillers, as well as drugs that accelerate the regeneration of joint tissue.
If the occurrence of vascular edema of the leg is not associated with severe diseases of the internal organs or thrombophlebitis, for its treatment the doctor prescribes vasodilators that help increase the tone of the veins (Detralex, etc.). In addition, absorbable gels (Essaven, Dolobene) are prescribed for the lower leg.
Treatment of ankle arthrosis and dislocation is first carried out using manual methods , which help restore the joint and return it to its original place. After this, it is secured in the required position with an elastic bandage. This helps the joint not move during movement.
Auxiliary treatment is represented by the following physiotherapeutic procedures:
In particularly difficult cases, the patient may undergo surgical treatment.
To alleviate the patient's condition, apply a cold compress to the leg . This process is carried out as follows: a heating pad is filled with ice or ice cubes are wrapped in gauze and applied to the affected area. This eliminates pain and swelling in the ankle area.
Folk remedies are also used as an auxiliary method of treatment . So, a potion based on kefir, compresses made from a soap-salt solution and chopped onions help very well. The ankle can hurt very badly, and in this case the following recipe helps: mix salt, sugar, soda and honey in equal quantities, add water and stir so that a mushy mass is obtained. This mixture is applied to the ankle area and left for 10 minutes. The pain begins to gradually subside.
Thus, pain arising in the ankle is a fairly common phenomenon and requires careful attention. Do not forget that in the absence of timely treatment, very serious complications can arise. In this case, even surgical intervention does not always help.
Pain can occur in any part of the leg and the causes of this pain are extremely varied.
The articles “Pain in the hip joint”, “Pain in the knee”, “Pain in the heel” discuss in detail the causes of pain in these areas of the lower extremities.
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 stress, overwork, and most often occurs in the calf muscle. The leg muscles begin to experience oxygen starvation, and breakdown products, in particular lactic acid, cease to be excreted from them. The result of this is pain in the leg muscles. To eliminate them, it is recommended to relax the muscles. To do this, just lie down or sit down, thereby changing the position of the limb, and strongly rub the cramped muscle with your hands.
Dull, aching and stabbing pain in the calf muscles, cramps often occur after prolonged standing or sedentary work. When, due to prolonged stagnation in the veins of the lower extremities, normal venous and arterial blood circulation does not occur, oxygen starvation occurs.
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 due to diseases of bones and joints, muscles and tendons, lymph nodes and blood vessels.
Let's consider the possible causes leading to pain in the lower extremities.
Leg bruises are the most common injuries to the lower extremities. They can be either independent or in combination with other injuries (contusion of internal organs, dislocations of joints, etc.). When a bruise occurs, the patient notes the connection between the injury and the occurrence of pain. There is swelling and hematoma (bruise) at the site of the injury. Impaired limb function depends on the location of the injury, its intensity and the volume of the damaged area.
Fractures of the bones of the lower extremities are a violation of the integrity of the bone, and sometimes the joint. Not all bone fractures are caused by trauma. For example, in people suffering from osteoporosis, the bones are so fragile that fractures can occur with minimal stress. Depending on the severity of the fracture (open or closed, with or without displacement), pain in the leg muscles will have varying intensity. There are two groups of signs of a fracture of the lower extremities. Probable: pain that increases with any movement; edema and swelling in the injured area; restriction of movements in the leg; the occurrence of subcutaneous hemorrhages. Reliable: unnatural position of the limb; pathological mobility of the leg in places where there are no joints; crepitation (crunching) of rubbing bone fragments; visually detectable fragments in open fractures (in these cases bleeding and traumatic shock are associated). In addition, if the neurovascular bundle is injured, there will be signs of impaired blood supply to the leg and foot, and neurological disorders.
Strained muscles of the lower limb can occur when jogging, fast walking, playing any active sport, and sometimes even when wearing poorly fitting shoes. The first sensations of pain usually occur immediately or within 24 hours after unusually intense muscle activity. The muscles look swollen, tense and heavy. Patients complain of pain, sometimes quite pronounced, that occurs when feeling the muscles. In some cases, it is accompanied by swelling of the muscle tissue, which is manifested by a significant increase in the size of the affected area. Pain and tenderness persist for several days and sometimes weeks. Pain increases with movement, especially when bending the knee and ankle joint.
