Многочисленные статистические данные свидетельствуют о том, что распространенность такой проблемы, как тяжесть в ногах, достаточно велика. Причины, вызывающие этот недуг, заставляющий человека испытывать болевые ощущения и дискомфорт, бывают достаточно разнообразны. Некоторые из них даже сложно связать с болевым синдромом. И за обыкновенной, казалось бы, тяжестью в ногах иногда скрывается не простая усталость, а серьезное заболевание. Важно не оставить без внимания этот сигнал и вовремя обратиться к специалисту.
Почему возникает боль и тяжесть в ногах?
Содержание статьи
Причины возникновения тяжести в ногах
Давайте рассмотрим наиболее часто встречающиеся причины этих симптомов:
- период полового созревания, беременность и роды, менопауза;
- наследственность;
- врожденная слабость соединительной ткани и стенок вен;
- неправильное питание и избыточная масса тела;
- вынужденное продолжительное положение сидя или стоя (приводит к венозному застою);
- ушибы коленей, голеностопного сустава и травмы ног;
- нарушение эндокринной системы (дисфункция щитовидной железы, сбои в работе поджелудочной железы, дисфункция надпочечников);
- прием гипотензивных, гормональных, сахароснижающих и противовоспалительных нестероидных препаратов (эти медикаментозные средства могут оказывать побочный эффект, суть которого сводится к скоплению жидкости в мягких тканях конечностей);
- стрессы, влекущие за собой нервные расстройства (т.к. происходят изменения в нервных окончаниях вен, что негативно сказывается на тонусе);
- сезонные обострения (высокая температура окружающей среды благоприятствует наиболее частому проявлению признаков тяжести в ногах).
Иногда проходят годы, прежде чем человек начнет замечать, что тяжесть в ногах стала постоянной спутницей. Все вышеперечисленные факторы служат серьезными предпосылками, которые могут способствовать развитию такого заболевания, как варикозное расширение вен.
Варикоз или варикозное расширение вен нижних конечностей — это медленно прогрессирующее патологическое расширение подкожных вен ног. Рано или поздно, но болезнь даст о себе знать и перестанет быть только эстетической проблемой, приведя к глубокому поражению вен. Тогда лечение станет более серьезным и длительным, чем простая профилактика, которая помогла бы избежать тяжелых последствий на ранней стадии развития варикоза.
Неэффективная работа глубоких вен приводит к хроническому застою крови и появлению характерной симптоматики «тяжелых ног»:
- вечерние и ночные судороги в икроножных мышцах;
- регулярно возникающие к вечеру и исчезающие к утру отеки (лодыжки и стопы, а затем уже и голени);
- постоянное чувство тяжести в ногах после нагрузки или физической работы;
- жжение по венам ног, в особенности после длительного периода стояния;
- чувство «распирания» и онемения ног;
- появление и исчезновение «сосудистых сеточек» в зависимости от положения ног.
Тяжесть в ногах при ходьбе
О чем говорит тяжесть в ногах при ходьбе?
- Патологии сердца и сосудистой системы: кардиомиопатия, перикардит, хроническая сердечная недостаточность, тромбофлебит. Все вышеперечисленные заболевания ведут к нарушению кровообращения и возникновению боли, тяжести в икрах ног, которая носит постоянный пульсирующий характер, усиливаясь при ходьбе;
- Патологии почек: острая и хроническая почечная недостаточность, нефротический синдром. В результате патологии происходит задержка вывода жидкости из организма и развитие на этом фоне отеков, а они уже могут локализоваться по всему телу, в частности в нижних конечностях;
- Патологии позвоночника: невралгия седалищного нерва (ишиас), люмбаго и другие заболевания напрямую связаны с заболеваниями ног:
- при ишиасе практически всегда возникает болевой синдром в голеностопных, коленных и тазобедренных суставах, т.к. седалищный нерв идет по задней поверхности ноги. Многие пациенты путают эти симптомы с обыденной усталостью, которая возникает после тяжелого физического труда;
- при люмбаго возникает резкая боль в поясничном отделе спины. Она сопровождается невыносимой тяжестью в ноге, поскольку поражается бедренный нерв.
Если вы регулярно ощущаете симптомы усталости и тяжести в ногах, напряжение и боль, необходимо как можно скорее обратиться к специалисту и выявить причину. Запущенные заболевания гораздо труднее поддаются лечению, нежели те, что выявлены на раннем этапе развития.
Видео: тяжесть в ногах
Компания «ВЕРТЕКС» не несет ответственности за достоверность информации, представленной в данном видео ролике. Источник — Все буде добре
Тяжесть в ногах: что делать и как лечить?
Тяжесть в ногах при ходьбе: диагностика причины
Как и лечение любого другого недуга, устранение тяжести и боли в венах ног в первую очередь должно быть направлено на искоренение основного заболевания.
