Врачи часто имеют дело с жалобами людей на боль в ноге от бедра до колена. Наблюдается такая патология в любом возрасте. Подобные боли встречаются у мужчин и женщин, стариков и детей. Ведь ноги постоянно подвергаются нагрузкам, выдерживая весь вес тела человека. Часто суставы или мышцы не справляются с этим, и возникает боль. Кроме того, болевые ощущения могут распространяться из поясничного отдела позвоночника. Самостоятельно определить, отчего появилась боль, невозможно. А без этого не получится избавиться от нее. Поэтому посещение врача и обследование должно стать первым шагом на пути к выздоровлению.
Общая характеристика
Подобная боль выше колена никогда не появляется сама по себе. Это всегда признак какой-то патологии, функциональных или анатомических отклонений. Болеть в ноге могут кости, мышцы, связки, подкожная клетчатка, нервы, суставы. Причем, не всегда источником болезненности является этот участок конечности. Часто подобная проблема появляется при патологиях позвоночника или стопы. Кроме того, иногда толчком к появлению болей становятся системные нарушения обменных процессов или кровообращения. Ведь в человеческом организме все тесно взаимосвязано. Поэтому часто ломит суставы при инфекционных заболеваниях, патологии почек приводят к отекам конечностей, а сердечно-сосудистые заболевания – к онемению и слабости мышц.
Чтобы определить, почему болит нога от бедра до колена, врач обязательно выяснит у пациента, где возникает боль, при каких условиях, как долго длится и какую имеет интенсивность. Ведь все эти признаки часто могут охарактеризовать патологию и помочь поставить диагноз. Чаще всего возникает дискомфорт при движениях, ходьбе или стоянии. Но некоторые патологии приводят к появлению болей даже в состоянии покоя. Такое явление говорит о прогрессировании патологического процесса или же о серьезной травме.
Болевые ощущения могут быть разными по локализации, интенсивности и характеру. Они могут появляться периодически, например, по вечерам, или же длиться постоянно. Возникать они могут не только при физической нагрузке на ногу, но и в покое. Болезненность может быть сильной или слабой. Например, острая сильная боль в ноге наблюдается после травмы или при некоторых неврологических патологиях. Но во втором случае она обычно жгучая, приступообразная.
Разным может также быть локализация болевых ощущений. Системные патологии, воспаление мышц или нарушение кровообращения обычно приводят к ноющим диффузным болям, распространяющимся по обеим конечностям. При воспалительных заболеваниях суставов и околосуставных тканей обычно возникают четко локализованные болезненные ощущения, концентрирующиеся около колена или таза. Патологии, приводящие к поражению нервных корешков, тоже вызывают подобные боли. Они могут локализоваться в задней части бедра, сбоку или изнутри.
Различаются болевые ощущения также по характеру. Чаще всего люди жалуются, что у них ноет нога от бедра до колена. Эти ощущения хоть и не сильные, но доставляют серьезный дискомфорт. Такие периодические ноющие боли, которые быстро проходят от приема обезболивающих, для некоторых больных не являются поводом для обращения к врачу. Такой подход может привести к тому, что патология будет прогрессировать, боли усилятся, станут хроническими. Кроме того, по характеру болевые ощущения могут быть колющими, стреляющими, жгучими, пекущими.
Если же боль резкая, сильная, посетить медицинское учреждение нужно как можно скорее. Чаще всего это симптом серьезных патологий. Это может быть травма; особенно опасно, если не наблюдается внешних повреждений, а болевые ощущения появляются не сразу после удара. Подобная боль возникает также при ущемлении нерва из-за остеохондроза или грыжи пояснично-крестцового отдела.
Острая боль часто возникает при наличии гнойного воспаления. При этом она постепенно нарастает, характеризуется пульсирующими ощущениями, чувством распирания. Если же боль ощущается в одном месте и усиливается при каждом движении, это может быть тромбофлебит. Все подобные патологии могут без лечения привести к серьезным осложнениям.
Нижние конечности человеческого организма подвержены постоянным нагрузкам. На их фоне даже в самых крепких мышечных и косно-суставных структурах этого сегмента опорно-двигательной системы возникают поломки. Одним из частых проявлений являются боли от бедра до колена или в любом другом сегменте конечности. Описанию этого симптома и его правильной интерпретации посвящена данная статья.