Muscle ruptures. 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, quite large ruptures may occur, sometimes even accompanied by complete separation of the muscle from the tendon. As a rule, such injuries occur when the limb is sharply bent in the direction opposite to the acting force. An example would be the moment of a sharp start or, conversely, a sudden stop while running. 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 grows and muscle spasm develops. When palpating the injured limb, local pain is noted. Sometimes you can feel the swelling caused by extensive hemorrhage by touch. If a complete rupture occurs (that is, a muscle is torn off in the area of its attachment to the tendon), it is even possible to feel the gap that appears between the ligament and the muscle. Such injuries are always accompanied by severe swelling in the area of the damaged muscle and a significant decrease in range of motion.
Long-term crush syndrome (LCS, crash syndrome) of soft tissues is a unique pathological condition that develops as a result of long-term (4-8 hours or more) crushing of the soft tissues of the extremities by fragments of destroyed buildings, structures, blocks of soil during collapses in mines, etc. Crash syndrome occurs in emergency situations (earthquake, building collapse, etc.).
A type of SDR is positional compression syndrome (PCS) of soft tissues, which complicates 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 torso by the weight of one’s own body. The most common causes of its development are poisoning with alcohol and its surrogates, drugs with narcotic and sleeping pills, carbon monoxide or exhaust gas poisoning. The victim complains of pain and the inability to move the injured limb, weakness, nausea, and thirst. He is pale and reacts sluggishly to his surroundings. The damaged limb quickly swells, its volume increases, and the tissues acquire a woody density due to muscle swelling. Hemorrhages, abrasions, and blisters filled with sulfur or bloody fluid are visible on the skin in the crush zone. Movement in the joints is impossible due to pain caused by damage to the muscles and nerve trunks. Sensitivity in the area of damage and underlying tissues is lost. The pulsation of blood vessels in this area is weakened or not detected at all due to increasing edema. Blood pressure decreases.
Aching pain in the leg muscles with spontaneous hematomas . Sometimes patients who are treated with anticoagulants may experience sudden hemorrhages in the muscles of the lower extremities. This pathology is characterized by aching pain and an increase in the size of the affected area. Such hematomas are formed without connection with previous injuries, or as a result of very minor injuries.
Chronic arterial insufficiency of the lower extremities is accompanied by a characteristic pain syndrome that occurs when walking a limited distance (up to 500 m). In some cases, the pain-free walking distance is only tens of meters. The resulting pain, associated with the accumulation of under-oxidized metabolic products (lactates, pyruvates, etc.) in the muscle tissue, forces the patient to stop, wait for the pain to disappear, and only then continue moving. This symptom is called “intermittent claudication” and its identification requires only a careful questioning of the patient. In some cases, ischemic pain in the lower extremities also 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 pain-free walking or pain at rest is an indication for hospitalization of the patient in the vascular surgical department for angiographic examination and surgical treatment.
Chronic venous disease (CVD, varicose veins) occurs as a consequence of insufficiency of the valve apparatus of the superficial venous system. Pain in chronic venous disease 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, goosebumps and tingling. The pain appears at the end of the day, after prolonged static exercise, both standing and sitting. Venous pain is provoked by heating (warm floors, hot bath, sauna, sauna, hot season, etc.), changes in hormonal levels (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 lifting the limb above the horizontal. Varicose veins develop rather slowly - over the course of years, and sometimes decades. Its progress is facilitated by: long-term static loads on the lower limbs when in an upright position; sedentary lifestyle; excess body weight; prolonged sitting (for example, during frequent long trips or flights); use of hormonal contraceptives or hormone replacement therapy; pregnancy. It must be remembered that the most well-known symptoms of varicose veins in the form of bulging veins 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 are most often pain, heaviness, tension in the leg muscles, fatigue and swelling. If such complaints arise, it is best to immediately contact a phlebologist. A detailed clinical picture of varicose veins of the lower extremities includes: swollen, nodular, protruding veins protruding above the surface of the skin and visible through it; intense pain in the leg muscles; inflammation of the skin over the vein area; thrombophlebitis; the appearance of poorly healing ulcers and bleeding.