В некоторых случаях для постановки диагноза консультации флеболога бывает недостаточно. Для выяснения причины тяжести в ногах может потребоваться проведение дополнительных исследований: осмотра у кардиолога и эндокринолога, осуществления коагулограммы, дуплексного сканирования сосудов.
Если после обследования врач поставит вам диагноз «варикозная болезнь вен нижних конечностей», то стоит подготовить себя к тому, что процесс восстановления может быть долгим и трудоемким. Но если не заниматься лечением варикоза, то возникает большой риск развития осложнений: тромбоз, тромбофлебит, трофические язвы и экземы.
Продолжительность лечения напрямую зависит от стадии, на которой обнаружено заболевание. Естественно, чем своевременнее вы начнете лечение, тем более результативным оно будет. Как показывает медицинская практика, больший эффект дает комплексное лечение, сочетающее правильную последовательность различных методов устранения тяжести в венах ног.
Лечение может быть консервативное и оперативное:
- Безоперационное (консервативное) лечение используется: на ранних стадиях заболевания; при наличии противопоказаний к оперативному вмешательству; является обязательным в послеоперационный период.
В понятие «консервативное лечение» входит снижение проявлений симптомов, за счет умеренной физической нагрузки, ношения эластичного белья, физиотерапии и лекарственных препаратов. Зачастую все вышеперечисленные методы консервативного лечения применяются совместно, тем самым достигается максимальный эффект.
На всех стадиях развития варикозной болезни рекомендовано применение венотонизирующих средств (иногда целые комплексы). Форма выпуска разная: таблетки, капсулы, кремы, гели, тоники. В состав этих препаратов преимущественно входят тонизирующие вещества растительного происхождения, активные натуральные компоненты которых, в большинстве своем, не имеют побочных реакций. Венотоники оказывают положительное действие на стенки вен, что проявляется уменьшением болезненных симптомов варикоза. - Если прибегнуть к медицинской статистике, то только в России около 35 миллионов человек страдают варикозной болезнью, и более 1,5 миллионов человек нуждается в оперативном лечении ежегодно. Методы хирургического лечения применяют в зависимости от степени поражения вен и выраженности заболевания. Если консервативное лечение неэффективно, то в таких случаях актуальны следующие виды лечения:
-
флебэктомия (оперативное удаление варикозно-расширенной вены);
склерозирование (введение в расширенную вену склерозанта, который вызывает слипание стенок вены, и кровоток по ней становится невозможным);
лазерная коагуляция (разрушительное воздействие лазером на стенку вены, в результате чего происходит "замуровывание" венозного просвета).
Какой из методов лечения подходит именно вам, может определить только врач.
Профилактика отечности и тяжести ног
Рекомендации врача при чувстве тяжести в ногах
Не стоит забывать о таком важном аспекте, как профилактика усталости и тяжести в ногах, позволяющая предупредить серьезные заболевания. Очень важно следить за своим здоровьем, вести правильный образ жизни и не игнорировать сигналы, подаваемые организмом. Группа мероприятий, о которых пойдет речь ниже, предупреждает венозный застой и варикозное расширение вен, как его неблагоприятное следствие.
Если вы все чаще задумываетесь о том, как убрать тяжесть в ногах и что для этого делать, предлагаем ознакомиться со следующими рекомендациями:
- Большое значение имеет гармоничное соотношение режимов труда и отдыха. Одно не должно преобладать над другим. Для нормализации тока крови по организму, человеку необходимо хотя бы 8 часов в сутки пребывать в положении лежа (это норма, отведенная на сон);
- Важно не пренебрегать продуктами, богатыми витамином Е (рыба, масло из пшеничных зародышей, сои и хлопка). Этот витамин дает питательную поддержку для сосудистой системы и способствует процессу циркуляции крови;
- Умеренная нагрузка, носящая характер постоянной, не требует большого количества времени, но оказывает благоприятное действие на циркуляцию крови. Обратите внимание на занятия спортом, которые не повлекут за собой серьезной нагрузки на организм: велосипедные прогулки, плавание или ходьба. Тем, кто занимается спортом профессионально, есть смысл уменьшить количество и интенсивность тренировок, пусть даже на время. Если же нагрузки невозможно ограничить в той мере, как этого хотелось бы, то самомассаж с использованием кремов и гелей для ног, обладающих венотонизирующим эффектом, будет способствовать предотвращению отеков и усталости в ногах. Для этой цели подходит Нормавен® Крем для ног. Средство было разработано специалистами фармацевтической компании, оно прошло клинические исследования и доказало свою эффективность в борьбе с тяжестью ног;
- Возьмите за правило носить компрессионное белье: чулки, гольфы или колготы. Оно оказывает точное расчетное давление на вены и показано для нормализации кровообращения, соответственно предупреждает застой;
- Чтобы свести к минимуму прилив крови к ногам в положении лежа, приподнимите нижний край кровати хотя бы на 5 см. Этого можно добиться, например, подложив под ножки кровати деревянные бруски;
- Отличной стимуляцией тонуса сосудов и капилляров может стать контрастный душ;
- Приобретите ортопедический массажный коврик, который способен улучшить кровообращение в стопах. Помимо тренировки мышц, вы ощутите еще и прекрасный тонизирующий эффект.