Что может быть субстратом боли
Локализация боли в промежутке между бедром и коленом далеко не всегда соответствует такой же зоне патологических изменений. Подобный феномен обусловлен наличием множественных анатомических образований в бедренной и коленной области, а также выше и ниже лежащих участках. Болевые импульсы способны исходить из:
- кожи и подкожной жировой клетчатки;
- мышечно-фасциальных комплексов;
- сухожилий и связок;
- костей и суставов (бедренная кость, коленный и тазобедренный суставы);
- крупных артериальных сосудов;
- поверхностных и глубоких вен;
- периферических нервных стволов на бедре;
- нервных структур в области пояснично-крестцового отдела позвоночника (корешки нервов, спинной мозг и его оболочки).
Важно помнить! Боль в верхнем сегменте нижней конечности (от бедра до колена) является неспецифическим симптомом. Причин для ее возникновения настолько много, что правильно определить наиболее вероятную может только специалист!
Причины возникновения боли
Возможные причины и состояния, при которых нижняя конечность болит в верхних отделах, приведены в таблице.
Группа причин | Заболевания, сопровождающиеся болью |
Травмы мягких тканей |
|
Травмы костей |
|
Воспаление мягких тканей |
|
Воспалительное и другие виды поражения костей |
|
- лейкоз;
- остеосаркома;
- миосаркома;
- ангиофибросаркома;
- метастазы злокачественных опухолей в бедренную кость.
- внутрисуставные переломы;
- деформирующий артроз;
- артриты различного происхождения.
- расширение вен на фоне варикозной болезни;
- тромбофлебит;
- флеботромбоз;
- венозная и лимфовенозная недостаточность.
- сужение просвета аорты и крупных артерий нижних конечностей на фоне атеросклероза;
- тромбозы и эмболии магистральных артерий;
- синдром Лериша.
- неврит;
- грыжи межпозвоночных дисков;
- остеохондроз;
- опухоли и травмы позвоночника.
- физическое переутомление ног;
- метеочувствительность;
- перенесенные травмы и операции на ногах;
- слабость мышц;
- периоды роста у детей;
- беременность.
Важно помнить! Боль в ногах может иметь разные характеристики. Она бывает как локальной, захватывающей небольшой участок, так и распространенной в виде полосы, как острой, так и тупой, как внезапной, так и продолжительной, как с дополнительными симптомами, так и без них. Детализация болевого синдрома – первый шаг на пути к определению причины его возникновения!
Симптомы, сочетающиеся с болью, это очень важно
Для определения причины боли в ноге, локализованной в сегменте от бедра до колена, важное значение имеют симптомы, которые сопровождают боль. Еще один значимый момент их оценки – определение связи болевого синдрома с имеющимися сопутствующими симптомами. Это значит, что они могут быть как проявлением одного и того же заболевания, так и следствием разных патологических процессов. Провести подобную дифференциальную диагностику в силах только опытный специалист.
Среди главных симптомов, которые чаще всего сопровождают боль в области бедра, выделяют:
- Отек . Может носить локальный характер, располагаясь на небольшом участке, соответствующем зоне патологически измененных тканей. Это может быть передняя, боковая, задняя поверхность бедра, коленного сустава, тазобедренной области и т.д. Наличие отека говорит о воспалительном происхождении боли, сосудистых нарушениях или травматическом повреждении тканей. Длительно сохраняющийся отек свидетельствует о травматическом или поражении бедренной кости остеомиелитическим процессом.
- Онемение кожи с чувством ползания мурашек . Практически всегда локализовано по наружной поверхности бедра и является свидетельством раздражения периферических нервов бедренной области или их корешков у места выхода из позвоночника.
- Покраснение кожи . Может иметь ограниченный характер в виде покрасневшей полосы или округлого очага. Первый вариант наиболее типичен для острого тромбофлебита поверхностных вен бедра (большой подкожной и ее притоков), второй – признак воспалительно-нагноительных процессов мягких тканей в области бедра. Если покраснение носит распространенный, практически циркулярный характер от колена до бедра, это может говорить о рожистом воспалении и фасцииите.
