Legs are in the grip of that. When the joints are in a vice: how to deal with gout? Situation: bruises appear on the big toes, nails turn black

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Are your sneakers always laced up the same way? But in vain! Changing the usual "crosses" to a more intricate scheme is not only fun, but also useful. Want to know why? Let's figure it out.

Usually such experiments are embarked on the sole purpose of making an impression. Indeed, a pair of bright, colorful laces that seem to "stitch" the sneaker with fancy stitches and eyelets look amazing. But few people know that by passing them into the holes in different ways, you can solve many problems that arise during training. Here is some of them.

Situation: laces are constantly untied

What to do? Try replacing them first. “This happens most often with synthetic round laces,” says a sports doctor. Evgeny Belyanushkin... - Whereas flat cotton will be much more "obedient". Tie them with a double knot for safety reasons. Alternatively, you can pass their ends in parallel through the upper holes: one through both penultimate holes, the second through the last. It will be more difficult for you to put on your sneakers, but the problem will be solved. " Durable lacing will protect you from possible injuries and even falls.

Situation: bruises appear on the big toes, nails turn black

What to do? Best of all, change your shoes as they are almost certainly too small for you. “Sports shoes should be bought by size,” comments Elena Palaguta, instructor of group programs "World Class Zhitnaya". "These are not leather shoes - don't expect them to stretch over time." When you try on a pair you like, try to determine what is the gap between the tip of the big toe and the toe of the sneaker, Evgeny Belyanushkin recommends. - The distance should be 0.5-1 cm. Otherwise, the finger will hit the toe of the shoe all the time, with force to rest against it while moving downhill - for example, on a jog or on a "track" operating in the "hills ". Hence the darkened nails and bruises. " To ease your position, try loosening the laces a little - this will give your fingers some extra space.

Situation: Heels slip during cardio

What to do? And, again, choose shoes by size. “If the sneakers are too big for you, you can partially correct the situation by putting on rather dense cotton socks under them,” explains the sports doctor Evgeny Belyanushkin. Did not work? Try using the lacing technique. To do this, guide the laces from the bottom as usual. But leave the two upper holes on each side free and "conjure" a little with them. Take one of the ends and first pass it through the last hole from the inside out, then through the one under it, inward. Repeat with the second tip to form a buttonhole on both sides. Thread the ends into opposite loops, tighten well and tie.

Situation: the shoe squeezes the toes a lot

What to do?“This is not such a rare situation,” says Elena Palaguta. - Sports shoes vary in size, but not in fullness - as a result, girls with wide feet suffer from the fact that they are pressed by sneakers. As a way out of this situation, you can try to choose a model with a fairly wide toe. When buying, turn over the pair you like, take a look at the sole, and it will immediately become clear to you how spacious it will turn out to be. Also, keep in mind that your foot will swell and grow slightly during exercise. " Have the sneakers already been purchased and need to “work with what we have”? Try to loosen the laces. It should securely fix the shoe on the foot, but not squeeze the legs, as in a vice. You can also use the incomplete lacing technique. From the lowest hole to the third, run the lace along the inside of the shoe, bypassing the second. Further, to the ankle, go according to the usual pattern.

Situation: the feet are cramping - they hurt

What to do? First, try to lacing your sneakers less tightly. By tightening them with force, you deprive the foot of the ability to move normally, pinch the blood vessels, squeeze the small bones, of which there are many. Perhaps the solution to the problem will be the following scheme. Pass the laces, as usual, through the two pairs of lower holes, and out through the third. And then pass each end with "stitches" on its side. At the top, tighten the laces again in a crisscross pattern and tie. “However, it is not a fact that this will solve the problem,” says Yevgeny Belyanushkin. - Feet often reduces with flat feet. In this case, it is more important to replace the insoles in sneakers with anatomical ones. Initially, they are the most common in sports shoes and cannot provide the necessary support for the foot with a lack of shock-absorbing properties. "

• Don't hide the ends of your laces inside your sneakers. When you bring them under the tongue, they press on the foot, when they "lay" on the sides - they hammer under it or rub. If they are too long, just trim them.
• Be sure to tie the ends. If, instead, you simply put them inside the shoe again, then this is not only inconvenient, but also dangerous. As you move, the lacing will loosen, you will begin to curl your toes, trying not to lose your shoes, and, in the end, you may get injured.
• Tighten the laces not only at the top, but also along the entire length... Pull them up each time you pass them through the next pair of holes.

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Leg pain is caused by a combination of symptoms arising from various diseases of the lower extremities. They manifest themselves in the form of painful sensations of an acute or pulling character. As a rule, it accompanies diseases of the muscular or vascular systems, and is also a consequence of injuries or neurological abnormalities.

Causes of leg pain

Disorders in the vascular system of the lower extremities are considered the most common cause of pain in the legs. This can be caused by atherosclerotic changes leading to a narrowing of the vascular lumen and a decrease in blood flow to muscle tissue. As a rule, varicose veins subsequently develop, which is also accompanied by painful sensations.

The risk of impaired blood supply in smokers, hypertensive patients, diabetes mellitus, stroke, heart attack significantly increases. Lack of oxygen causes blockages in the arteries, most often in the form of sudden cramps when walking.