- Рекомендуется сократить посещение солярия и не допускать длительного пребывания на солнце. В случае, если соблюдение данной рекомендации становится невозможным, тоник с охлаждающим эффектом станет быстрой помощью вашим ногам.
- Следует уделить пристальное внимание подбору обуви. У женщин тяжесть в ногах после работы обусловлена ношением обуви на плоской подошве, либо с высоким каблуком, поэтому необходимо отказаться хотя бы на время от подобной обуви. Ношение высокого каблука само по себе нарушает физиологическое расположение мышц, тем самым вызывая их перегрузку. Следует чаще отдавать предпочтение неузкой обуви, имеющей средней величины или низкий каблук (2,5-5 см) и умеренно гибкую подошву. Если вы хотите устранить тяжесть в ногах, обусловленную плоскостопием, то дополнительно к перечисленным требованиям, носите ортопедические стельки.
- СОВРЕМЕННЫЕ ПРОБЛЕМЫ ВАРИКОЗНОЙ БОЛЕЗНИ НИЖНИХ КОНЕЧНОСТЕЙ (ЭПИДЕМИОЛОГИЯ, ДИАГНОСТИКА, ЛЕЧЕНИЕ) И ЕЕ ОСОБЕННОСТИ У ЛИЦ СТАРШИХ ВОЗРАСТНЫХ ГРУПП. Литынский А.В., Поляков П.И., Горелик С.Г. // Научные ведомости Белгородского государственного университета. Серия: Медицина. Фармация. – 2012.
- ЭФФЕКТЫ КОМПРЕССИОННОЙ ТЕРАПИИ ПРИ АМБУЛАТОРНОМ ВЕДЕНИИ ПАЦИЕНТОВ С ВАРИКОЗНОЙ БОЛЕЗНЬЮ НИЖНИХ КОНЕЧНОСТЕЙ. Бурлева Е.П., Белова А.Д., Супрунова Н.В., Эктова М.В. // Стационарозамещающие технологии: Амбулаторная хирургия. – 2017. – №1-2. – С. 29-34.
- https://www.medicalnewstoday.com/articles/321670.php
- https://belmapo.by/varikoz.-meryi-profilaktiki,-pitanie-i-gimnastika.html
Для точной диагностики обращайтесь к специалисту.
Ноги ежедневно подвергаются повышенным нагрузкам. Вечером после трудового дня в них возникают дискомфортные ощущения: тяжесть, боль. Если появляется усталость в ногах, причины и лечение следует определить незамедлительно. Это не позволит развиться тяжелым осложнениям.
Причины
Часто встречаются следующие причины усталости в ногах:
- Высокие каблуки. Когда женщина долгое время ходит или стоит в обуви на высоком каблуке, ноги начинают болеть, в них появляется тяжесть.
- Некомфортная обувь. В тесных, узких, с неудобной колодкой, из некачественных материалов туфлях или сапогах ноги быстро устают.
- Неадекватные физические нагрузки, интенсивные спортивные тренировки приводят к болям и дискомфортным ощущениям в ногах.
- Слабость и усталость возникают при заболеваниях, связанных с нарушенным кровообращением. Тяжесть в ногах появляется при наличии в сосудах атеросклеротических бляшек, при высоком холестерине, сахарном диабете.
- Утомление ног вызывают отеки, плоскостопие, варикозное расширение вен. Эти заболевания приводят к возникновению болей, судорог.
- Дискомфорт появляется при патологиях сердца, сосудов, суставов и мышц. Они возникают на фоне остеохондроза и прочих заболеваний позвоночника.
Появление слабости и усталости нижних конечностей провоцирует пониженный мышечный тонус. Ослабление мускулатуры ног вызывают разные причины, включая деструктивные изменения в позвоночнике. Когда одновременно с мышцами ног слабеет мускулатура рук, провоцирующим фактором выступает остеохондроз. Тонус падает из-за разрушившихся хрящей.
Как устранить слабость
При слабости, провоцирующей усталость в нижних конечностях, лечат первопричину: заболевания позвоночника, эндокринные болезни, патологии сосудов. Корректируют образ жизни, организуют отдых. Избавиться от проблемы помогают:
- Прогулки на свежем воздухе.
- Рациональное питание. В меню добавляют овощные блюда, фрукты. Они не позволяют развиваться авитаминозу и анемии, обеспечивают ткани питательными веществами.
- Контрастный душ и ножные ванночки поднимают мышечный тонус.
- Комфортная обувь. Необходимо подбирать свободные удобные изделия.
- Нельзя стоять продолжительное время. Надо периодически прохаживаться, присаживаться.
- Правильная осанка. Следует делать гимнастику и массаж для укрепления спины.