Thrombophlebitis is an acute inflammation of the walls of a vein with the formation of a blood clot in its lumen. Symptoms depend on the location of the thrombosis. There are thrombophlebitis of superficial (mainly varicose) veins and thrombophlebitis of deep veins of the lower extremities. Acute thrombophlebitis of the superficial veins of the lower extremities develops, as a rule, in varicose veins. The great saphenous vein is most often affected. Along the course of the thrombosed vein, acute nagging pains, a local increase in temperature, skin hyperemia and a dense painful cord upon palpation occur; body temperature may rise to 37.5 - 38 ° C. The manifestations of acute thrombophlebitis of the deep veins of the leg depend on the extent and location of the thrombus, and the number of veins involved in the process. The disease usually begins acutely, with pain in the calf muscles, a feeling of fullness in the lower leg, especially when lowering it down, and an increase in body temperature. Swelling appears in the distal parts of the leg, the skin becomes slightly bluish, and after 2-3 days a network of dilated superficial veins appears on the legs, thighs, and abdomen. When dorsiflexing the foot, sharp pain appears in the calf muscles. Pain may occur with deep palpation (palpation) of the calf muscle. Early diagnostic signs of deep thrombophlebitis are:
• Homans' symptom: consists of the appearance or significant intensification of pain in the calf muscles when dorsiflexing the foot at the ankle joint;
• Moses test, which is performed in two steps: a) compression of the tibia in the anteroposterior direction; b) compression of the lower leg from the sides. The test is considered positive if pain occurs only at the first dose;
• Lowenberg test, performed using a sphygmomanometer. A pneumatic cuff is placed on the middle third of the leg and the pressure in it is slowly increased to 150 mmHg. Art. The test is considered positive if pain occurs 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 serious complication of this disease is the risk of a blood clot breaking off from the inner walls of a venous vessel. This clot of coagulated blood can travel through the body's bloodstream 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 a detached blood clot in thrombophlebitis of the lower extremities.
Lymphostasis is 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 swelling of the lower extremities, pain, heaviness and fatigue in the limbs, and the appearance of trophic disorders on the skin. In children, lymphedema (lymphostasis) usually develops as a result of a congenital defect of the lymphatic vessels. In adults, the main causes of lymphedema are infectious (streptococcal infection, causing erysipelas) and parasitic diseases (filaria, toxoplasma, etc.), consequences of various injuries or surgical interventions.
Nagging pain in the leg muscles with myoenthesitis and paratenonitis. These names combine a group of combined inflammatory lesions of the muscles and ligaments of the lower extremities. These pathologies are a consequence of chronic overstrain of the leg muscles under high and intense loads, and are accompanied by microtrauma to muscles and ligaments. Additional risk factors are general fatigue, chronic diseases, hypothermia, etc. Myoenthesitis is inflammation at the junction of the muscle into the tendon, paratenonitis is damage to the tissue around the tendon, insertitis is an 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 leg muscles and swelling in the corresponding area. With the chronic course of these diseases and continued stress, muscle tears can occur, and sometimes they are completely torn from their attachment points.
Muscle inflammation (myositis) is manifested by local muscle pain, which intensifies with pressure on the muscles or with movement. This pain causes tension in the affected muscles and limits joint mobility. Sometimes myositis can manifest itself as swelling or redness of the skin in the sore spot. Also, symptoms of myositis 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 (ARVI, influenza, chronic tonsillitis), exposure to toxic substances, trauma, metabolic disorders, hypothermia, excessive muscle tension, professional activity (violinists, pianists, PC operators, drivers are at risk of developing myositis), muscle convulsions, parasites (trichinosis, cysticercosis). With open injuries and infection in the wound, purulent myositis can develop. It manifests itself: increased body temperature; gradual increase in muscle pain; chills; swelling, tension and tightness of the muscle.
Malignant tumors have a rich clinical picture. Symptoms such as weakness and loss of appetite, increased body temperature, exhaustion, anemia (anemia) in the later stages of the disease, lethargy, adynamia that disrupts sleep can be identified. Local manifestations include severe pain, which can be characterized as persistent, constant, increasing over time and at night, which is poorly relieved or not relieved at all by painkillers. The function of the joint is disrupted when the process is located periarticularly, a pathological fracture often occurs (that is, not associated with trauma or damage, but occurs spontaneously, when lifting weights, turning, or even at rest), the “jellyfish head” symptom may be observed (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.
One of the reasons for constant pain in the muscles of the lower extremities can be flat feet. With this pathology, the arch of the foot flattens - it becomes flatter, which causes a disruption in its shock-absorbing functions. Flat feet are manifested by a feeling of “leaden” heaviness, pain in the leg muscles and rapid fatigue when walking. Also, with this pathology, the knee joints suffer greatly, since they bear most of the load. In addition, the load on the spine increases, since the body has to somehow compensate for shocks and jolts during movement. The main symptoms of flat feet are worn out and worn-out shoes on the inside; very rapid fatigue and the appearance of pain in the leg muscles when walking and staying in an upright position for a long time; heaviness in the legs, their cramps and swelling at the end of the day; swelling of the ankles; increase in foot size in width.