Leg pain is also present in neurological disorders due to inflammation and irritation of the nerve fibers that innervate the legs. Pain is often caused by gout and arthritis, which cause joint inflammation. The cause of leg pain may be associated with diseases of the lower spine, for example, in the vertebral column, pulling pains in the leg are often noted.

Disruption of the venous system is characterized by a decrease in pain when lifting the leg; for problems with arteries, the pain subsides a little if the leg is lowered. Numbness and tingling in the lower extremities indicates the presence of diseases of the spine.

Symptoms of leg pain

With the development of venous stasis, pulling dull pains in the legs appear, a feeling of tension and heaviness is created. If the process has a protracted course, then most often it ends with varicose veins of the lower extremities. The pain is pronounced and manifests itself most often in the lower part of the limb, while patients may feel a feeling of numbness, tingling. As a rule, it occurs in the late afternoon, after prolonged exertion in a standing or even sitting position.

Pain can also occur when exposed to heat in a sauna, steam bath, or while taking a hot bath. In women, it is provoked by a change in hormonal levels, which is associated with the menstrual cycle. Externally, varicose veins are manifested by protrusion of the venous nodes and the appearance of spider veins.

Infectious diseases such as osteomyelitis, which cause acute, prolonged pain in the bones of the lower extremities, are very dangerous and have extremely serious consequences.

Injuries and bruises of the lower extremities, alone or in combination with other injuries, often cause pain in the legs. Most often, bruises of the legs occur, swelling and hematoma form in their place. The nature of the pain is determined by the location, the degree of its intensity and the area of ​​damage.

The disease is accompanied by congestion in the superficial veins of the lower extremities, a decrease in elasticity and an increase in the permeability of the vascular wall. In the later stages, the pathology can be complicated by thrombophlebitis, which is characterized by the formation of blood clots on the inflamed mucous membrane of the veins. This causes a constant pain syndrome against the background of edema and heaviness in the muscles of the legs.

Atherosclerosis of the arteries

Violation of water-salt metabolism

In case of violation of water-salt metabolism, a decrease in the concentration of potassium in the blood serum occurs. This chemical element is responsible for the processes of excitation in cells and the transmission of neuromuscular impulses. As a result, there is a violation of the contraction of muscle cells, including the lower extremities. Potassium loss can be caused by:

1. Diseases with profuse diarrhea.
2. Conditions accompanied by profuse vomiting.
3. Uncontrolled intake of diuretics.

As a result of dehydration, there are:

• chest pain, rhythm disturbance;
• decrease in blood pressure;
• feeling thirsty;
• cramps of the lower extremities;
• pain and heaviness in the calf muscles;
• violation of motor function, up to the development of paresis and paralysis.

A critical decrease in the level of potassium in the blood can be fatal as a result of cardiac dysfunction.

Calf cramps, which are more common at night, may indicate a lack of magnesium in the body. Usually, taking this element will fix the problem.

Excessive physical activity

With fatigue and overtraining, heaviness in the legs occurs as a result of excess accumulation of lactic acid and does not need treatment. Discomfort in the calf muscles associated with diseases requires careful diagnosis and the appointment of complex therapy.

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1. Hello Anastasia.
   Consultant doctor's answer:

   There are more than enough reasons for pain:
   the outflow of venous blood is disturbed;
   a focus of inflammation arose in the nerve fibers at the periphery.
   If the pain is pulsating, then there may be an inflammatory process in the vein. If the place swells and is compacted - the development of thrombophlebitis, which is fraught with the separation of a blood clot at any time.
   In a sitting position, calves begin to ache with a deficiency of vitamins, microelements, in particular calcium in the body. It is worth revising the diet, taking a general and detailed blood test.
   Perhaps there are problems of a neuralgic nature or there have been old injuries in the case of sprains or muscle sprains.
   Calves hurt also in case of vascular diseases, impaired circulation of venous blood. When walking, the blood rises. With prolonged sitting, it begins to stagnate in the calf muscles. The reason for this is a sedentary lifestyle, overweight, or accumulation of toxins, oxygen starvation in the muscles.
   With inflammation of the sciatic nerve, the spine itself does not hurt, but paroxysmal pain occurs in the muscles.
   It is osteochondrosis, as you noticed, that leads to muscle discomfort. The reason for this is a pinched nerve, damage to the nervous system at the periphery. You need the help of a neurologist and most likely you need to contact him.
   The musculoskeletal system has a complex structure, is practically entangled in nerve fibers, and pain can radiate into the calves of the legs from almost any node of the peripheral from the spinal column. As a rule, blood circulation is impaired in one leg, i.e. in the place of pathology and has a local flow. What to do, the joint loses its elasticity and flexibility.
   A comprehensive examination, CT, MRI is required. If the cause of pain in the gastrocnemius muscle is unclear, it is the syndrome that needs to be eradicated, and not the pain itself, by rubbing in various ointments and gels. Try anti-inflammatories and to increase blood flow. Apply a cold towel to the sore spot.
   You need to see a rheumatologist, an infectious disease specialist. And, of course, only complete diagnostics. Massage, physiotherapy, therapeutic mud, foot baths with the addition of nettle, mint, chamomile, sage, plantain should be beneficial.

