К сожалению, существует очень много патологий, которые могут повлиять на ногу и возникновение боли в левой ноге . Но многие из них разрешимы с помощью соответствующей медицинской помощи. В данной статье мы рассмотрим, какие проблемы могут повлиять на возникновение такой боли. Самая частая проблема – это боль в пояснице при зажатии седалищного нерва отражающая в ногу. Боль отдающая в левую ногу может варьироваться от слабой до сильной, появляться дискомфорт в левой ноге, который приходит и уходит или переходит в изнурительную боль, которая затрудняет сон, прогулки или занятия простой повседневной деятельностью.
Ноющие боли в левой ноге могут также сопровождаться неврологическими симптомами, такими как чувство онемения или слабости, жжения, покалывания. Слабость может быть постоянной, или это может произойти внезапно и вызывать нечувствительность ноги. Конечно, тупая боль в левой ноге,боль в голенях, может быть вызвана проблемами в мышцах, суставах, кровоснабжении, венах, связках и т.д. , но часто основная причина проблемы начинается в нижней части спины, где возникает седалищный нерв, а затем движется по пути нерва (называемого ишиасом).
Симптомы ишиаса и описание боли в левой ноге при данном заболевании:
- Боль как горение (жжение). Боль исходит из нижней части спины или ягодиц вдоль ноги или может проявляться в виде прерывистой боли, которая расширяется сверху донизу в ноге, а иногда и в стопу. В отличие от многих форм боли в спине, эта тупая боль в левой ног часто может быть продолжительной и раздражающей и иногда невыносимой. Этот тип боли горения довольно типичен, когда нервный корень в нижней части позвоночника раздражен и часто называют ишиасом.
- Боль или покалывание стопы. Онемение от поясничной проблемы может быть почти непрерывным и может серьезно повлиять на качество жизни человека. Например, может быть трудно или почти невозможно ходить или водить автомобиль. Типичные симптомы могут варьироваться от легкого покалывания, до полного онемения левой ноги и стопы.
- Слабость и тяжесть левой ноги. Здесь преобладающая жалоба заключается в том, что слабость или тяжесть левой ноги существенно мешают движению.
- Постоянная боль левой ноги. Этот тип боли обычно ощущается в области ягодиц. Этот тип боли обычно описывается как «боль нерва», резкая и пульсирующая боли. Он обычно присутствует только с одной стороны и обычно называется ишиасом или поясничной радикулопатией. Хотя боль обычно с одной стороны, но она может возникать с обеих сторон, если обе стороны затронуты.
Если болит левая нога (правая) и боль ухудшается (возрастает) при сидении, стоя или ходьбе, это может указывать на проблему с определенной частью анатомии в нижней части спины. Поиск более удобных позиций обычно облегчает боль. Для большинства симптомов боли в левой ноге тщательный диагноз основной причины проблем является важным первым шагом к достижению эффективного лечения.
Другие причины боли в левой ноге и симптомы
- Дегенеративные изменения позвоночного диска. С возрастом наши межпозвоночные диски обезвоживают (теряют воду), дегенерируют, теряют гибкость и допускают небольшие аномальные движения, которые могут вызывать боли с диска, которые могут излучать ногу. В то время как основным симптомом заболевания дегенерации поясничного диска обычно является низкая боль, боли в ногах и стопах также являются распространенными симптомами.
- Грыжа межпозвоночного диска. Имеет тенденцию оказывать давление на самую слабую точку диска, область, расположенную чуть ниже нервного корешка. Это вызывает боль, которая может излучаться по всей длине прохождения седалищного нерва по всей ноге. В зависимости от вовлеченного нервного корешков могут быть задействованы другие нервы (рядом с седалищным нервом). Симптомы грыжы межпозвоночного диска обычно меняются в зависимости от того, где находится грыжа диска.
- Спинальный стеноз в поясничной области возникает, когда спинальные нервные корни сжимаются, обычно в костном канале, где спинной мозг расположен внутри позвоночника. Стеноз позвоночника обычно, но не всегда, встречается у пожилых пациентов, где суставы позвонков расширены и деформированы из-за дегенерации позвоночного столба, который имеет тенденцию возникать с возрастом. Симптомы спинномозгового стеноза имеют тенденцию улучшаться, когда пациент наклоняется вперед, положение, которое имеет эффект вытяжения позвоночника, уменьшая давление от корней спинного нерва.
