Edema of the legs from the knee to the foot
Very often, seeking medical helpdoctors of different specialties are associated with diseases in which the legs hurt from the knee to the foot. Such a complaint can not be regarded unequivocally, since there are more than enough reasons for its appearance. Their description and valuable advice on choosing the right treatment tactics are given in this article.
What can be caused by pain in the legs
The main causes of pain in the legs below the knee level are shown in the table.
Anatomical structures that are the source of pain
Soft tissues (skin, fascia, muscles, subcutaneous fatty tissue)
- Fasciitis and fasciol cellulitis;
- Suppurative diseases;
- Trophic ulcers.
- Physical overwork;
- Post-traumatic hematoma;
- Stretch and tear.
Dense connective tissue formations (tendons, ligaments)
- Tendonitis and tendovaginitis;
Stretches and tears of tendon-ligamentous complexes
Knee joint injury with:
- Purulent bursitis;
- Acute and chronic osteomyelitis.
- Acute synovial rupture in the knee joint;
- Contusion of the tibia;
- Complete and incomplete fractures of the bones of the lower leg.
- Varicose veins of the lower extremities;
- Venous insufficiency;
- Acute and chronic thrombophlebitis;
- Post-thrombophlebitic disease.
Reduction of vascular lumen, formation of thrombi
- Obliterating atherosclerosis of the vessels of the legs;
- Obliterating endarteritis;
- Burgess's disease;
- Diabetic angiopathy;
- Raynaud's syndrome;
- Chronic arterial insufficiency;
- Thrombosis and embolism of the arteries of the lower extremities.
Lymphostasis or elephantiasis on the background:
- Pathology of veins;
- Chronic erysipelatous inflammation of the lower leg;
- Postponed suppuration and trauma;
- Inguinal lymphodiscussion after oncological operations.
- Polyneuropathy of various origin;
- The defeat of nerve structures in diabetes mellitus;
- Discoogenic radiculopathy;
- Osteocondritis of the spine;
- Intervertebral hernia;
- Injuries and inflammatory-degenerative diseases of the spinal cord.
Combined lesion of several anatomical formations
- Periods of active growth of children;
- Hormonal changes in the body (especially in premenopausal women);
- Congestive heart failure;
- Diseases of the endocrine system, accompanied by violations of the mineral-electrolyte metabolism;
- Pregnancy and the puerperium;
- Lesion of leg bones in leukemia;
- Disorders of posture (curvature of the spine, flat feet);
- Insufficient level of physical activity.
Important to remember! One of the common causes of pain in the legs is the surgical interventions on the arteries, veins, bones of the lower limbs and the spine. Damaged structures, despite the restoration of integrity, become a source of periodic pain!
Basics of a differentiated approach to clarifying the most likely cause of pain
In order to determine why the shins hurt, you need to follow such rules:
- Be sure to detail all the characteristics of the pain syndrome: when it occurs, how much will continue, where the pain is localized, its nature, under what conditions it decreases.
- The account of the anamnestic data: age, a floor, accompanying diseases, the transferred traumas and operations.
- A thorough examination. Not only pain zones should be inspected. Complex evaluation of all vital body parameters (temperature, skin color, pulse characteristics, blood pressure, palpation of the abdomen and lymph nodes, etc.).
- Evaluation of the results of additional research methods: clinical analysis of blood and urine, radiography, ultrasound, etc.
- Dynamic monitoring of pain syndrome. Very often it is impossible to correctly determine the causes of acute pain in the legs during a primary examination. Even a brief observation of the patient pushes the idea of a correct diagnosis.
Important to remember! The presence of persistent pain in the legs, especially in combination with any other complaints, is the reason for immediate appeal to specialists. Under the mask, at first glance, the usual harmless symptoms often hide serious diseases that can not immediately be recognized even by professionals!
Pain syndrome with lesions of the soft tissues of the shins
To suggest that the pathological changes in the soft tissue of the lower leg (skin, muscle, fascia of the tendon) are the cause of leg soreness, the following symptoms may occur:
- With myositis and tendovaginitis, the legs ache in the projectiona certain muscle or a muscle complex of one of the limbs. Pain is enhanced by palpation and physical strain of the shin. Often an increase in muscle tone in the form of a dense strand is determined.
