Why swollen legs ache from indomethacin
Swelling of the legs - excessive accumulation of fluid in the soft tissues of the legs.
Legs can become swollen and in practically healthy people. As a rule, this is preceded by excessive and unusual for the person physical exertion on the legs (long standing in a standing position, unusually long walking, etc.), wearing uncomfortable shoes or very tight clothes that compress the vessels of the legs. But often swelling of the legs is a symptom of various diseases, including very serious ones.
Cardiac (cardiac) edema on the legs
Most often, swelling on the legs is due toheart failure. Lead to the appearance of cardiac (cardiac) edema can various diseases: heart disease, myocardial infarction, atherosclerotic cardiosclerosis, congestive cardiomyopathy, cardiac aneurysm. Simultaneously with edema on the legs with these pathologies, an increase in the size of the heart, liver, and cardiac arrhythmia (most often atrial fibrillation) can be determined. In most cases, the development of cardiac edema on the legs is preceded by the appearance of dyspnea.
Cardiac edema on the legs are locatedsymmetrically, grow slowly, spread, as a rule, from the bottom up. By the evening cardiac swelling of the feet is worse. Skin over the area of edema is cold, cyanotic. To the touch soft fabrics have a dough consistency. When pressing on the area of edema, there remains a long-terminating fossa. With the long existence of such edema, trophic skin changes, dermatitis, and cracks can develop. If a person with cardiac edema of the legs is forced to remain in a lying position for a long time (with severe infection, a spinal fracture), then the swelling on the legs may decrease or completely disappear, and instead they will appear in the lumbar region.
Swelling of the legs due to a violation of venous outflow
Another important reason for the appearance of edema of the legs -violation of venous outflow. This mechanism of edema formation occurs with varicose veins of the legs, thrombophlebitis of the deep veins of the shins, postthrombophlebitic syndrome, and inferior vena cava syndrome.
With varicose veins of the legs, the appearance of edemapreceded by a feeling of heaviness in the legs, aching pains and convulsive muscle contractions at night. In the beginning, after a long walk or standing, the foot and shin pastes appear pasty. These symptoms can be accompanied by a distinct expansion of the subcutaneous veins and skin itching. The edemas on their feet are more pronounced in the evening, and during the night they decrease. To the touch, they are dense, they can increase if thrombophlebitis is attached, lymphangitis. With the process running, in addition to edema on the legs, eczema, trophic ulcers, and dermatitis may also occur.
For thrombophlebitis of the deep veins of the lower legs are characteristicpain in the calf muscles, increasing with movements in the ankle. There may also be an asymmetric swelling in the ankles (you can detect this by measuring the circumference of both shins in symmetrical areas by measuring the centimeter tape). Also, in the region of the shins, a local increase in body temperature can be detected, soreness in probing.
Post-thrombophlebitic syndrome is characteristic ofwomen aged 30-60 years. For this pathology, edema of the legs on the legs is inherent, less on the thighs. These swellings increase with prolonged standing, towards evening, and decrease - in a lying position, especially with a raised leg. As a rule, swelling occurs on one leg. It is accompanied by a feeling of heaviness in the leg, drawing pains that increase with physical activity. With pressure, the fossa, as a rule, does not remain. The skin of the affected shin is thinned, the hair disappears, cyanosis and brown pigmentation appear, especially in the lower third of the shin.
The syndrome of the inferior vena cava is due todisorders of blood flow in the system of the inferior vena cava. With this pathology, swelling can cover the legs completely, extending to the buttocks, genitals, anterior abdominal wall. Swelling can be accompanied by aching pain in the legs with spread to the groin, buttocks, abdominal wall. In addition, multiple trophic ulcers develop on the shins, which practically do not lend themselves to conservative treatment.
Edema of the legs due to impaired lymph flow
Swelling of the legs can be associated with a violationlymph drainage from the lower extremities at a certain level. One of the causes of this condition is inflammatory damage to the lymphatic vessels (lymphangitis). Usually lymphangitis is a complication of purulent-inflammatory disease of the extremities. In most cases, one limb is affected. Locally, swelling, fever, redness will be determined. In the course of the lymphatic vessels, painful tendons and densifications will be palpated. Edema of the limb arises when deep lymph vessels are involved in the process.
Another reason for impaired lymph flow -elephantiasis. Primary elephantiasis is the defect of lymphatic vessels at the level of deep trunks. Puffiness first appears on one leg, then the second leg is also involved in the process. But the asymmetry of the legs is mostly preserved. Edema in this pathology is 3 stages. The first stage is lymphedema (soft lymphatic edema). They increase with prolonged standing, in hot weather, decrease in the supine position. These swellings have a dough consistency. The skin over them is not changed, pale, it is easily displaced, at pressing there is a fossa. In the second, transitional stage, fibrotic changes develop in the distal part of the foot: the skin thickens, is poorly displaced, the depression does not remain with pressure.