2. Hello.
   Sorry for the delay - I just arrived.
   Consultant doctor's answer:

   It is not entirely clear what “sensations as if they are driving through a hematoma” means. Does your son feel in your leg or do you feel as if you are feeling the fluid structure? Or is it about pain in your son, similar to that if you touch a bruise on the skin?
   If we are talking about a suspicion of the presence of fluid, then it is necessary to urgently contact the surgeon directly.

   If we are talking about pain, and such sensations have not been observed before, then they can really be associated with severe hypothermia against the background of a recent cold and pharyngitis. With viral diseases, the vessels of the whole body suffer and may even be damaged. Also, high temperature, intoxication impairs the functioning of the thyroid gland, which affects the metabolic processes in the tissues and blood vessels of the body, and can even contribute to vascular spasms.
   Recommended:
   See a pediatrician or adolescent doctor. Ultrasound of the vessels of the lower extremities, rheovasography can determine the functional state of the vessels and surrounding tissues. Also, consultation with an endocrinologist will eliminate the negative impact of a recently transferred disease on the hormonal activity of the thyroid gland.
   Herbal preparations with anti-inflammatory, anti-edematous and antispasmodic effects can improve metabolism and metabolism in blood vessels, help recovery. For example, Quercetin. Also shown are vitamin preparations that have a positive effect on the vascular wall: rutin or in combination with vitamin C - ascorutin. The choice of specific drugs, dose and time of admission can only be selected by the attending physician after examination and diagnosis.

3. Hello Oksana.
   Here's what a consultant doctor (good therapist) says:

   With flat feet, equinism, hallux valgus, uneven and prolonged contractions of individual muscle sections, stretching of the fascia, and disruption of the ligamentous apparatus of the lower extremities occur. In addition, in the described case, shortening of the muscles and tendons of the lower leg is also likely. This leads to constant tension of the musculo-ligamentous system, the impossibility of relaxation. As a result, blood supply, nutrition and metabolism in the legs are disrupted. And it is the deformities of the foot that are most likely to be the cause of the impaired condition of the child. Unfortunately, long-term, uneven load affects not only the muscles, but also the joints (knee, hip), which can also hurt and deform in the future.
   Examination, observation and treatment by a competent orthopedic doctor is necessary. Pain, exercise intolerance are symptoms, they form part of the clinical picture and are significant for the doctor. The degree of flat feet is recorded during X-ray examination by special techniques (in different projections, with a load). This study should be carried out periodically, to save images and conclusions to record the possible progression of the process.
   It is very important to carry out treatment activities under the supervision of an orthopedist. Special massages, physiotherapy, physiotherapy exercises are used, developed individually to restore the normal arch of the foot. Swimming is a good sport to reduce stress on joints, muscles, ligaments and blood vessels. To reduce tension and pain, you can recommend in the evening to take warm foot (for the legs, feet) baths with salt (2 tablespoons of coarse or sea salt per 10 liters of water) lasting about 20 minutes.
   Depending on the situation, it is possible to resolve the issue not only about orthopedic insoles (they need to be changed several times a year), but also about special shoes with rigid fixation of the foot. Constant medical supervision is necessary, with the progression of the process - a solution to the issue of possible surgical correction.

4. 1. Hello Elina.
      Sorry for such a lengthy answer.

      Yes, pain can be a consequence of trauma.
      With the described symptoms, it is necessary to exclude the presence of muscle injury, sprains of the ligamentous apparatus, traumatic vascular injury, as well as expansion of the venous vessels (deep vein varicose veins). It is important to take into account (with sedentary work and intense exertion) that changes in the spine can also manifest as pain in the extremities, swelling and heaviness in them.
      In this case, it is recommended to consult a surgeon. The doctor will examine the leg and send it to the necessary examinations: a general blood test (to exclude the inflammatory process), the determination of the indicators of the blood coagulation system (which is important in case of possible vascular changes), ultrasound of the vessels of the lower extremities. And also, if necessary, will send for consultation to related specialists: vascular surgeon, traumatologist, neuropathologist.

5. Good afternoon, Timur. Now is the time that the main doctors who answer the questions are all either on the road (business trips, recertification, etc.) or have just returned and are still busy ... Therefore, we had to wait so long. Sorry. If the answer is relevant, then here is:

   Such a complex of symptoms makes it necessary, first of all, to exclude the pathology of the vessels of the lower extremities, muscles and nerve endings. At the same time, nerve fibers are most often affected secondarily.
   Also, intense physical activity can provoke pain syndrome in the presence of flat feet (both longitudinal and transverse). At the same time, pain in the calves can gradually arise and intensify, as well as decrease after rest.
   First of all, in this case, a consultation with a surgeon is recommended. If necessary, the doctor will refer you to a vascular surgeon, neuropathologist, orthopedist for consultation. To confirm the diagnosis, instrumental methods are used: x-rays of the feet, ultrasound examinations of the arteries and veins.
   After receiving the results of a complete examination and confirmation of the diagnosis by the attending physician, adequate and effective therapy can be prescribed.