- Боль в левой ноге от спондилолистеза. Спондилолистез возникает, когда позвонок сдвигается по отношению к следующему нижнему позвонку, нарушая естественную структуру сегмента позвоночника, а также его устойчивость и гибкость. Нестабильность может привести к нерву, который защемляется или воспаляется, вызывая боль в ногах. Ишиас является симптомом проблемы в поясничной области.
- синдром piriformis и дисфункция крестцово-подвздошных суставов также могут вызывать боль в левой ноге и типичные симптомы ишиаса.
- Боль в левой ноге от проблем с сосудами. Боль в левой ноге также может быть вызвана сосудистыми проблемами. Хроническая венозная недостаточность с образованием венозных варикозов. Вызовет ощущение тяжести или горения. Если проблема находится на артериальном уровне, и есть препятствие для нормального артериального кровообращения, боль проявляется после усилия или после использования ноги в течение длительного периода. Причиной боли является нарушение кровоснабжения и недостаток кислорода, которые артериальный круг не сможет адекватно удовлетворить. Альтернативно, другой проблемой может быть образование сгустка в сосудах, которые будут вызывать боль. В этих случаях мы говорим о тромбозе глубоких вен (ТГВ).
- Боль в левой ноге от мышечных проблем. Мышечные травмы могут вызвать боль в левой ноге. Наиболее часто встречается у спортсменов , но все же возможно и у людей с малоподвижным образом жизни.
Диагностика боли в левой ноге
Точный диагноз боли в левой ноге пациента будет поставлен, если пациент сможет предоставить четкую информацию о характере боли и симптомах. Эта информация как часть полной истории болезни в сочетании с физическими и диагностическими тестами (такими как МРТ-сканирование, миелография, компьютерная томография и т. д.) позволят специалисту по более точно поставить диагноз и определиться с возможными вариантами лечения.
Лечение болей в левой ноге
Многие пациенты находят облегчение боли посредством сочетания физической терапии и отдыха во время обострения острой боли, хотя значительную нестабильность и стойкую боль можно лечить с помощью операций, целевых инъекции (блокад), чтобы помочь уменьшить воспаление от воспаленного нервного корешка.
ЛЕЧЕНИЕ В АКТИВ ЦЕНТРЕ
Актив Центр предлагает лечение боли в левой ноге при патологиях позвоночника.
- Мы применяем наиболее эффективные методики в лечение опорно двигательного аппарата консервативными методами.
- Применение комплексно несколько методик, позволяет снять болевой синдром, остановить развитие заболевания, улучшить самочувствие, скорректировать осанку и избавить пациента от болезни без медикаментов, операций.
- Команда опытных специалистов Актив Центра обеспечит безопасный вариант лечения и облегчения состояния.
- От диагноза до лечения Ваше здоровье для нас главные приоритеты.
- Наши клиенты чувствуют улучшения уже после первой недели занятий с реабилитологом.
- Мы сможем помочь Вам обратить внимание на возможные нарушения самочувствия и подсказать, с какими заболеваниями они могут быть связаны, а так же сориентироваться по диагнозу и возможным вариантам восстановления и оздоровления функций позвоночника и стопы.
- Мы добиваемся и главное закрепляем результат лечения!
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Общие сведения
Ноги — парный орган опоры и движения человека. Нога анатомически состоит из трёх основных частей:
Бедро образовано бедренной костью (самой массивной и прочной из человеческих костей) и надколенником, защищающим коленный сустав. Голень образуют большая и малая берцовые кости. Стопу образуют множество мелких костей. Место сочленения бедренной кости с тазовой костью называется тазобедренным суставом.
Сочленение бедренной и берцовых костей называется коленным суставом, а берцовых костей с костями стопы: голеностопным суставом. Ахиллово сухожилие ограничивает движения стопы относительно берцовой кости. Травмы голеностопного и особенно коленного сустава опасны, поскольку часто приносят необратимый вред.
Боль и тяжесть в ногах становятся спутниками жизни многих людей. Некоторые люди продолжают терпеть такие боли на протяжении долгого периода времени. Между тем, крайне необходимо провести диагностирование и выявить причину появления дискомфортного состояния. Ведь вылечить заболевание на начальной стадии намного легче, чем запущенное.