Osteoarticular tuberculosis is manifested by symptoms of tuberculosis intoxication and local damage to the osteoarticular system. The severity of tuberculosis 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 primarily on pulmonary tuberculosis. Symptoms of local damage vary depending on its location and the stage of development of tuberculous inflammation. Patients are bothered by periodic back or joint pain, fatigue, and muscle tension. The main clinical forms of osteoarticular tuberculosis are: tuberculous osteitis, spinal tuberculosis and joint tuberculosis.
Erysipelas is 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, increased heart rate, and increased body temperature. A small red or pink spot appears on the skin, which within a few hours turns into a characteristic erysipelas. Redness is a clearly demarcated area of skin with uneven boundaries in the form of teeth, “tongues”. The skin in the area of redness is tense, hot to the touch, moderately painful when touched, 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, and the pulse quickens (above 90 beats per minute). At this stage, osteomyelitis can be mistaken for a common acute respiratory infection (for example, influenza). On the 2-3 day of illness, local signs appear in the form of local pain over the affected area, limited mobility and swelling of the soft tissues of the limb segment, and redness of the skin. The bones of the lower extremities (femur and tibia) are most often affected.
Since arthritis of the hip and knee joints have already been discussed in the relevant articles, we will focus on damage to the ankle and toe joints. Arthritis is an inflammation of the joints, which can occur in both acute (severe pain, swelling of the ankle and toes) and chronic forms (long-term, low-intensity pain in the joints). However, the symptoms of the disease are specific to each specific pathology. Osteoarthritis causes the destruction of joint cartilage, thereby causing pain and inflammation. In such patients, movements are difficult and painful. While walking, pain and swelling intensify, and after rest, stiffness of movement occurs. Gouty arthritis mainly affects the lower extremities, but inflammation can also be localized to the arms. Uric acid crystals are deposited in the joint of the big toe, since this is the joint that is most stressed when walking or running. This type of arthritis causes unbearable pain that occurs during exertion. Rheumatoid arthritis is a very serious chronic disease that affects all joints. After some time, due to constant inflammation, the joints become deformed, and therefore patients often become disabled. Foot deformity is accompanied by changes in several joints at once, which prevents people from walking, and the resulting pain haunts them.
Typical symptoms are a crawling sensation, burning sensation, pain in the legs and feet, and muscle cramps at night. A neurological examination reveals a weakening of the Achilles reflexes, impaired sensitivity of the “socks” and “stockings” type, and a decrease in muscle-articular sensitivity. If treatment is not started in a timely manner and therapy is ineffective, complications of diabetic polyneuropathy develop, such as trophic foot ulcers, which can lead to necrosis, gangrene (diabetic foot) and often to amputations. Patients with diabetes require an annual neurological and clinical examination of the foot.
Pain associated with lumbosacral osteochondrosis is localized along the back of the 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 heavy objects or sudden movements of the body may act as provoking factors. It is also typical that the pain intensifies when moving or going down stairs.
Peripheral nerve diseases can also cause pain in the calf muscles. With neuralgia, pain is paroxysmal in nature and occurs along the nerve fibers. In the intervals between attacks, there is practically no pain, and the painful attack itself can last from several seconds to several minutes. With Raynaud's disease, you may experience pain in your toes after they become “numb.”
If a person does not have neurological abnormalities, then painful muscle syndrome is caused by inflammatory or metabolic myopathies.
According to the international classification, myopathies are of three types: 1) caused by drugs and toxins, 2) idiopathic inflammatory, 3) caused by infections. 95% of idiopathic inflammatory myopathies are polymyositis, myositis, and dermatomyositis, which arise as a consequence of systemic connective tissue diseases. The cause of pain can also be myositis with intracellular inclusions and paraneoplastic myositis. In all these cases, consultation with a rheumatologist is necessary to prevent or identify a systemic disease, which resulted in pain in the calves. This type of myopathy, such as drug-induced, is most often associated with taking fibrates and statins.
Water-electrolyte imbalance. With some violations of 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, excessive vomiting or taking diuretics. Since disturbances in water-salt balance are not an independent disease, but arise as a result of some pathology, the symptoms will be different, but the main ones are considered to be constant thirst and widespread swelling. A decrease in blood pressure, palpitations and heart rhythm disturbances are also possible.