The third stage of primary elephantia is fibredema(complete fibrosis). It is characterized by hyperkeratosis (excessive thickening of the stratum corneum of the epidermis). The tissue grows in the form of formless mounds, separated by deep folds. Accompanying complications - trophic ulcers, dermatitis, a purulent-septic infection can develop.
Secondary elephantism can arise ascomplication of pustular inflammations of the skin (pyoderma), chronic inflammation of the vagina or rectum, erysipelas, after the transferred lymphadenitis and lymphangitis, when lymphatic vessels are compressed by scars after deep burns, trauma. Clinical manifestations of secondary elephantiasis are the same as in the case of primary elephantia.
Swelling of the legs due to inflammatory processes, insect bites
Edema on the legs may appear on the backgroundinflammatory processes on the legs (with erysipelas, phlegmon, abscess), combined with severe symptoms of the underlying disease. Such swelling is vague, accompanied by classic signs of inflammation (redness, pain).
Edema on the legs can occur as a reaction to the bites of insects, snakes, other poisonous animals, the impact of combat irritants.
Swelling of the legs against a background of neurological, endocrine diseases
Another reason for edema on the legs -neurological diseases (a stroke that caused paralysis of the lower extremities), poliomyelitis, syringomyelia. In the affected limbs, the permeability of capillaries rises, with moderate edema of paralyzed limbs.
Edema on the legs can develop with endocrinediseases. So, owing to myxedema, swelling of the subcutaneous tissue (shins, face) appears. To the touch they are dense, the skin above them is not going to fold. When pressing on such edema, the hole does not remain.
Swelling of the feet during pregnancy and premenstrual syndrome
Quite often swelling of the legs (ankles) appear in thelate pregnancy (after 30 weeks). The appearance of such edema is caused by hormonal changes in the body of a pregnant woman, leading to violations of water-salt metabolism and blood circulation in the capillary system.
Swelling of pregnant women (dropsy of pregnant women) can besuspected of a more significant weight gain. Normally, the pregnant woman gets 300-400 grams per week, with a drop of pregnant women gaining weight in a week may be 1-2 kg. First, edema appears on the feet and legs, then rises higher. Even with a severe course of dropsy of pregnant women, there is no accumulation of fluid in the abdominal or thoracic cavity (ascites or hydrothorax).
When pregnancy swelling on the legs can developand with nephropathy of pregnant women (kidney pathology). In addition to edema on the legs, there will be changes in the analysis of urine (increased protein content) and arterial hypertension.
Women may experience minor swelling in thelegs in the second half of the menstrual cycle (edema with premenstrual syndrome). They are associated with hormonal imbalance (excess estrogen and a lack of progesterone), as a result of this changes in vascular permeability, there is a delay in sodium and water in the tissues of the body. Premenstrual edema can appear in the area of the feet and shins, and after the termination of the menstrual flow rapidly decrease and disappear.
Moderately expressed swelling of the legs may appear andwhen using certain medications. To the medicines having this effect, include estrogens, androgens, DOXA, drugs from licorice root, reserpine. After the abolition of the corresponding drugs, edema is passed.
People whose work is associated with long-termstaying in the standing position (sellers, lifters), there may be orthostatic swelling. Appear such edema on the feet and legs, mostly in the evening. They are expressed moderately and pass independently after rest.
If the swelling on the legs have arisen recently, are expressedmild or moderate, their appearance was preceded by a prolonged stay in a standing position or other unusual physical activity for you, and there are no other alarming symptoms, then you can wait with a visit to the doctor.
At home you need to wash your feet, you can takecontrast shower, and then you need to rest your feet. To do this, take a horizontal position, the legs should be slightly raised (you can put a high pillow under your feet).
If swelling does not come off in the morning (or go downpartially), and you will not have the opportunity to visit a doctor, you can drink a diuretic. A quick effect can be obtained after using furosemide (lazix). However, furosemide, together with the liquid, promotes the excretion of potassium from the body, which can adversely affect the work of the heart. Therefore, the most safe diuretics are potassium-sparing diuretics - veroshpiron (spironolactone). Take it 1 tablet (25 mg) for several days, preferably in the morning. If you take diuretics before bed, the diuretic effect of the drug will reach its maximum at night, which will lead to sleep disturbance.
On their own, leg swelling is not a symptom,requiring urgent medical attention. But in a number of cases, when they are a manifestation of serious diseases and occur simultaneously with their other symptoms, emergency care is needed. For example, when the swelling of the legs is combined with other manifestations of a pronounced allergic reaction (edema of the whole body, the appearance of a large rash, asthma attack, asthma, etc.), with a violation of the heart rhythm, the release of foam from the respiratory tract (with acute heart failure). With the development of such conditions, it is urgent to call an ambulance.