6. Hello Christina.
   The answer from the practitioner and the site consultant:

   In medicine, there is restless legs syndrome. In this case, first of all, it is necessary to exclude it. Given the family history (the presence of varicose veins in the father), we can assume the presence of varicose changes in the lower extremities. When deep veins are affected, no changes occur on the surface, upon examination, the skin will not be changed, and the dilated veins are not visible.
   There are a lot of other possible reasons: from changes in the spine (osteochondrosis with secondary changes in nerve endings (radiculopathy or radiculitis), nutritional disorders with the development of a lack of certain vitamins and minerals, changes not only in veins, but also in arteries, and ending with general diseases (hormonal sphere, respiratory system).
   To diagnose the described changes, it is necessary to investigate the state of the vascular system (ultrasound of the vessels of the lower extremities, rheovasography), general clinical studies (the state of the coagulation system).
   Consultation of a surgeon, phlebologist and a physician is recommended. Doctors will select the direction of the diagnostic search, and only after the diagnosis has been established, they will be able to prescribe an adequate correction.

7. Good afternoon, Maxim.

   Diagnosed with gonarthrosis. This condition can present with knee pain and movement disorders. It is treated for a long time (since the disease is usually chronic, it can last for months and years, with periods of exacerbation and remission). The course of therapy includes anti-inflammatory drugs and physiotherapy. Spa treatment (mud therapy) is effective when there are no signs of an active inflammatory process that often accompany gonarthrosis (arthrosis of the knee joint). Particular attention should be paid to the ligamentous apparatus (taking into account the surgical intervention). It is treated under the supervision of an orthopedic surgeon or surgeon.
   Discomfort in the legs can be associated not only with venous vessels, but also with arterial ones. In this context, it is recommended to consult a vascular surgeon, conduct studies of arterial vessels, ultrasound duplex angioscanning of the arteries of the lower extremities and rheovasography. And according to the results of the research, doctors will be able to prescribe the appropriate treatment.

8. Good afternoon, Olga.

   The described picture most likely corresponds to changes in the veins, internal veins of the lower extremities. Therefore, they may not be visible from the outside.
   For diagnosis (exclusion of varicose veins of the lower extremities), it is recommended to contact a surgeon (you can - to a vascular surgeon, phlebologist). Instrumental studies are carried out: rheovasography and ultrasound (dopplerography) of the veins of the lower extremities. It is important to determine whether there is a tendency to thrombus formation (blood test for coagulation and duration of bleeding, blood platelets, coagulogram, PTI or INR).
   Treatment measures will be determined by the attending physician.
   It is also important to exclude the presence of flat feet (it can aggravate or even cause pain, heaviness in the legs, diagnosed by the surgeon).
   From general recommendations: comfortable shoes, try not to be for a long time with bent knees (sitting, in particular), as this impairs the movement of blood in the legs, try not to stand for a long time, take foot salt baths in the evening, lie in the evening for half an hour with legs raised above the level of the head (to facilitate the outflow of blood from the veins of the legs to the trunk area), a diet without large amounts of salt, so as not to increase tissue swelling.

9. Hello Dmitry!

   Given such a precise localization with the involvement of specific muscles in the process, and symptoms that resemble a change in sensitivity (stone, heavy legs), which can be combined with changes in the blood circulation of these muscles, first of all, it is necessary to exclude secondary changes (nerves and muscles) against the background of disorders from the side of the spine (osteochondrosis, nerve entrapment, secondary radicular syndrome, up to the exclusion of protrusion and hernia of the intervertebral disc, when the nerve endings are pinched in the area of ​​the exit from the spinal column).
   It is recommended to visit a competent neurologist. The doctor can diagnose local changes in sensitivity, as well as disturbances in the work of motor nerve endings.
   In terms of examination, the most informative MRI of the spine, the study can only be prescribed by a doctor.
   Until the diagnosis is established, it is recommended to refrain from physical efforts that can aggravate the condition, including stretch marks. If you cannot do without swimming, then it is better on your back and with a small range of motion and speed.
   It is indicated after the diagnosis and determination of possible contraindications drug therapy, manual therapy.

10. Hello Andrey!

    With prolonged and intense loads (which include long-distance marathon running), trauma to vascular formations, nerve structures, muscle tissue and articular-ligamentous apparatus is possible. Therefore, it is necessary to exclude the presence of neuropathy (changes in nerves) and vasopathy (vessels) of a traumatic nature. Injury increases when running on hard and uneven surfaces (asphalt, slabs, rocky road), imperfectly fitted shoes, and increases in the presence of flat feet.
    For an accurate diagnosis, it is necessary to consult a doctor (neurologist, surgeon), additional studies: ultrasound of blood vessels, blood tests to identify signs of inflammation and the state of the blood coagulation system.
    From general recommendations, it is important to pay attention to the nature of the warm-up (warming up all muscle groups) and stretching exercises. Water treatments (swimming pool, sauna) and massage help to normalize blood circulation (in the absence of inflammatory changes).
    Products and vitamin complexes (containing vitamins of group P, C (ascorutin)), group B, bioflavonoids (quercetin)), agents affecting venous outflow and blood vessels in general (detralex, escin, angionorm), chondroprotectors (containing chondroitin and glucosamine) improve the condition of the vascular wall, nervous system and musculoskeletal system. The choice of specific remedies can only be made by the attending physician.