Народные методы
Для лечения слабости в ногах используют растительные препараты. Дома дискомфортные ощущения снимают средствами, приготовленными по следующим рецептам:
- Контрастные ножные ванночки. В одно ведро наливают прохладную воду (не выше 15 градусов), во второе – горячую (40 градусов). Ноги попеременно погружают в емкости. Заканчивают процедуру в ведре с холодной водой. Такая процедура избавляет от кручения, перенапряжения и беспокойства, возникающих в ногах. Делают ванночки перед сном, ноги после них обсушивают, надевают на них теплые носочки.
- В домашних условиях делают компрессы с медом. Ноги натирают жидким медом (закристаллизовавшийся продукт подогревают), накладывают теплую повязку. Аппликацию оставляют на сутки. После снятия повязки ноги моют в теплой воде. Лечатся семь дней. Компресс эффективен при слабости в конечностях и болях в позвоночнике.
Как избавиться от усталости
К тяжести приводит ежедневная работа на ногах, в конце дня хочется быстро снять усталость. Облегчение наступает после полноценного отдыха. Чтобы усталость прошла, в положении лежа кладут ноги на возвышение под углом 45° и отдыхают 15 минут.
Помогает снять усталость ног после работы массаж. Делают его, придерживаясь следующего алгоритма:
- Оливковое масло подогревают. Смазывают им лодыжки вдоль, втирают мягкими круговыми движениями от пальцев ступни к пятке и дальше по икроножной мышце до верха.
- Когда массируется ступня, особое внимание акцентируют на впадине. Обрабатывая ее, делают растирающие и надавливающие движения. Они снимают напряжение и боль.
- Для расслабления ног используют массажеры. Стопы ставят на поверхность приспособления, выполняют катающие движения. От соприкосновения с роликами сосуды, проходящие по мышцам ступни, расширяются, кровоток в них улучшается, отечность и боль уходят.
- Избавиться от усталости помогает массаж теннисным мячиком. Его придавливают стопой и катают.
- Болезненность в пальцах и стопе проходит, если подбирать с пола ногами маленькие предметы: фасоль, бусины и прочее.
Народные методы от усталости и отечности
Дома можно делать компрессы, растирки, ванночки. Процедуры быстро снимают отеки, болезненность, раздражение. Они успокаивают, приносят облегчение.
Компрессы
Если ноги устали, используют следующие средства:
- Аппликация с капустными листьями снимает отеки и тяжесть. Листы отбивают до выделения сока, обкладывают ими ступни, фиксируют повязкой. Спустя 30 минут аппликацию убирают, принимают ножную ванночку.
- Растирка с чесночной настойкой. Если дневная нагрузка была повышенной, вечером ноги растирают настойкой из чеснока. Зубчики одной головки измельчают в кашицу, заливают 250 мл кипятка. Оставляют на 30 минут. Раствор втирают в стопы, через 15 минут ноги обмывают, обмакивают их в холодную воду.
- Аппликация с голубой глиной. Берут 2 столовые ложки средства, вливают воду до густоты сметаны. Наносят глину на ступни. Спустя 30 минут ноги моют, массажируют, смазывают кремом.
- Примочка с экстрактом розмарина. 50 г растения заливают литром кипятка. Остужают, фильтруют, пропитывают жидкостью полотенце, обертывают им нижние конечности. Ложатся, кладут ноги на валик или подушку. Продолжительность процедуры 15 минут.
Травяные ванны
Лечение ног предполагает использование водных процедур. Усталость, слабость и боль снимают травяные, содовые и солевые ванны. Они нормализуют кровообращение и обмен веществ в тканях, вытягивают токсины и молочную кислоту.
Обязательное условие их использования – температура жидкости должна составлять 37 градусов. Принимают ванну 15–20 минут. Делают сидячие и ножные ванны.
- Сбор из мяты, крапивы, мелиссы. Травы берутся в равных количествах. В 250 мл кипятка кладут столовую ложку сбора, дают остыть, фильтруют. Выливают настой в таз с 3 л горячей воды.
- Сбор из ромашки, календулы, мелиссы, мяты – эффективное средство для снятия усталости и расслабления перед сном. Травы, взятые в равных количествах, перемешивают. В 250 мл вскипевшей воды всыпают 2 столовые ложки сбора. Оставляют на 30 минут для настаивания. Процеживают, переливают в таз, разбавляют 3 л воды.
- В травяные ванночки можно добавлять по столовой ложке соли (морской или пищевой) и чайной соды.
- Усталость и отеки снимают ванночки с вытяжкой из календулы, листьев березы, липового цвета, ягод можжевельника, брусники, хвоща. Для расслабляющих и улучшающих сон ванночек берут пустырник, валериану, мелиссу, мяту, зверобой, лаванду, ромашку, шалфей. Травы комбинируют между собой или используют по отдельности. Настой готовят традиционным способом – 1–2 столовые ложки травы заливают 250 мл кипятка, настаивают, процеживают, выливают в таз с водой.