Причины боли в левой ноге
Существует несколько причин, которые вызывают боль в левой ноге. Это заболевания позвоночника, суставов, сосудов ног, либо мышц. Чаще всего появление боль в левой ноге связана с заболеваниями сосудов. Происходит это из-за нарушения оттока венозной крови и повышения вследствие этого давления в сосудах. Образовавшийся венозный застой является причиной раздражения нервных окончаний и развития болевого синдрома. Чаще всего такие боли в левой ноге носят «тупой» характер, ощущается тяжесть в ноге. Таким образом, постепенно развивается варикозное расширение вен.
При другом сосудистом заболевании — тромбофлебите, наблюдается боль пульсирующего характера, часто переходящая в чувство жжения под кожей. При тромбофлебите боль в левой ноге носит постоянный характер, особенно это касается боли в икроножных мышцах.
Еще одна причина боли в левой ноге — атеросклероз артерий. При этом заболевании происходит уплотнение стенок сосудов, больной при этом ощущает сжимающие боли в икроножных мышцах. Чаще всего атеросклероз вызывает болевой синдром именно в мышцах голени. Боли усиливаются при ходьбе. Характерным симптомом атеросклероза является ощущение холодных стоп, вне зависимости от времени года.
Следующей группой заболеваний, провоцирующих появление боли в левой ноге являются болезни позвоночника. Имеющиеся нарушения в работе позвоночника, например, в межпозвонковых дисках, приводят к появлению так называемых иррадиирующих болей, отдающих в ногу. К такому виду болей можно отнести ишиас (воспаление седалищного нерва). При этом заболевании боли от позвоночника по ходу седалищного нерва передаются в ноги.
Поражение бедренного нерва
Чаще всего данное заболевание бывает вторичным при поясничном остеохондрозе, реже спондилите (особенно у детей), опухоли позвоночника и характеризуется болями по передне-внутренней поверхности бедра. Отмечается болезненность при пальпации по ходу бедренного нерва. Положительные симптомы натяжения нервов: болезненность по передней поверхности бедра при сгибании ноги в коленном суставе в положении больного на животе; сила четырехглавой мышцы снижается, коленный рефлекс снижен или отсутствует, гипестезия в зоне иннервации бедренного нерва.
Болевой синдром вследствие поражения бедренного нерва следует дифференцировать от болевого синдрома в результате воспаления подвздошно-поясничной мышцы (псоит), который сопровождается сгибательной контрактурой бедра. Очень часто боль в левой ноге связана с заболеваниями суставов. Боль как бы «выкручивает» ногу. Обострение этого болевого синдрома наблюдается при смене погоды. На более серьезных стадиях заболеваний суставов боли могут носить постоянный, подчас просто мучительный характер. Особенно это касается приступов боли при подагре. Боли в коленном суставе могут свидетельствовать о разрушении хряща этого сустава. Но точный диагноз и назначение лекарств может сделать только опытный специалист.
Заболевания периферических нервов могут также провоцировать боль в левой ноге. При невралгиях боли носят приступообразный характер и возникают по ходу нервных волокон. В перерывах между приступами боль практически отсутствует, а сам болевой приступ может длиться от нескольких секунд до нескольких минут.
Наиболее сильная боль в левой ноге возникает при воспалении мышц. Миозиты — это довольно серьезное заболевание, которое необходимо лечить под постоянным наблюдением врача.
Боли в левой ноге могут вызываться таким инфекционным заболеванием костей как остеомиелит. Боли при данном заболевании острые и продолжительные. В данном случае причиной возникновения болей выступают сами кости.
В некоторых случаях причиной боли в левой ноге является травма (ушиб, перелом, растяжение или разрыв связок и мышц), тогда последовательность действий более или менее очевидна. Однако иногда повреждение развивается постепенно в результате чрезмерной физической нагрузки, выполнения упражнений без предварительной разминки, ношения неудобной обуви, бега по твердой поверхности.
Резкая боль в голени левой ноги в сочетании с внезапной краснотой кожи и повышением температуры свидетельствует в пользу рожистого воспаления (рожи). Плотный отек, пульсирующие и распирающие болевые ощущения в голени могут указывать на следующие проблемы:
гнойный воспалительный процесс (флегмону).
При этом они усиливают при ощупывании и работе мускулатуры. Обратиться за медицинской помощью следует, если боль в ногах не проходит в течение трех и более дней, распространяется на все отделы нижних конечностей, сопровождается их слабостью, онемением и охлаждением, синюшностью или отечностью кожного покрова.