Pathology of subcutaneous fat tissue. Panniculitis is a progressive inflammatory lesion of subcutaneous fatty tissue, 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 is nodular formations located in the subcutaneous fatty tissue at varying depths. Most often they appear on the legs and arms. After the resolution of panniculitis nodes, foci of atrophy of fatty tissue remain, which look like rounded areas of skin retraction. The nodular variant of panniculitis is 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 over the nodes can have a color from normal to bright pink. The plaque version of panniculitis consists of separate clusters of nodes that, merging, form tuberous conglomerates. The color of the skin over such formations can be pink, burgundy or burgundy-bluish. In some cases, conglomerates of nodes spread to the entire tissue of the leg or thigh, compressing vascular and nerve bundles, which causes severe pain and swelling of the limb, leading to lymphostasis. The infiltrative version of panniculitis occurs with the melting of nodes or their conglomerates. In this case, in the area of the node or plaque, usually of a bright red or burgundy hue, a fluctuation appears, typical of an abscess or phlegmon. However, when the nodes are opened, it is not pus that comes out of them, but an oily yellow mass. At the site of the opened node, a long-term non-healing ulceration forms. In addition to local manifestations of panniculitis, there may also be general ones, such as weakness, malaise, loss of appetite, fever, nausea and vomiting.
Pain in the leg muscles in obese people. The cause of pain in the muscles of the lower extremities can also be obesity. If a person is overweight, then additional stress is placed on the lower limbs and they experience increased pressure. This inevitably leads to pain in the leg muscles, especially with small feet.
Analysis of clinical data is the first stage of the diagnostic process in patients with a complaint 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. general blood test (moderate neutrophilic leukocytosis with a shift to the left, aneosinophilia, moderately increased erythrocyte sedimentation rate in erysipelas and other infectious and inflammatory diseases);
2. electrolytes, urea, creatinine (assessment of water and electrolyte disorders);
3. blood glucose (normal levels are 3.3-5.5 mmol/l, an increase in glucose levels indicates the likelihood of diabetes mellitus);
4. Biochemical blood test: increase in uric acid with gout, increase in cholesterol levels with atherosclerotic vascular lesions;
5. Microbiological examination (for example, scraping from the urethra for chlamydia if reactive arthritis is suspected);
6. X-ray examination - specific changes characteristic of a particular pathology are revealed;
7. Testing for tumor markers if a malignant neoplasm is suspected;
8. Serological analysis: rheumatoid factor in rheumatoid arthritis;
9. Puncture bone biopsy for suspected bone tuberculosis and osteomyelitis: material for inoculation is obtained by aspiration of pus from the bone or soft tissue, or a bone biopsy is performed;
10. Ultrasound scanning (duplex scanning) of the vessels of the lower extremities allows identifying vascular diseases at the preclinical level;
11. Angiography of the vessels of the lower extremities is carried out if chronic venous insufficiency, atherosclerosis of the vessels of the lower extremities, etc. are suspected;
12. Magnetic resonance imaging and computed tomography (diseases of the nervous system, lymphostasis, etc.);
13. Rheovasography of the arteries of the lower extremities (chronic arterial insufficiency of the lower extremities);
14. Skeletal scintigraphy – when searching for metastatic foci of cancer;
15. Ankle pressure index (ALPI, the ratio of pressure in the arteries on the ankle to the pressure in the brachial artery, normally 1 - 1.2); a decrease in this indicator indicates the presence of narrowing in the arteries of the lower extremity.
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 leg muscles, you need to follow some rules:
1. In case of vascular pathologies, it is necessary to limit the content of fatty, cholesterol-rich foods in your diet. It will be useful to lose excess weight, as well as 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 at the ankle joint until sufficient tension is felt in the lower leg muscles 10-20 times.
- Circular movements of the foot in the ankle joint 10-20 times.
- Lateral turns of the foot 10-20 times.
- Flexion and extension of the toes 10-20 times.
Try to avoid being in a static, sitting or standing position for long periods of time. If your type of activity requires this, then you need to regularly take breaks, warm up, and change your body position. During your work break, do the following exercises:
- standing, roll from heel to toe 8-12 times;
- for 30 - 60 seconds, walking in place with a high rise of the shin.
2. If you have diseases of the spine or joints, you need to pay attention to the timely treatment of these pathologies and follow the doctor’s recommendations.
3. Periodic exercises aimed at strengthening the abdominal muscles will lead to the release of muscle tension in the lower back, which will reduce the likelihood of radiating pain from the lower back.
In all cases of prolonged or recurrent pain in the lower extremities, you should consult a doctor to undergo the necessary examination to identify the disease that caused this condition.
In the absence of timely diagnosis and treatment under the supervision of a doctor, the disease progresses and complications develop. One of the most dangerous 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.
Therapist, traumatologist - depending on whether there was an injury. You may need the help of the following doctors: infectious disease specialist, parasitologist, rheumatologist, vascular surgeon, oncologist, endocrinologist, neurologist, dermatologist.