- Ванночка с экстрактом из апельсиновых корочек – хороший домашний способ снять усталость в ногах. Кипятят 1 л воды, кладут в него стакан цедры, томят пять минут. После остывания процеживают и добавляют в таз с теплой водой.
- Солевая ванночка – проверенный народный метод избавления от усталости. В таз наливают 4 л горячей воды, растворяют в жидкости 0,5 стакана морской соли. Если хотят принять сидячую ванну, количество соли увеличивают до 1–2 кг.
- Содовая ванночка. В 3 л теплой воды растворяют 3 столовые ложки чайной соды. Парят ноги 10 минут.
- Ванночки с эфирными маслами – эффективный способ устранения боли и тяжести в ногах. Готовят содовый или солевой раствор, добавляют в него 2–3 капельки масла можжевельника, пихты, грейпфрута или лаванды.
Приведенные рецепты подходят для лечения людей любой возрастной категории, в том числе пожилых пациентов. Однако всем им нужен совет доктора. Народные средства обладают противопоказаниями. Например, солевые ванны нельзя принимать при гипертонии.
Если усталость ног вызывает беременность, необходима консультация врача. Тепловые процедуры, травяные экстракты способны спровоцировать выкидыш и другие нежелательные последствия.
Кремы, гели и мази
Наружные средства врач выписывает с учетом патологий, способных вызывать усталость и тяжесть в ногах. При варикозе и тромбах назначают гели на основе гепарина. Они разжижают кровь, снимают воспаление, отеки, тяжесть, устраняют застойные явления в венах. Пациентам выписывают гепариновую мазь, Лиотон.
Кремы с венотонизирующим действием нормализуют кровообращение, подавляют судороги, убирают усталость, нормализуют работу сосудов. Избавляются от тяжести в нижних конечностях с помощью Доппельгерца, Детралекса.
Мази с экстрактом пиявок устраняют усталость при заболеваниях вен. Они налаживают ток крови и лимфы, восстанавливают питание тканей – улучшают транспортировку кислорода и полезных веществ в очаг поражения.
Кремы для ног с растительными экстрактами стимулируют кровоток, устраняют усталость, смягчают кожу, восстанавливают тканевое питание, практически не дают побочных реакций. Используют средства на основе конского каштана, смородины, чайного дерева, фруктовых кислот. Бороться с усталостью помогают средства Green Mama, растирка из серии «Аптечка Агафьи», бальзам «Можжевеловый».
Препараты, содержащие ментол, обладают охлаждающим и отвлекающим эффектом, быстро избавляют от тяжести в ногах. Расслабляющее действие на мышцы оказывают охлаждающий крем-гель Virta, крем Youngfaces.
Местные лекарственные средства используют для лечения по назначению врача.
Усталость и слабость ног – небезобидное явление. Иногда оно возникает на фоне серьезных патологий. Определяет причину тяжести в ногах врач. Если усталость возникает от повышенных нагрузок, ее устраняют в домашних условиях народными методами. Когда она вызвана варикозом или другими болезнями, врач назначает соответствующее терапевтическое лечение.
Тяжесть в ногах – симптом, знакомый каждому. После тяжелого рабочего дня, интенсивных физических упражнений все испытывали подобное явление. Это результат длительной статической нагрузки, мышечного напряжения.
Болезни, для которых характерен симптом тяжести в ногах:
- варикозное расширение вен;
- тромбоз глубоких вен на ногах;
- лимфедема (патологическая отечность);
- плоскостопие;
- артроз или артрит суставов ног;
- остеохондроз поясничного отдела позвоночника;
- сердечная недостаточность;
- гломерулонефрит.
Тяжесть в нижних конечностях – синдром усталых ног. Развивается во всех возрастных категориях. Клиника – неприятное чувство в ногах, которое сопровождается тупой болью без четкой локализации или гудением, отечностью, усталостью. Пастозность (отечность) не всегда явно выражена. Проявляется передавливанием кожи на месте расположения манжетки носков или отпечатком тесной обуви. При прогрессировании синдрома возможно онемения, парестезии (ползания мурашек), судороги мышц голени. Как правило, симптомы развиваются во второй половине дня и проходят к утру, после сна и отдыха.
Патогенез включает такие аспекты:
- мышечное перенапряжение;
- недостаточность венозных клапанов, сниженный тонус сосудистой стенки, ухудшение оттока крови от нижних конечностей;
Недостаточность венозных клапанов (фото: www.pinterest.com)
- выход жидкости из сосудов в интерстициальное (межклеточное) пространство.
Встречается как физиологическое явление (например, долгая прогулка или физическая нагрузка) или проявление заболевания (варикоз, заболевание почек и сердца).