11. Hello Angela!

    The described picture requires the determination of the state of the vessels and nerve fibers of the lower extremities along with the diagnosis of changes in the spine. Changes in blood vessels (both arteries and veins) can be secondary in relation to osteochondrosis of the spine, as well as mechanical pressure and tissue nutritional disorders with excess body weight. It is important to rule out any common illnesses. Especially those associated with metabolic disorders.
    Since it is necessary to exclude radicular syndrome with damage to the sciatic nerve, nerve fibers and plexuses of the thighs, legs and feet (the so-called secondary neuropathy), arterial angiopathy, varicose veins of the lower extremities, it is recommended:
    Consultation of a therapist (determination of the state of the cardiovascular and other systems), consultation of an endocrinologist (to exclude diseases that cause changes in blood vessels and nerves), a neurologist and, if necessary, which will be determined by a therapist - a vascular surgeon.
    In terms of examination, in addition to general clinical blood and urine tests: X-ray (and, if necessary, MRI) of the lumbar and sacral spine), rheovasography and ultrasound of the vessels of the lower extremities.
    After examination and diagnosis, doctors will be able to give clear recommendations on lifestyle and nutrition, choose medicines, doses and timing of administration.

12. Hello Yana!
    Therapist's answer:

    Given the described picture, first of all, it is necessary to exclude changes in the vessels of the veins of the lower extremities. A feeling of fullness and pain may indicate local venous congestion. At the same time, if the changes concern the internal venous network, then this does not manifest itself outside in any way - there may be no expansion and visual appearance of veins, as well as swelling.
    The presence of pain indicates the need to determine the state of the peripheral nerves. Osteochondrosis of the spine can lead to secondary radicular syndrome and the reaction of nerves far from the spine. What causes the pain.
    To diagnose osteochondrosis at the first stage, an X-ray examination is used, in this case it is necessary to examine the lumbar and sacral regions. Osteochondrosis is often a common process; it may not be limited to the cervical spine only.

Knee pain is a very unpleasant symptom that accompanies a variety of diseases. Knee discomfort can significantly impair quality of life. Why does the knee joint hurt and how can you cope with this problem?

Possible reasons

Why do knees hurt? Anyone who has ever experienced pain in the knee joint is looking for the answer to this question. Unpleasant sensations can be localized on the front surface of the knee or behind it, and also cover the entire joint, like a vise. The pain can be stabbing or aching, aggravated by movement, flexion and extension of the leg. Possible swelling of the skin around the joint, the appearance of a hematoma or rash. All of these symptoms are based on different causes of the disease.

What can trigger the appearance of knee pain:

• arthrosis;
• arthritis;
• periarthritis;
• meniscopathy;
• infectious diseases;
• trauma;
• tumors and cysts;
• circulatory disorders;
• neuralgia.

All of these causes can cause sudden or chronic pain in the knee area. Each of the diseases has its own characteristic features that make it possible to distinguish one pathology from another. Treatment of diseases will also differ depending on the cause that triggered the development of knee pain.

Arthrosis

The causes of painful sensations in the knee joint very often lie in the destruction of its cartilage. This phenomenon is called gonarthrosis. Pathology most often occurs in people over 40 years old, suffering from various chronic diseases. Recently, there has been a clear trend towards the rejuvenation of arthrosis.

Gonarthrosis does not occur overnight. The disease develops gradually over several years. At first, there is mild knee pain when walking, climbing stairs, or standing up. Over time, the pain intensifies, and swelling of the joint appears. If the causes of the disease are not found and treatment is not started, arthrosis can lead to significant deformation of the organ and limitation of mobility in the knee joint.

Treatment of arthrosis consists in the use of drugs that improve the blood supply to the joint and restore cartilage. With severe knee pain, analgesics are prescribed in a short course. In case of severe deformity of the joint, surgical treatment (arthroplasty) is performed.

Arthritis

If knee pain occurs at rest, worsens at night, and does not decrease with a change in body position, you should think about arthritis.

What are the reasons for the development of inflammation in the joint?

• Rheumatoid arthritis.
• Rheumatism.
• Gout.
• Psoriasis.
• Ankylosing spondylitis.

With arthritis, knees hurt as if by themselves, for no apparent reason. When bending or extending the knee, the intensity of pain remains virtually unchanged. A noticeable swelling appears, the skin over the joint turns red. In most cases, several groups of joints are simultaneously affected.

If you experience joint pain, do not self-medicate and consult a doctor.

Treatment for arthritis includes taking analgesics and drugs that affect the immune system. Physiotherapy methods are also actively used, as well as physiotherapy exercises. With timely treatment started, you can forget about painful sensations in the joint for a long time.

Periarthritis

Under this term, bursitis, synovitis and other lesions of the periarticular tissue are combined. A pronounced edema appears, the skin over the affected organ changes color. Severe knee pain occurs when walking. The causes of periarthritis are similar to the factors that provoke inflammation of the articular cartilage. It is also possible to develop synovitis and bursitis against the background of autoimmune processes in the body, after trauma and hypothermia.

If knee pain occurs when bending or climbing stairs, inflammation of the knee tendons should be suspected. In this case, the pain does not extend to the entire knee, but is located at one point on the inside of the leg. Edema and redness of the skin are not typical for this pathology.

Meniscopathy

Meniscus injuries are one of the most common causes of knee discomfort. The disease usually occurs after a previous injury. At the moment of hitting or falling on the knee, a characteristic crunch is heard, after which severe pain occurs. Bending knee pain persists for two weeks, after which all symptoms subside. The appearance of edema and redness of the skin at the site of injury is very characteristic.