General practitioner Kletkina Yu.V.
As mentioned above, causes of ankle pain can include sprains. They are often combined with microscopic tendon ruptures and muscle tissue injuries. Usually the pain in this case occurs suddenly after you twist your ankle, stumble, or land poorly after a jump. Cases of ankle sprains increase in winter when there is ice on the sidewalks. People who are actively involved in outdoor sports and weightlifting are at risk.
Another reason for constant aching pain in the ankle joint lies in the destruction of cartilage tissue in the lumbar and sacral spine. At the same time, the pain syndrome is not isolated. It covers the entire outer or inner surface of the thigh and lower leg. The pain may be shooting or stabbing in nature. Treatment in this case affects the underlying disease, such as a herniated disc, osteochondrosis or protrusion. It makes no sense to treat the ankle joint separately.
If your ankle joint hurts when walking and there is no discomfort at rest, then the cause of this symptom should be looked for in several directions. First of all, it is worth ruling out a heel spur. This is an overgrowth of bone tissue with an inflammatory process in the area of the lower part of the heel bone. Osteophyte is formed due to poor nutrition, wearing poor-quality shoes, or against the background of long-term degenerative processes in the ankle joint. Incorrect foot placement plays a huge role in the pathogenesis of this disease. Moreover, clubfoot and flatfoot have the same destructive effect. The pain in the ankle joint when walking in this case is acute. Soft tissues are injured. Purulent aseptic arthritis may occur.
Another common cause of this symptom is a sprained ligament. It is differentiated according to the cause-and-effect relationship between a fall, impact, dislocations and the development of a clinical picture of this type. To exclude bone cracks and muscle fiber ruptures, an urgent consultation with a traumatologist is necessary.
If you have not had an injury, but your leg constantly hurts in the ankle joint, then it is necessary to rule out arthrosis and arthritis. Typically, these diseases develop in people who, while performing professional duties, are forced to spend long periods of time on their feet. Increasing physical stress on the musculoskeletal system increases the chances of destruction of cartilage tissue.
Arthritis is characterized by redness of the skin, swelling around the ankle joint, and difficulty moving when flexing and extending the foot. The pain does not intensify when placing weight on the heel. A person can move independently. Lameness appears only in advanced cases. With arthritis of traumatic etiology, pain in the ankle joint is localized to one limb. In rheumatoid and reactive inflammatory processes, both limbs are involved. In this case, there may be associated pain in other large joints.
Arthrosis of the ankle joint is a fairly rare disease that mainly affects older people. The risk group includes people who have worked for a long time as loaders, sellers, painters, plasterers, turners, and welders. Sometimes it occurs as an occupational disease in athletes. Against the background of constant increased physical activity, bone tissue grows with concomitant destruction of cartilage. Pathological lesions are visible on x-rays. When walking, they irritate soft tissues, and reactive inflammation occurs.
Severe pain in the ankle joint is a reason to urgently seek medical help. It is important to promptly exclude injuries that may worsen without properly provided first aid. First you need to apply a tight bandage. After this, try to keep your leg horizontal. This will reduce swelling and reduce pain.
Be careful. Cracks in the heel bone can appear in a similar way. For them to occur, a jump from a small height and landing on the heel may be sufficient. Cracks also occur during tangential side impacts.
Another dangerous situation is tendon rupture due to a fall or dislocation. In this case, further movements in the ankle joint can only aggravate the situation by increasing the area of the wound surface and increasing internal bleeding. Typical signs of this condition: massive bruising, severe pain, limited or no mobility in the ankle.
In addition to the fact that sprain and injury could occur, it is worth remembering other causes of joint disease:
In some cases - within several days. And sometimes they reach a period of 3 weeks. After this, the pain goes away completely.
However, in the future, the area that has experienced pain and swelling may be weak and susceptible to other injuries. Therefore, it must be protected.
As a result of an infectious disease, or as a consequence of diabetes, the ankle suffers from pain and swelling. It is worth understanding the reasons for this.
No matter how old a person is, he may experience pain in this joint.
Often the pain occurs due to a dislocation, when a person fell on his knee and the ligaments were torn.
Such a rupture leads to severe pain, to which swelling and tumors are added. At the same time, it is no longer possible to move normally. But this reason is not the only one. There are others too.
For example, the ankle contains parts such as tendons, cartilage, and blood vessels. And when the integrity of at least one of them is violated, pain and swelling occurs. As a rule, this is a consequence of fluid accumulating in the surrounding tissues.
The severity of each ankle injury can be different and the consequences from it are also different.