Тяжесть в ногах – многофакторная и полиэтиологическая проблема. Усталость и дискомфорт могут возникать как результат длительных нагрузок, продолжительного стояния на ногах. Профессии, представители которых чаще других жалуются на синдром тяжести в нижних конечностях:
Эти люди проводят рабочий день на ногах без отдыха. Также фактор риска — лишний вес. Суставы могут нормально работать при определенной нагрузке, а дополнительные килограммы нарушают функционирование, их поверхность стирается и разрушается. Развиваются артриты, артрозы. Большое количество жира осложняет процесс сокращения сосудов и отток крови.
Прием контрацептивов, содержащих гормоны, приводит к дискомфорту в ногах. После окончания лечения симптом проходит. Ходьба на каблуках — фактор риска развития синдрома усталых ног. Женщины насильно меняют форму и физиологическое положение ступни, тем самым провоцируют напряжение мышц.
В жаркую погоду, помимо общего снижения активности и работоспособности, происходит потеря организмом жидкости, ее выход в межклеточное пространство, теряется тонус вен.
Плоскостопие — искривление свода стопы. Проявляется нарушением костных структур ноги и ее связочного аппарата. Встречается врожденная и приобретенная (травматическая, рахитическая) формы.
Плоскостопие (фото: www. medvoice.ru)
Венозная недостаточность развивается в результате потери тонуса стенки сосуда и неправильного функционирования клапанов. Результат — нарушение оттока крови, застой жидкости.
Недостаток белка в организме ведет к образованию отеков. Помимо увеличения конечностей, развивается синдром усталых ног. Например, при гломерулонефрите.
При сердечной недостаточности развивается задержка жидкости в организме, так как сердце не обеспечивает должный выброс крови. Поэтому увеличивается секреция альдостерона (гормон, который задерживает натрий и воду). В первую очередь отекают ноги, что является причиной их усталости.
Синдром усталых ног сопровождает клинику многих заболеваний (описано в таблице ниже).
Варикозное расширение вен нижних конечностей
Чувство усталости, жжения в ногах, боль по ходу вен. Сосуды видно невооруженным взглядом – увеличенные, извитые, узловатые. Вены мягкие, кожа над ними не изменена. Появляются темные пигментации, телеангиэктазии (сосудистые звездочки) на голени. К вечеру развиваются отеки, которые проходят после отдыха в горизонтальном положении
Увеличение пораженной конечности. Отек плотный, холодный. Кожа бледная, напряженная. Боль, ограничение подвижности конечности. Отек распространяется постепенно, начиная со стопы, продвигается вверх. Не проходит после отдыха
Тупые, давящие боли, тяжесть в области сердца, перебои его работы, инспираторная одышка (тяжело совершить вдох). Пациент не может заниматься физическими упражнениями, долго ходить, так как начинает задыхаться. Приступы сердечной астмы происходят обычно ночью. Когда человек лежит, возникает резкий приступ удушья, что заставляет проснуться. Помимо чувства нехватки воздуха, пациент ощущает сердцебиение, резкую слабость, потливость
Остеохондроз поясничного отдела позвоночника
Характеризуется ноющей болью в пояснице, реже люмбаго (резкие прострелы). Мышцы спины напряжены. Онемение, чувство жжения, покалывания, ползания мурашек по нижним конечностям
Свод стопы патологический, меняется его продольная или поперечная конфигурация. Форма ступни модифицируется – укорачивается за счет отклонения первого пальца в сторону мизинца с формированием так называемой «косточки» на ноге. Люди обращаются к врачу по поводу косметического дефекта, возникают натоптыши (грубые кожные наросты) и мозоли из-за неправильной формы. Во время ходьбы боли в ногах. К вечеру тяжесть и усталость нижних конечностей
Артрит, артроз суставов нижних конечностей
Боль тазобедренных, коленных или голеностопных суставов. Затруднение движений, хруст и щелканье при ходьбе или сгибании ноги. Деформация суставов, покраснение
Развивается после инфекционного заболевания (грипп, ангина) через 2-3 недели после выздоровления. Может сочетаться с системными патологиями (красная волчанка, склеродермия). Характеризуется общей слабостью, повышением температуры тела, головной болью и ломотой в пояснице. Человек становится бледным, отекает лицо и ноги. Особенность опухлости – появляется утром, уменьшается с течением дня. Меняется цвет мочи – розовая и мутная (по типу мясных помоев). Повышается артериальное давление
Тромбоз глубоких вен на ногах
Развивается остро, за несколько часов. Возникает боль в пораженной конечности, гиперемия (покраснение) или синюшность ноги, местное повышение температуры. Поверхностные вены набухшие, при пальпации болезненные. Нижняя конечность отечная, больные не могут наступить на ногу из-за чувства распирания, боли
Совет врача. При появлении симптомов обратитесь к семейному доктору
Синдром усталых ног — не всегда проявление патологии. Причиной появления тяжести в нижних конечностях иногда служит физический труд или условия работы. Для исключения или подтверждения патологии необходимо обратиться к врачу.