If you suspect damage to the meniscus, contact the emergency room.

If the disease is not properly treated from the very beginning, its consequences can last a lifetime. Knee pain may recur at any time when walking, standing up, or climbing stairs. Deformity of the joint during meniscopathy is not typical. Cartilage change occurs only if gonarthrosis develops against the background of a meniscus injury.

Trauma

Of all knee injuries, ligament and cartilage injuries are the most common. Fractures of the bones that make up the articular surface are possible, as well as dislocations. Pain in the knees with injury occurs suddenly, accompanied by the appearance of edema and a decrease in limb mobility. A sharp increase in joint size is possible due to the effusion of synovial fluid at the time of injury. A characteristic sign of traumatic injury is hematoma - the accumulation of blood in soft tissues.

Cysts and tumors

Cysts and various tumors are quite common causes of knee discomfort. Of all neoplasms, surgeons most often have to deal with Baker's cyst. This round-shaped formation is located in the popliteal fossa and causes noticeable inconvenience to the patient. Baker's cyst is characterized by pain in the knee joint during movement. The cyst itself is clearly visible during knee extension and almost completely disappears at the time of knee flexion. This feature allows you to distinguish Baker's cyst from many other neoplasms in the popliteal fossa. Treatment consists in removing the cyst by arthroscopic or classical approach.

Circulatory disorders

If a young man's knee hurts when walking, you should not immediately look for a serious pathology. In adolescents under the age of 18, knee pain may be associated with a period of active growth. At this time, the development of blood vessels may not keep pace with the growth of bones. There are pains, always bilateral, aggravated by exertion and hypothermia. Painful sensations can be felt even with a simple change in the weather or after suffering stress.

There is no special treatment for temporary circulatory disorders. Such discomfort can be easily removed with warming ointments and self-massage. Often knee pain associated with vascular growth disappears on its own after a short rest.

Neuralgia

The causes of painful sensations in the legs can be associated with diseases of the spine. Osteochondrosis and herniated discs are common sources of pain in the knee area. If your knees hurt while squatting, the cause of the discomfort should be sought in the lumbar spine. Probably, there was a pinched nerve or inflammation developed at the place of origin of the roots. An accurate diagnosis can be made by a neurologist after a targeted examination of the patient.

Treatment for neuralgia includes anti-inflammatory drugs, gymnastics, and massage. A good effect is seen from manual therapy and acupuncture. With severe pain, novocaine blockade is performed.

Infectious diseases

Some pathogens can trigger the development of reactive arthritis. An example is Lyme disease. The infection enters the bloodstream after a tick bite and spreads throughout the body. There is a chill, the body temperature rises, painful sensations appear in the muscles and joints. If your knees hurt against a background of fever, you should definitely see a doctor and exclude an infectious disease.

An infectious disease doctor together with a rheumatologist should treat bacterial and viral damage to the joints. Antibacterial and antiviral drugs are prescribed, as well as agents that stimulate the immune system. For severe pain, analgesics are used. After the symptoms of the disease have subsided, massage and exercise therapy are recommended.

What to do?

Knee pain is a reason to see a doctor. There is no single treatment regimen for all diseases. Treat the knee only after finding out the cause of the pain. For this, an X-ray or ultrasound of the affected organ is necessarily done. If necessary, the doctor can perform computed tomography or magnetic resonance imaging to rule out tumors and other serious diseases.

Of course, this wait-and-see tactic is only good when the knee pain can be tolerated. But what if your knees hurt very badly? What to do to relieve acute pain?

• Reduced load.

The first thing to do is to remove the stress on the affected leg. In case of acute pain, you need to fix the knee, providing it with complete immobility, and immediately call a doctor. There may be a fracture or dislocation behind the severe pain. With moderate soreness, it is enough just to reduce physical activity and not to load the knee once again.

• Bandage.

If your knee hurts when bending or while walking, you should take care of purchasing a bandage. A special bandage will not only eliminate discomfort, but will also help reduce stress on the leg. Treatment of many pathologies of the knee joint involves prolonged wearing of a bandage until all symptoms of the disease subside.

• Cold.

It is by no means worth treating knee injuries with warm compresses. In many pathologies, the use of heat can cause deterioration and progression of the disease. It is best to apply cold (ice wrapped in gauze) to the knee. A cold compress will relieve acute pain, remove swelling and noticeably ease the condition for a while.

Knowing why the knee hurts, you can take all the necessary measures to eliminate the discomfort. You need to act carefully, because not all diseases can be treated at home. If the treatment started has not brought the desired effect, you should definitely consult a doctor.

An acquaintance of mine who works as a pioneer pharmacist once complained that, putting on summer shoes, she could hardly squeeze into her last year's shoes. “You know,” she said to me, “I understand everything: what else can a lady like me wait for if she did not step over the balzac age yesterday, but was on her feet every day for a whole shift. Puffiness and fatigue, therefore, I fully justify. But when, due to purple bruises on your legs, you cannot put on a skirt or squeeze into your favorite shoes, I simply cannot ignore this as a woman! "

Actually, there is no need to ignore this. Moreover, you do not think that all these symptoms are the lot of ladies, whose age is described by the correct phrase "a little over thirty", but whom we are all accustomed to seeing in a blue cambric dressing gown at the entrance. Be that as it may: in fact, most of the symptoms of chronic venous insufficiency (which we also know as varicose veins of the lower extremities or just varicose veins) are familiar to many of us. Even if you are actually a little over thirty and you are an office worker who spends all the time at the computer; if you are a young loader or pregnant; if you, as they say here in Ukraine, are a "big woman" or a slender beauty on a 20-centimeter stiletto heel, sooner or later the majority may still feel the unpleasant symptoms of this disease.