- Повышение температуры тела . Неспецифичный симптом, который может сопровождать любое заболевание, проявляющееся болью в бедренном сегменте нижней конечности. Не типичен для заболеваний структур нервной системы.
- Наличие плотного опухолевидного образования . Если боль в бедре сочетается с наличием ограниченного дополнительного образования в виде опухоли, это чаще всего говорит об онкологическом процессе. Расположение опухоли сзади в подколенной области может свидетельствовать о кисте Бейкера.
Сильная и острая боль
Одной из важных рубрик в детализации болевого синдрома, локализованного в сегменте нижней конечности от бедра до колена, является характер боли. Острая сильная боль всегда говорит о серьезной проблеме в организме. Ее появление может сигнализировать о наличии:
- Нагноительных процессов в области бедра и прилежащих участках. В таком случае болевой синдром сопровождается отеком, небольшим покраснением, болезненностью движений и ходьбы, повышением температуры тела. Характерен анамнез постепенного нарастания боли. В течение нескольких дней нога болит умеренно с усилением до критического уровня.
- Травматических повреждений костей, сухожилий, мышц, связок и суставных структур тазобедренной, коленной и области бедра. Боль не всегда возникает в момент получения травмы и способна появиться через некоторое время. Скопление крови и жидкости вызывает чувство распирания сзади колена. Поэтому обязательно должен учитываться факт получения травмы и ее объективные признаки в виде синяков, ссадин, гематом.
- Прогрессирующая межпозвоночная грыжа. Увеличение размеров или нестабильность межпозвоночной грыжи всегда вызывает резкие боли в том участке позвоночника, в котором она расположена. Очень часто при этом тянет ногу или возникает резкий болевой приступ по ходу нерва, исходящего из соответствующего сегмента спинного мозга. Больные описывают его, как прострел по наружной поверхности бедра.
- Острый тромбофлебит. Воспалительный процесс в большой подкожной вене сопровождается образованием тромбов в ее просвете, в процесс вовлекаются окружающие ткани. Формируется воспалительный инфильтрат по ходу вены от паха до колена, плотный и резко болезненный. Боль усиливается при любых движениях.
Ноющая и хроническая боль
Наиболее частым видом болей в ноге от бедра до колена является хроническая боль, беспокоящая человека на протяжении определенного временного промежутка. Она бывает ноющей, колющей, сопровождается онемением, возникает на фоне определенных факторов или спонтанно, носит периодический характер, проходит самостоятельно или в результате тех или иных действий, как правило, ограничена определенной анатомической зоной бедра. Практически каждый человек в повседневной жизни сталкивается с подобной болью.
Если у человека ноет нога, это может говорить о:
- физическом переутомлении и перенапряжении;
- туннельно-фасциальном синдроме;
- варикозной болезни венозной системы нижних конечностей;
- остеохондрозе позвоночника;
- хронических дегенеративных процессах в суставах.
Варикозная болезнь венозной системы нижних конечностей
Данное заболевание сопровождается периодическими болями по ходу вен, подверженных варикозному расширению. Чаще всего это внутренняя поверхность бедра выше колена. Такие боли провоцируются длительным пребыванием в вертикальном положении и тяжелыми физическими нагрузками.
Остеохондроз позвоночника
При длительном существовании остеохондроз вызывает раздражение нервных корешков, иннервирующих область бедра. Это проявляется частыми или постоянными ноющими болями в зоне разветвления раздраженного нерва от ягодицы до колена. Как правило, параллельно возникает боль в пояснице, мышечная слабость нижней конечности и онемение болезненной зоны.
Хронические дегенеративные процессы в суставах
Застарелые травмы, повреждения менисков, остеоартроз вызывают не только поражение суставного хряща, но и тканей, поддерживающих суставы в стойком положении. На этом фоне возникает их перерастяжение, хроническое воспаление, возможно скопление жидкости в заворотах суставной капсулы. Все эти состояния сопровождаются сдавлением окружающих тканей, что проявляется ноющей болью. Как правило, она локализована сзади под коленом вблизи от пораженных сочленений и может распространяться на выше и ниже лежащие участки по наружной поверхности бедра. Правая нога поражается чаще.