Профилактика и лечение
Для того чтобы предупредить появление боли в левой ноге необходимо соблюдать некоторые правила. Например, при сосудистых проблемах необходимо:
Ограничить в рационе жирную, богатую холестерином пищу;
сбросить лишний вес;
регулярно выполнять специальный комплекс упражнений для предупреждения развития варикозного расширения вен.
Старайтесь исключить длительное стояние или сидение. При сидячей или стоячей работе необходимо регулярно делать перерывы и менять положение. Стоит обратиться к врачу, если резкие боли в ноге не отступают на протяжении трех дней, а также:
Ноги немеют, холодеют и слабеют;
боль отдает в верхние и нижние части ноги;
кожа синеет и набухает;
после травмы появился сильный отек.
При проблемах с позвоночником или суставами необходимо производить своевременное лечение этих заболеваний и следовать указаниям врача. При проблемном позвоночнике и частых иррадиирующих болях в правую ногу, полезно проведение регулярных курсов массажа. Выполнение упражнений, направленных на укрепление мышц живота приводит к уменьшению напряжения мышц нижних отделов спины и, как правило, снижают частоту иррадиирующих болей.
Тянущие боли пациентами определяются по связи со сгибанием или разгибанием конечности, большей распространенности с охватом всей поверхности спереди или сзади. Характер ощущений позволяет предположить патологический процесс по ходу нервного ствола. Поэтому с подобными проявлениями чаще сталкиваются неврологи.
Какие уровни иннервации ног страдают в первую очередь?
Если боль в левой или правой ноге вызвана нарушенной иннервацией, то можно предполагать 3 возможных уровня поражения:
- изменения остистых отростков позвоночника поясничного (L) или крестцового (S) отделов, называемые остеохондрозом — патологическое разрастание костной ткани, приводящее к сдавлению нервных веток в месте выхода из спинного мозга;
- радикулиты или радикулопатии — воспалительные или другие (дегенеративные при сахарном диабете, алкогольном отравлении, интоксикациях) изменения самих нервных корешков без нарушений структуры позвонков;
- воспаление седалищного и бедренного нервов, расположенных между мышцами ягодиц и бедра.
Самые упорные боли связаны с выпадением грыжевого диска спинного мозга, с опухолью.
Все виды сопровождаются «длинными» болями тянущего, ноющего или стреляющего характера от поясницы до голени. Для врача важно определить различия в этих заболеваниях. Для этого, кроме характера болей, учитывается место иррадиации в ногу.
Как выглядит пациент?
Тянущие боли заставляют человека принимать вынужденное положение. При пояснично-крестцовом радикулите болезненность распространяется по задне-наружной поверхности бедра и голени в стопы. Значительно усиливается интенсивность при движении, кашле, чихании, дефекации. Пациент лежит в постели с согнутой ногой.
При поражении седалищного нерва бедро повернуто кнаружи, а если воспален бедренный нерв — кнутри.
Пытаясь повернуться, пациент опирается на руки и здоровую ногу, а чтобы сесть, ему приходится напрячь ягодицу со здоровой стороны и отклониться назад.
В положении стоя больная конечность полусогнута, на нее делается легкий упор носком. Туловище принимает форму противоболевого защитного сколиоза: искривление позвоночника в больную сторону при воспалении седалищного нерва, в здоровую — при радикулите (для уменьшения сдавления корешка).
Диагностические признаки
В качестве дифференциальной диагностики неврологи пользуются симптомами, указывающими на сопутствующие зоны нарушения чувствительности (от анестезии до покалывания), проверяют тонус мышц на пояснице и ногах. Напряжение в ягодицах, икрах ног тоже носит защитное происхождение.
Поражение седалищного нерва вызывает снижение тонуса ягодичных мышц, их атрофию, сглаженность и опущение ягодичной складки.
Имеется разница в болевом синдроме, зависящая от уровня поражения корешков спинного мозга или выпадения грыжи. Она показана в таблице.
Уровень поражения | Локализация боли | Наличие онемения |
L3-L4 | задняя поверхность бедра, голени | область колена, немного выше и ниже |
L4-L5 | задняя поверхность поясницы и наружная сторона бедра до колена | снаружи на икроножной мышце и сзади над пяткой |
L5 — S1 | ягодичная область, задняя поверхность бедра, голени | наружная (боковая) часть икры, лодыжки, стопы |
Для остеохондроза характерны:
- асимметричность болей;
- связь с судорогами в мышцах;
- возникновение в любое время суток;
- отсутствие чувства слабости и усталости.
Симптомы натяжения
Симптомы проверяются неврологом, они подтверждают характер тянущих болей.