Another thing is that many simply do not want to admit to themselves in their problems, or sometimes sincerely explain all these phenomena in the same way as my friend - the consequences of age, peculiarities of work, fatigue. We are so used to reassuring ourselves optimistically that everything will go away on its own, or that the problem can be solved by using simple cosmetics.

Puffiness and heaviness in the lower extremities after a hard day, which creates the feeling that the legs are clamped on all sides in a vice? - Just think! Well, what did you want by the end of the working day ?!

Restless legs syndrome, which manifests itself as a burning sensation, tingling sensation, internal tension and does not allow us to work or rest calmly? Night cramps in the calf muscles? - Come on, with whom it does not happen!

An unaesthetic purple capillary mesh that gradually appears and covers the ankle, and then rises up the lower leg, showing veins protruding on the surface? - Well, this is what we all have in our family! You will need to buy some foot cream later!

Constant heaviness and fatigue of the legs, which makes itself felt even in the morning, when, it would seem, the whole body should rest and recover after a hard day? Puffiness that never goes away, because of which, in order to squeeze into shoes, you have to spend a good 5-10 minutes, and because of which the feeling of lightness of the gait is completely forgotten? Protruding veins, dry and peeling skin on the legs, dark age spots and bruises? .. And then we understand that we should, perhaps, already go to the pharmacy ...

A common story

However, in order to somehow reassure those affected by this problem, it should be noted that chronic venous insufficiency is not a disease of modern civilization at all. We find references to this problem almost from the moment writing appeared. For example, in the days of Ancient Egypt, the mention of varicose veins of the lower extremities is in the Ebers papyrus, which is more than 3500 years old. It also mentions the first attempt at treating him. The famous Greek surgeon and obstetrician Pavel Eginsky, long before Friedrich Trendelenburg, proposed ligation and surgical removal of varicose veins as a method of treatment. In ancient Rome, in the medical treatise "De Medicina", a Roman physician named Celsius described methods of dressing and removing varicose veins, as well as possible complications. Thanks to historical notes, today it can be said with precision that the first historical character who underwent phlebectomy was the Roman tyrant Gaius Marius. After one leg was operated on, he, tormented by pain (after all, anesthesia did not exist at that time!), Refused to substitute the second, said: "I see, the treatment is not worth the pain."

In the ancient Indian manual of surgery "Sushruta Samhita" (270 BC) described the method of cleansing trophic ulcers using the larvae of meat flies in combination with tight bandaging of the limb. First, Hippocrates, and then Avicenna, described a direct connection between chronic venous insufficiency and the occurrence of ulcers. It was only in 1628 that William Harvey discovered the circulatory system and described the valves in the venous vessels of the lower extremities, and in 1676 R. Weissman (a surgeon sergeant to the British King Charles II) established that varicose veins may be the result of valve insufficiency. At the same time, compression stockings were used for the first time to treat patients with chronic venous insufficiency. In 1868 I. Ge and A. Spender independently from each other revealed that trophic ulcers can be a consequence of deep vein thrombosis.

Causes and Effects

Today we are well aware that chronic venous insufficiency is a consequence of a violation of the outflow of blood from the veins of the lower extremities and an inevitable human companion, our payback for upright walking. However, what contributes to this? In order to explain this phenomenon, there are many theories. According to the first, this is facilitated by a violation of hemodynamics and insufficiency of the valves of the venous system. The pressure of blood from the arteries, the contraction of the leg muscles during movement, and the presence of valves in the veins prevent blood from flowing back. It is believed that it is the inability of these valves to perform their function that causes a violation of venous blood flow, leads to overstretching of the veins, and an increase in the lumen of the vein further aggravates the operation of the valve, which can no longer completely close it. The downward blood flow increases, it stagnates with thrombus formation and swelling.

According to the second theory, chronic venous insufficiency develops due to the fact that the blood flow is impeded by the arising blood clots, the formation of which is facilitated by changes in the vascular wall, disturbances in the blood coagulation system and a slowdown in blood flow.

Those supporting the third theory believe that chronic venous insufficiency develops due to congenital weakness of the elements of the venous wall. According to the fourth, neuroendocrine disorders are the main reason for the development of chronic venous insufficiency, and the fifth is immunological disorders and allergic reactions.

However, be that as it may, varicose veins of the lower extremities are by no means a harmless disease. And it creates far from only cosmetic problems: stagnant dermatitis and hyperpigmentation of the skin due to trophic disturbances, edema and constant fatigue of the legs, which affects not only our gait, but also our mood and performance, not to mention bruises, and subsequently - and intractable and difficult to heal trophic ulcers. So is it worth waiting for all these "delights" or is it better (to paraphrase the words of the Roman commander) to say that the future complications and the pain experienced are worth the treatment? Moreover, now we have access to funds that can quite simply, painlessly and effectively help us with this, and this is the season in the yard when it is so important to take care of the beauty of the legs.