Во время вынашивания ребенка организм женщины претерпевает колоссальные изменения. Нагрузки на тело будущей матери приводят к нарушению кровотока и появлению тяжести в ногах. Причины:
- у плода развивается своя система кровообращения, то есть у матери появляется дополнительный кровоток. Сердце женщины перегружается объемом поступившей крови, тем самым замедляется отток жидкости из нижних конечностей;
- с прогрессированием беременности увеличивается матка. Она придавливает рядом лежащие сосуды, что ограничивает отток крови из нижних отделов тела;
- естественный гормон, который помогает сохранить и выносить ребенка – прогестерон. Одно из его свойств – размягчение стенки сосуда. Вена теряет физиологический тонус, что нарушает продвижение крови;
- во время беременности женщина всегда набирает вес, иногда по 30-40 кг, что также негативно сказывается на кровообращении и опорно-двигательной системе.
Беременные женщины имеют те же заболевания, что другие люди. Все патологии во время вынашивания ребенка обостряются: пороки сердца, почечные заболевания, сахарный диабет.
Семейный доктор определяет диагноз, назначает лечение. Если требуется консультация узкого специалиста, семейный врач дает направление на прием таких врачей:
Часто необходимы консультации смежных специалистов. Врачи определяют причину проблемы, проведя специальные исследования.
Выяснение причины и постановка диагноза базируются на сборе анамнеза. Пациент рассказывает, когда появились симптомы, какие признаки сопутствовали, бывали ли улучшения состояния и что для этого человек делал, как лечился. Обязательные методы определения любой патологии – общий анализ крови и мочи, глюкоза, электрокардиография.
Следующий шаг – биохимическое исследование крови и коагулограмма (определение свертывающей системы плазмы).
- ультразвуковое исследование вен нижних конечностей;
- ангиосканирование;
- допплерография вен;
- ультразвуковое исследование сердца, органов брюшной полости и малого таза (почки, матка);
- рентген позвоночника и суставов нижних конечностей;
- плантография – исследование строения стопы.
Диагностика состояния клапанного аппарата вен:
- проба Троянова-Тренделенбурга. Человек лежит на спине, подняв одну ногу на 45°. Врач поглаживает конечность от стопы к паху, тем самым опорожняя вены. После этого на верхнюю треть бедра накладывается жгут. Пациент встает. В норме наполнение вен голени не происходит за 15 секунд. Если это произошло раньше – несостоятельность клапанов;
- проба Гаккенбруха. Доктор нащупывает овальную ямку – место впадения большой подкожной вены в бедренную. Если при кашле пациента чувствуется толчок под пальцами, значит, клапан не выполняет функцию;
- маршевая проба. Пациент стоит, ниже колена неплотно накладывается жгут, чтобы пережать только поверхностные вены. После человек ходит 5-10 минут. Если подкожные и варикозно измененные вены спадаются, значит, глубокие сосуды проходимы, и наоборот.
Компьютерная (КТ) и магнитно-резонансная томография (МРТ) почек, позвоночника, суставов – методы диагностики последней очереди. Используют при неэффективности предыдущих или противопоказаниях к ним.
Терапия синдрома усталых ног включает симптоматическое лечение и устранение этиологического фактора.
Лечение причины, вызвавшей тяжесть в нижних конечностях (описано в таблице ниже).
Варикозное расширение вен
Консервативная терапия: венотоники и антиагреганты. Склеротерапия – введение в освобожденный от крови сосуд препарат (Полидоканол, Фибро-вейн), который закупоривает вену.
Хирургическое лечение: устранение патологического рефлюкса (ликвидация нарушения клапанного аппарата), иссечение варикозно-расширенных вен, лазерная коагуляция
Тромбоз глубоких вен
Гепарин 30-40 тысяч единиц в сутки 7-10 дней. С 3-5-го дня добавляют непрямые антикоагулянты (Варфарин, Ривароксабан). В комплексе принимают венотоники, обезболивающие препараты (Ибупрофен 200 мг 3 раза в день, Кейвер по 2 мл 3 раза в сутки). Хирургическое лечение – тромбэктомия (удаление тромба)
Лимфодренажный массаж. Аппаратная пневмокомпрессия. Противоотечная терапия (Фуросемид, Верошпирон, Трифас). Хирургическое лечение – коагуляция лимфатических сосудов
Антибактериальная терапия – ампициллин, офлоксацин, азитромицин (препарат и его дозировку подбирает врач). Гормональная терапия – Преднизолон 1 мг на кг веса пациента.