If a person feels pain in the ankle, swelling has appeared and it is already difficult to walk, then the best solution would be to consult a doctor.
After all, he will be able to conduct diagnostics, during which he will be able to determine what the basis of pain and swelling is.
What is special attention paid to during therapy?
Here are its main principles:
In this case, an important role is given to the cause of swelling, because this is the only way to begin effective treatment. It is noteworthy that you can be treated right at home. At the beginning of such recovery, you can use cold compresses and pain-relieving ointments.
What if the cause of the pain is arthritis or arthrosis? Then it is worth purchasing non-steroidal drugs. If you add physical education and physiotherapeutic procedures to such treatment, it will be more effective. In addition, it is important to remember that in some cases a special diet will be required to help relieve swelling.
The important point is that you should not think that swelling is a specific disease. It is only a sign that pathological changes have occurred in the body. In this case, it is not just the symptoms that are treated, but the cause of their manifestation.
Only with a good examination can you choose the right and appropriate treatment. In some cases, surgery cannot be avoided, during which immobilization of the joint will be required. When a patient notices that pus is accumulating in his joints, it is important to take measures to remove it.
In this case, antibiotics and steroids are prescribed. Horse chestnut has become a good medicine, which is included in some drugs. Lysine aescinate can be administered intravenously to relieve pain. And to eliminate swelling, Aescin gel is used for several days.
In order to restore hemodynamics and strengthen the veins, the following solution can be administered:
If you want to completely eliminate swelling, then you cannot do without a full course of examinations.
Watch a video about the causes and treatment of ankle pain:
Treatment with folk remedies:
First you need to cut off a piece of fat and place it on the area of the body that hurts. The lard should be salty.
For insulation, an oilcloth and a scarf are placed on top. Until the lard becomes a sieve, it should not be removed. Do this procedure until the pain goes away.
Make such a compress every evening and keep it on all night, and soon you will notice that joint mobility improves.
If you feel severe pain in your ankle, then first of all protect it from any stress. To do this, it is important to rest for several days and not touch the painful area.
In some cases, crutches will be needed to relieve stress on the ankle while walking.
If you notice that your ankles are starting to swell, it is important to keep your leg elevated above the level of your heart for 15 minutes. If you apply ice compresses every day for 15 minutes, you can significantly reduce the pain.
If the pain is unbearable, then medications such as acetaminophen and ibuprofen are used.
And then it is important to contact a specialist to completely get rid of pain.
If your joints hurt, it is very important to know the cause of such discomfort. This will help you quickly select effective treatment and begin to get rid of the disease.
To eliminate pain, it is first necessary to eliminate the causes of its occurrence. Let's look at the most common of them.
Gout is a special inflammatory process that affects the big toe and the foot itself.
This disease can occur for several reasons:
The latter cause of the occurrence and development of gout leads to pain in the ankle while walking. Excessive amounts of this substance are not excreted through waste products, but are deposited in the body. Blood and joints are affected.
Arthritis is a disease that is similar in nature to gout. It can be called a consequence of this disease.
Arthritis appears as a tumor that affects one or more joints. This tumor occurs due to excess uric acid and its deposition in the body.
This disease is typical for older people with limited activity. It negatively affects the condition of the leg joints.
Osteoarthritis is a disease that is directly related to the cartilage of the ankle joint. Due to many factors, cartilage wears out greatly, loses its original properties, and cannot perform its functions to the required extent.
This leads to significant disturbances in the functioning of the joints.
Osteoarthritis should never be allowed to develop. In the absence of timely diagnostic and therapeutic measures, the cartilage of the ankle joint may disappear completely. Strong bone friction occurs. This inevitably leads to weakening of muscle tissue and ligament dysfunction.
This disease is a type of arthritis. It is accompanied by changes in the condition of the skin. Red rashes that resemble small scales begin to appear.
In addition to changes in the condition of the skin, symptoms such as swelling of the limbs and direct pain may be observed.
This type of arthritis is characterized by disturbances and malfunctions of the immune system. As a result, the joints and tissues that surround them are affected.
In this case, the inflammation is long-term and affects absolutely healthy tissue.
Septic arthritis is directly related to blood contamination by pathogenic bacteria. Can infection enter the body in a variety of ways?
Septic arthritis can lead to blood poisoning and death. The main symptoms of this disease are swelling of the limb, severe and prolonged pain, fever, etc.
Dislocation is a common occurrence. Many people do not even realize that they have such an injury.
It is accompanied by sprain or complete rupture of the ligaments. This causes severe pain.