Физическое переутомление и перенапряжение
На их фоне мышцы и околосуставные ткани оказываются в напряженном состоянии, что закономерно проявляется раздражением болевых рецепторов и ощущением болезненности. Если речь идет о чрезмерных нагрузках для неприспособленных мышц, то боль в бедре обуславливается накоплением недоокисленных веществ (в первую очередь молочной кислоты). На фоне отдыха такие боли самостоятельно проходят.
Туннельно-фасциальные синдромы
По наружной поверхности бедра проходит плотная соединительнотканная пластинка – широкая бедренная фасция. Между нею и мышцами, а также через ее толщу проходят периферические нервы. Если мышца, натягивающая широкую фасцию, длительно находится в напряжении, это приводит к сдавлению нервов и нарушает их кровоснабжение. Как результат, тянущая боль, сопровождающаяся чувством ползания мурашек и онемением наружной поверхности бедра.
Важно помнить! Боли в бедренно-коленном сегменте нижних конечностей, являясь неспецифическим симптомом, все-таки обладают определенной специфичностью. Важно знать возможные варианты болевого синдрома и уметь его правильно дифференцировать. Не стоит делать это самостоятельно. Обращение к специалисту – единственное правильное решение в такой ситуации.
Если болит нога от бедра до колена, то не всегда можно утверждать, что источник дискомфорта находится в конечности. Выраженность болевых ощущений может быть разной степени: легкая, тянущая и сильная, резкая. Также возникают нарушения походки и скованность движений.
Боль может охватывать бедро полностью или появиться лишь спереди.
Чаще всего встречается боль, сопровождающаяся легким онемением. Она возникает периодически и в начале развития патологии проходит без применения медицинских препаратов. Тяжелые формы нарушений провоцируют возникновение боли даже в состоянии покоя.
Острая боль говорит о проблемах в работе организма.
Болевой синдром могут вызвать следующие структурные элементы бедра:
- подкожный жир, кожный покров;
- мышцы;
- связки, сухожилия.
Причины болезненных ощущений
Вызвать боли в ноге могут разные факторы. К ним относятся:
- травмы (переломы, растяжения, вывихи и пр.);
- защемление седалищного нерва;
- усталость, чрезмерное перенапряжение (ноет и тянет в ноге, в этом случае чаще всего дискомфорт проходит самостоятельно);
- реакция организма на погодные условия;
- беременность (повышенная нагрузка на суставы ног);
- избыточный вес (сильная нагрузка на суставы);
- опухолевые новообразования (саркома, лейкоз, метастазы);
- воспаления, вызванные инфекционными процессами (абсцессы, лимфодениты);
- венозные и сосудистые патологии в бедре (варикоз, тромбофлебит, флеботромбоз);
- нарушения работы нервной системы (межпозвонковые грыжи, неврит, тромбоз).
Заболевания с данной симптоматикой
При отсутствии видимой причины дискомфорта от бедра до колена (травмы, переломы), можно заподозрить развитие некоторых заболеваний:
Заболевание | Симптоматика | Описание |
Артроз | Помимо боли от бедра до колена, проявляются дополнительные признаки патологии: ограниченная подвижность ног, хруст в суставах при ходьбе или движении. | Воспалительный процесс в суставах. Заболевание развивается длительное время, не доставляя неудобств вначале. Симптоматика проявляется в результате травм или повышенных физических нагрузок. |
Инфаркт тазобедренного сустава (некроз головки бедра) | Симптомы аналогичны с проявлением артроза, однако имеют одно важное отличие — при некрозе болевые ощущения локализуются исключительно в передней части бедра. | Конечность при некрозе остается подвижной. |
Артрит | Боли в ноге появляются в утреннее время суток и отдают в поясницу, бедро и/или пах. Через несколько часов дискомфорт проходит. | При тяжелой хронической форме артрита боли присутствуют постоянно, даже в состоянии полного покоя, развивается хромота. |
Остеохондроз | Ноющая внутренняя волнообразная боль с наружной стороны бедра, отдающая в колено или стопу, является признаками дистрофии позвонков поясничного отдела позвоночника. Неприятные ощущения становятся сильнее в ночное время суток, а утром подвижность ноги ограничивается. | При остеохондрозе развивается дистрофический процесс в межпозвоночных дисках. |