- Redness of the skin with local edemathe lower leg speaks of inflammatory-suppurative changes in soft tissues. If they are combined with an increase in body temperature and the throbbing pain of the reddened area, which increases with palpation and walking, the cause becomes obvious. It can be an abscess, a phlegmon, a carbuncle, a suppressed hematoma.
- Common redness of the skin in combination withexpressed by circular edema of the leg below the knee and foot, sharp hyperthermia to high figures (39˚С-40˚С) is characteristic for two diseases: erysipelas and fasciitis.
- The presence of injuries during the week before the onset of pain in the leg should be the reason for the exclusion of post-traumatic hematomas, sprain-rupture of ligaments, muscles and tendons.
To diagnose all these diseases, you needseek medical assistance from an orthopedic trauma specialist or surgeon. Treatment includes the creation of functional rest of the affected limb (plaster bandage, orthosis, elastic bandaging), anti-inflammatory drugs, thermal compresses, physiotherapy procedures. When infectious and suppuration, antibiotics are prescribed.
The prolonged existence of varicose veins leads to a constant progression of venous insufficiency, the appearance of trophic skin disorders and the intensification of pain in the legs
Pain in the lower leg with diseases of the knee joint
A frequent reason for discussions between surgeons andorthopedic traumatologists become pain in the knee and below it. With such diseases as arthrosis-arthritis and acute synovial rupture in the back pouches of the knee, a large amount of fluid accumulates. Perhaps the formation of Baker's cyst. Against this background, there is a pronounced stretching of the soft tissues that cover them. In the first place, these are the muscles of the posterior group of the lower leg. Therefore, patients can complain that when walking this area is very sore. The pains are combined with a small local edema, muscle tension and the inability to completely bend the leg in the knee due to the sensation of a foreign body in the popliteal region.
The second most frequent disease isprostatellar bursitis. Characterized by severe soreness along the anterior surface of the upper third of the tibia and patella. It is always combined with redness and swelling of the skin in this area. It is possible to increase the body temperature with suppuration bursitis.
Pain in the pathology of the lympho-venous system of the lower extremities
To suggest that the pain in the legs from the knees to the feet is associated with the problems of venous circulation, such symptoms may occur:
- the presence of varicose transformed superficial veins;
- the appearance of vascular asterisks;
- trophic changes in the skin and subcutaneous tissue (darkening, ulcers, densification, pigment spots);
- swelling of the legs and feet;
- reddening of the skin along the inner surface of the thigh and lower leg in the projection of the course of the large saphenous vein.
For all types of this pathology,intense character. Most patients complain of heaviness in the legs, which increases by the evening, there may be intense pain along the course of the dilated veins. The only exception is patients with decompensated venous insufficiency and the formation of trophic ulcers. Affected areas of them hurt very much.
With lymphostasis, moderate pains are combined with marked dense edema of the shins and the back surface of the foot. The second component is a specific sign of the lymphatic nature of the edema.
Pain in the arterial vessels of the legs and peripheral nerves
Specific symptom of occlusal involvementarteries of the lower extremities - intermittent claudication. This means that a person, after walking a short distance, is forced to stop due to the fact that the shin is badly hurt. If the pains occur at night in a state of rest and are combined with pallor, cold skin of the feet, darkening of the fingers, this clearly indicates severe violations of the patency of the arteries. Such patients need urgent consultation of a vascular surgeon.
Pain in the defeat of peripheral structuresThe nervous system is always acute intense. Very often it is clearly localized in the form of a band along the peripheral nerve and has the character of a lumbago. If the spinal cord is affected, peripheral paralysis of the foot or of the entire lower limb, weakening of muscular strength.
The muscles and bones of the shins experience a tremendousload. Therefore, they often ache or ache with any changes in the body. Such physiological conditions include pregnancy, rapid weight gain, physical overfatigue as a result of unusual loads, periods of active growth in children. Pathological conditions can be: osteoporosis of various origin, metabolic disturbances in the body, infiltration of bone tissue by immature leukocytes in leukemia, flatfoot and curvature of the spine. In all these cases, the pain is moderate, intensified against the background of a long stay on the legs and decreases after rest.
Important to remember! Pain in the legs is a nonspecific symptom, which can be a signal of both pathological and physiological changes in the body!