A dislocation can be caused by failure to follow the proper technique for performing various physical exercises, or by walking on uneven road surfaces.
Symptoms accompanying pain are swelling of the limb, hematoma formation, etc. Symptoms completely depend on the severity of the injury.
Plantar fasciitis is a disease of the connective tissue covering the bone structures of the foot.
This disease most often affects people who regularly engage in intense physical activity. This lifestyle puts a lot of pressure on the feet and the connective tissues in the feet.
The following categories of people are also susceptible to this disease:
The heel bone is one of the most important components of the body's bone structure. It provides great support to the musculoskeletal system when walking.
The heel bone is quite often susceptible to fractures. It is quite easy to injure it - when falling from a great height or regular loads.
But there are other causes of pain in the ankle joint that are in no way related to specific injuries and diseases of the lower extremities. Such reasons include:
Quite often, due to the lack of necessary information, people postpone an appointment with a specialist or do not visit him at all. Who should I contact if I have this problem?
The main specialist in this area is a traumatologist. Even if the pain is not due to herbs, this doctor will prescribe an effective diagnosis for you. Based on its results, decisions on further treatment will be made.
The traumatologist will first of all send you for an x-ray. From the picture it will be more clear about the cause of the pain.
It is immediately clear that in order to get rid of ankle pain, it is necessary to cure the cause of its occurrence. Based on the information described above, we can say with confidence that these reasons can be very different. Treatment in each case is selected by a specialist in a specific area.
Using ice will help temporarily relieve pain. Ice compresses and ice packs - all this can temporarily relieve the patient from discomfort.
Quite often, if the ankle hurts when walking, treatment is carried out independently, using traditional methods. Not all of them are effective. Many can lead to unpleasant consequences. This once again proves that you cannot self-medicate.
A fairly common mistake in treating foot pain is keeping the feet warm. Various dressings and bandages are applied to create a greenhouse effect. But this can only worsen the swelling of the legs and increase the pain.
The second mistake in treatment is active rubbing and massage of the ankle. Any such effects can only increase discomfort, especially when pain occurs due to problems with ligaments.
The most important task of treating this disease is to restore the ankle joint and relieve severe pain when walking. This can only be achieved through a set of procedures. It includes the following activities:
Additional measures include taking those medications that reduce the risk of re-infection of tissues and blood, increase the rate of tissue regeneration, etc. Such drugs significantly increase the effectiveness of the main treatment. But it is useless to use them yourself; this can lead to serious consequences.
Many experts advise regularly consuming vitamin complexes. They are necessary to maintain normal levels of useful elements in the blood. This will strengthen the patient’s health and improve his well-being.
Attention! The prescription of vitamin complexes should be made only by a specialist. Uncontrolled use of such drugs can lead to the occurrence and development of allergic reactions. When selecting vitamins, the specialist takes into account your health status, the severity of the disease and many other factors.
Prevention is a very important step that can maintain an optimal level of your activity and maintain your health at the proper level. There are several basic rules to avoid ankle pain.
The very first rule is choosing the right shoes. It should fit you in size, provide normal stability when walking or running, and prevent slipping.
Quite often, feet hurt when wearing high-heeled shoes for a long time. It is worth limiting the time you wear such shoes to several hours.
Particular attention should be paid to shoes for sports. It should be as convenient and comfortable as possible, without restricting the foot.
The second rule is proper nutrition. Proper nutrition allows you not only to maintain the health of the whole body, but also to get rid of excess weight. Excess weight is the main cause of excess pressure on the ankle joint. This leads to severe pain.
Diversify your diet with healthy foods. This will allow you to maintain normal levels of all necessary substances in the body. Don't neglect foods that contain iron and magnesium. They have a positive effect on the condition of bone structures.
Incorporate physical activity into your life. It is important to control its intensity and duration. An excellent option for maintaining healthy legs would be those sports that do not require much stress and evoke only positive emotions in you. Take up dancing, Pilates, fitness or swimming. Regularly walk outdoors, ride a bike or rollerblade.
But you should approach sports with caution. This is especially true for those cases where there is a predisposition to such diseases. If you feel severe fatigue, discomfort and pain in the legs, or general malaise, you should immediately stop playing sports, normalize your breathing and then stick to a more moderate pace.
To stimulate blood circulation and improve tissue condition, you can do therapeutic massage. To achieve best results, it must be done regularly. The massage must be performed by a specialist.
An excellent method of prevention and immediate recovery is physical therapy. A set of exercises allows you to restore the activity of muscle tissue, strengthen blood vessels and joints, and restore their lost functions.