Ревматическая полимиалгия | Боль в ноге сопровождается сильным повышением температуры тела, развитием общей слабости, ломотой в плечевых суставах. | Самая редкая причина, по которой болит конечность. Часто развивается как осложнение после тяжелого вирусного или инфекционного заболевания, например гриппа. |
Костные или мышечные опухоли | Рост и развитие опухолей сопровождаются воспалительными процессами не только в ногах, но и в других органах и/или частях тела. | В зависимости от того, является ли новообразование доброкачественным или злокачественным, интенсивность и характер болей разные. |
Защемление седалищного нерва | Острая боль появляется в бедре и ягодицах | Данное заболевание может вызвать сильное ограничение движений в связи с высокой интенсивностью болевого синдрома. |
Варикозное расширение вен | Периодические болевые ощущения от паха до колена | Нарушения нормального оттока крови из-за расширения вен |
Туннельно-фасциальный синдром | Болезненность в области бедра | Синдром возникает при сдавливании нервных волокон, проходящих через широкую бедренную фасцию. |
Остеоартроз | Ноющая боль в ноге от бедра до колена, преимущественно на внешней стороне бедра | Дегенеративные процессы развиваются в суставных хрящах. Болевой синдром дополняется опуханием и хрустом в области пораженного сустава. |
Межпозвоночная грыжа | Дискомфорт и резкая боль в ноге, иррадирующая в поясницу и ягодицы, дополняется онемением и покалыванием в ноге | При межпозвоночной грыже происходит выпячивание межпозвонкового диска, что способствует защемлению нервных окончаний. |
Рассмотрим, к какому врачу обратиться. В первую очередь необходимо записаться на прием к терапевту, который выдаст направление к нужному специалисту: ортопеду-травматологу, хирургу или сосудистому хирургу.
Виды лечения
Курс терапии зависит от причины, спровоцировавшей болевые ощущения в ноге от бедра до колена.
Медикаментозное лечение заключается в применении следующих групп препаратов:
- нестероидные противовоспалительные средства (Нимесил, Диклофенак, Индометацин, Напроксен);
- обезболивающие (Аспирин, Метамизол, Кеторолак);
- хондропротекторы (Алфлутоп, Мукартрин, Артра);
- антибиотики (если боль вызвана развитием инфекции, используют Азитромицин, Линкомицин, Доксициклин).
Снижение болевых приступов достигается путем прохождения физиотерапевтических процедур, таких как:
- ультразвук;
- лазеротерапия;
- электростимуляция;
- гидротерапия;
- криотерапия.
После облегчения болевых ощущений назначается курс лечебной гимнастики. Полезно при заболеваниях суставов в период ремиссии посещать бассейн.
В случаях отсутствия результатов после консервативной терапии или при тяжелой форме нарушения, вызвавшего боли в ноге от бедра до колена, применяется оперативное вмешательство, в процессе которого максимально устраняют причины развития патологии. В ряде случаев может потребоваться замена сустава.
Как снять сильную боль
Если боль появилась в результате сильного физического перенапряжения, в домашних условиях можно снять дискомфорт:
- приняв теплую ванну (в воду можно добавить травяные отвары или эфирные масла ромашки аптечной, календулы, коры дуба, липового цвета или мяты);
- сделав легкий расслабляющий массаж с применением кремов или эфирных масел;
- сделав холодный компресс (кусочки льда, завернутые в ткань, прикладывают к больному месту).
Также можно лечь на спину, приподняв ноги, что поможет восстановить кровообращение в ногах.
Профилактические меры
Для того чтобы снизить риск повторного возникновения ноющей или острой боли в ногах и предупредить их развитие, можно принять следующие меры профилактики:
- Регулярно проходить обследование всего организма.
- Придерживаться правил здорового питания.
- Пить больше воды (жидкость помогает увеличить количество смазки на костях).
- Вести активный образ жизни, выполняя умеренные физические нагрузки.
- Не запускать развитие заболеваний.
- Не допускать появления лишнего веса.
- Носить удобную одежду и обувь.
- Выделять достаточное количество времени на сон.
- Отказаться от курения и употребления алкогольных напитков.
Внимательное отношение к своему здоровью поможет избежать многих проблем, в т. ч. и болей в ногах.
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