Make a choice

What is needed for this help to be effective, and to be able to reward the legs with a pair of new shoes or show them without hesitation, modestly peeking out from under the skirt? Just a correctly selected remedy that will help get rid of the purple mesh on the feet, bruises and puffiness, which will also worsen with the arrival of the summer heat, and at the same time the dryness of the skin accompanying the varicose veins of the lower extremities. And all this -!

What allows us to make a choice in favor of this drug? Of course, first of all, these are the properties heparin, which is the active substance of this product. Thanks to heparin, LYOTON 1000 GEL provides not only an increase in the tone of the vein walls and improves lymphatic drainage, such as troxerutin or horse chestnut products. Due to its direct anticoagulant properties, heparin has a positive effect on the rheological properties of blood. It reduces its viscosity, promotes the "resorption" of blood clots, binds and inactivates biologically active substances that damage the endothelium. It also reduces the ability of the endothelium to adsorb blood clots, inhibits the pathogenic effect of platelet factors, and restores the potential of cell membranes.

The anticoagulant effect of heparin is not its only merit in the fight against bruising and vascular reticulum. It blocks many enzymes (eg plasmin, trypsin, hyaluronidase) and inflammatory mediators, reduces platelet count and activates macrophages. Thanks to this, heparin is known for its anti-inflammatory and wound-healing properties, reduces the severity of pain.

However, the therapeutic effect of LYOTON 1000 GEL depends not only on the properties of heparin, but also on its concentration, as well as the ability to easily overcome skin barriers due to such a form as a gel.

So, LYOTON 1000 GEL contains 1000 IU of heparin in 1 g of gel, which is several times higher than other similar heparin preparations for topical use. Due to this, a high diffusion pressure is achieved, which leads to a high concentration of the drug in the tissues, as well as its higher absorption compared to forms containing 500 U per 1 g (Stüttgen G., Panse P., Bauer E., 1990).

And the gel form itself provides heparin with good penetration through the skin into soft tissues, which deserves no less attention. So, previously used fatty bases (pork fat or petroleum jelly) were devoid of osmotic activity, which means that they practically did not absorb exudate and released medicinal substances very poorly, and favorable conditions for the development of microorganisms were created on the skin. With the advent of polyethylene oxide bases, a high efficiency of the preparations was achieved, but their diffusion was predominantly unidirectional. Such funds absorbed liquid too well, which often led to tissue dehydration and local irritation. Finally, the emerging form such as a gel makes it possible not only to easily and more fully release medicinal substances, but also to actively transfer them through the skin to those foci that require treatment, taking with them exudate, dead cells and microorganisms. LYOTON 1000 GEL was created on such an alcohol-water gel base. It significantly surpasses heparin-containing ointments in characteristics and ensures better penetration of heparin into the corresponding layers of the skin (Zesch A., 1976), and, having a high content of the active substance, contributes to an even faster achievement of high concentrations of heparin in soft tissues (Stüttgen G., Panse P ., Bauer E., 1990).

... Hurries to help us

Who can help LYOTON 1000 GEL? Those who are concerned about diseases of the superficial veins, such as chronic venous insufficiency and associated complications (phlebothrombosis, thrombophlebitis, trophic ulcers); the consequences of previous operations, in the presence of bruising and inflammation, as well as in injuries and bruises, subcutaneous hematomas and sprains. Due to its properties, LYOTON 1000 GEL promotes gradual suppression of pain (in 90% of patients), a decrease in the severity of edema (86%) and the size of seals (80%), a feeling of heaviness, as well as erythema (Navrátilová Z. et al., 2000; Bihari I., 2001; Daróczy J., 2002).

Of course, all this could not pass unnoticed either for specialists who have been widely recommending LYOTON 1000 GEL for several years, or for the patients themselves. For the convenience of the latter, at the beginning of 2011, Berlin-Chemie added an additional 30 g to the previously existing packaging of the drug. This means that LYOTON 1000 GEL has become even more convenient to take with you on trips, in case of unforeseen injuries and bruises. which are not uncommon during work on personal plots, the season of which has just started, or during a short active rest during the May holidays.

Chronic venous insufficiency- the disease is far from seasonal. However, it is with the beginning of spring that most of those who are worried about this problem realize that capillary mesh and blue swollen veins are so unaesthetic!

That is why, at the beginning of 2011, the Berlin-Chemie company, for the convenience of patients, in addition to the existing LYOTON 1000 GEL 50 g, introduced another form to the Ukrainian pharmaceutical market - LYOTON 1000 GEL 30 g. This helped the LYOTON 1000 GEL brand as a whole in the summer of 2011 to demonstrate an increase in the volume of pharmacy sales both in monetary and physical terms (Fig. 1 and 2). LIOTON 1000 GEL is not lagging behind in 2012. So, according to the results of the I quarter. This year, the brand's retail sales have shown strong dynamics, increasing by 25% over the same period last year! (Fig. 3) At the same time, the volume of pharmacy sales of the competitive group (C05B “Agents used for varicose veins” and C05C “Capillary stabilizing agents”) for the same period decreased by 4% (Fig. 4). Such a positive trend, demonstrated by the LIOTON 1000 GEL brand, allows us to look optimistically at its future and call its market tomorrow promising.