Наиболее популярен у врачей симптом Лассега. Он имеет 2 фазы:
- 1 — при поднимании за пятку разогнутой в коленном суставе ноги возникает острая боль в ягодице и по ходу седалищного нерва;
- 2 — при сгибании этой ноги в колене боль исчезает.
- в первой позиции натяжение носка на себя — боль резко усиливается, напрягаются мышцы-сгибатели бедра;
- отведение поднятой ноги в сторону вызывает боли в приводящих мышцах.
Для поражения нервной проводимости типично в начале заболевания повышение ахиллова и коленного рефлексов на больной стороне, их угасание по мере выздоровления.
В лечении применяют:
- препараты для снятия мышечного спазма (миорелаксанты);
- нестероидные противовоспалительные средства;
- физиопроцедуры (УВЧ, электрофорез, фонофорез);
- витамины группы В;
- массаж и акупунктуру.
При мануальной терапии врач непосредственно воздействует на точки выхода нервных корешков. Лечение довольно эффективно в руках умелого специалиста.
Авитаминоз как причина болей
К возникновению болевого синдрома причастны недостаток витаминов С, В, кальция и магния. Это часто связано с разнообразными модными диетами для похудения. Возврат к полноценному питанию приводит к исчезновению болей.
Особое отношение к состоянию дефицита витаминов и микроэлементов при беременности. Повышенная потребность организма женщины в витаминах из-за требований плода нуждается в компенсации дополнительными овощами, фруктами. Акушеры-гинекологи назначают специальные витаминные комплексы, обогащенные минеральными добавками. В зависимости от состояния будущей матери, закладывается здоровье малыша.
Как на ноги влияет интоксикация?
Тянущие ощущения в ногах возникают при острой и хронической интоксикации. Острый процесс возможен:
- во время лихорадящего периода при инфекционных заболеваниях, гриппе, ОРВИ;
- в затяжной восстановительной стадии при отсутствии или плохом лечении инфекции.
Хроническая интоксикация происходит:
- у алкоголиков, наркоманов;
- у лиц, длительно контактирующих с ядохимикатами;
- при хронической почечной недостаточности.
Механизм болей одинаков: в организме накапливаются недоокисленные шлаки, молочная кислота, кетоновые тела.
Похожий процесс развивается при подагре.
Для снятия интоксикации применяют:
- жидкости в виде питья и внутривенно (разбавляется концентрация токсических веществ), в составе жидкости обязательно должны быть ощелачивающие растворы (минеральная вода «Ессентуки», сода);
- витамины как составляющую часть ферментов для обеззараживания организма;
- процедуру гемодиализа и гемосорбции.
Другие причины болей
Нельзя исключить из причин тянущих болей в ногах геморрой. Этой болезнью страдает половина взрослого населения. Флебит геморроидальных вен является хроническим очагом инфекции, расположен в одной зоне с седалищными нервами, способствует поддержке воспалительного процесса.
В лечении используются:
- свечи с обезболивающим и противовоспалительным эффектом;
- препараты-венотоники внутрь;
- склерозирующие малые оперативные вмешательства, позволяющие исключить расширенные геморроидальные вены из кровообращения;
- в тяжелых и запущенных случаях — операция удаления ущемленных узлов.
Синдром «беспокойных ног» чаще возникает у женщин. Типичны боли «гудящие», ноющие, тянущие. При этом других заболеваний не обнаруживают. Причиной считается психика человека. Чаще всего возникает у женщин, не умеющих расслабляться, переживших стрессовые ситуации, работающих на напряженных участках.
Подобные проявления приводят к серьезным неврозам, служат толчком для развития гипертонической болезни. Поэтому выявить вовремя и научиться снимать напряжение – важная задача.
- изменения режима работы;
- занятий спортом;
- применения расслабляющих методик йоги, аутотренинга;
- приема растительных успокаивающих средств или седативных лекарств.
Дополнительные методы диагностики
В диагностике тянущих болей в ногах необходимо выявить причину. Помогают:
- общий анализ крови;
- биохимические тесты на почечные и печеночные пробы, билирубин, креатинин, остаточный азот;
- определение витаминов, кальция и минералов в крови;
- рентгенография позвоночника;
- УЗИ почек и печени;
- ангиография периферических сосудов.
Боли в ногах — хороший пример проявлений общих изменений в организме. Они не только ограничивают активность человека, но должны восприниматься как сигнал о системных поражениях.
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