Неспецифические противовоспалительные средства – Делагил, Плаквенил по 250 мг на сутки 14-21 день. Антигипертензивная терапия (Эналаприл 5-10 мг 1 раз в сутки постоянно)
Остеохондроз поясничного отдела позвоночника
Физическая гимнастика. Массаж. Нестероидные противовоспалительные средства (Ибупрофен 200 мг 2 раза в день, Мелоксикам 15 мг 1 раз в сутки)
Лечебная физкультура. Массаж. Специальная ортопедическая обувь. Хирургическое лечение – резекция (удаление) участков костей, пересадка сухожилий
Антиагреганты (Аспирин 75 мг 1 раз в сутки ежедневно постоянно). Нитраты (Дикор 20-40 мг 1-2 раза в сутки постоянно). Антигипертензивная терапия (Эналаприл 5-10 мг раз в день постоянно или Кандесартан 4-8 мг в том же режиме). Диуретики (противоотечная терапия) – Фуросемид, Верошпирон
Венотоники – симптоматическое лечение тяжести в ногах. Улучшает тонус сосудов, снижает растяжимость вен, улучшает микроциркуляцию, стабилизирует отток лимфы:
- Детралекс принимают по 1 таблетке 2 раза в день. Срок лечения 2 месяца. Курс — дважды в году;
- Троксевазин 300 мг 2 раза в сутки. Длительность лечения 2-3 месяца;
- Венорутон-гель наносят на проблемные участки дважды в сутки, втирать до полного впитывания. Использовать постоянно при наличии симптомов;
- Эскузан рекомендуют принимать по 15-20 капель 2 раза на сутки перед едой. Курс лечения от 2-х недель до 2-3-х месяцев.
Эластическое бинтование усиливает кровоток в глубоких венах, препятствует образованию отека, улучшает микроциркуляцию и обменные процессы в тканях. Процедуру важно начинать утром до подъема с кровати. Бинт накладывают с небольшим натяжением от пальцев стопы до бедра с обязательным захватом пятки и голеностопного сустава. Каждый последующий тур материи должен наполовину перекрывать предыдущий.
Эластическое бинтование ног (фото: www. wikihow.com)
Используют средства народной медицины. Эти рецепты помогают снять усталость ног, улучшают циркуляцию крови:
- мускатный настой. Ч. л. молотого мускатного ореха залить 200 мл кипятка. Настоять 20-30 минут. Выпивать по 100 мл дважды на сутки. Срок лечения 7-10 дней. Курс можно возобновлять раз в три месяца;
- настойка на каштане. 50 г цветов конского каштана залить 500 мл медицинского спирта. Закрыть плотной крышкой, поставить в прохладное темное место. Настаивать 2 недели. Ежедневно взбалтывать. После готовности препарат процедить через марлю, поставить в холодильник. Принимать по ст. л. перед каждым приемом пищи, запивая водой. Срок лечения 3-4 недели. Курс возобновлять раз в три месяца;
- домашний гель из каланхоэ. Листья растения помыть и разрезать вдоль. Наполнить ними пол литровую банку. Залить медицинским спиртом. Закрыть плотной крышкой и настаивать 3 недели, ежедневно взбалтывая. После готовности препарата небольшое количество жидкости легкими массажными движениями втирать в стопы и голени перед сном. Курс лечения без ограничений при хорошей переносимости препарата.
Народные средства рекомендуют использовать в период восстановления болезни и комплексно с традиционной медициной.
Важно! Тяжесть в ногах – синдром, который характеризуется чувством дискомфорта, ощущением усталости, боли в нижних конечностях. Сопутствующий симптом при варикозном расширении вен, тромбозе сосудов, патологии почек и сердца. В качестве лечения используют симптоматическую терапию (венотоники, диуретики) и хирургическое вмешательство
Лечебная гимнастика нормализует тонус сосудов, улучшает кровообращение и микроциркуляцию, препятствует застою жидкости в ногах. Упражнения:
- исходное положение стоя, спина прямая. Встать на ступеньку или небольшую платформу носком одной стопы. Удерживать положение 10 секунд. Поменять ногу. Повторить 5 раз;
- на пол положить деталь (монета, пуговица, частица конструктора "Лего"). Пальцами стопы нужно захватить и поднять ее. Повтор для каждой ноги 3 раза;
- ножницы. Исходное положение – лежа на спине. Поднять прямые ноги под углом 90°. Попеременно скрещивать друг с другом. Повторить 15-20 раз. Выполнить 3 подхода.
Основное условие эффективности лечебной физкультуры – регулярные занятия.
При синдроме усталых ног, который сопровождает другие патологии, возможно развитие трофических язв. Это истончение и повреждение кожи, открытая рана, которая не заживает более 6 недель. При ее инфицировании возможно развитие гангрены и сепсиса.
Основное направление предупреждения синдрома усталых ног – формирование здорового образа жизни:
- отказ от вредных привычек (курение, алкоголизм, наркомания);
- поддержание нормального веса тела;
- правильное питание (исключить фастфуд, сбалансировать потребление жиров и углеводов);
- регулирование времени работы и отдыха;
- умеренные физические нагрузки;
- отказ или сокращение времени ношения обуви на каблуках. Исключить узкую одежду, которая препятствует оттоку крови из нижней части тела вверх.
Также важный компонент профилактики – своевременное обнаружение причины тяжести в ногах и раннее лечение.
Тяжесть в ногах – симптом, который хорошо поддается терапии. Важно вовремя обратиться к врачу и начать лечение. При ранней терапии и профилактике прогноз благоприятный.
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