The bone below the knee in front causes pain. Basics of a differentiated approach to identifying the most likely cause of pain

Every day, the legs, their joints, muscles and tendons experience high physical stress. As a result, lower extremity pain is not uncommon. It happens periodically in the life of every person.

By the evening, even the young and quite healthy people There may be pain, a feeling of heaviness and swelling in the legs, especially in the area below the knees. These phenomena occur more often in people whose activities are associated with long work on their feet (salespeople, surgeons, couriers, loaders).

The reasons why pain in the legs below the knees may appear are very diverse.

They may belong to the following groups of pathologies:

any diseases of cardio-vascular system ;
diseases of the lumbosacral spine(spinal hernia, osteochondrosis, deformities);
mechanical injuries ligaments, tendons; nerve diseases (neuralgia, pinched nerves), etc.

Excessive stress on the lower limbs can also cause pain below the knee.

This phenomenon is often observed in athletes after training, when wearing uncomfortable shoes, as a result of prolonged walking or standing on their feet. In these cases, pain is associated with functional disorders, it goes away quite quickly after rest or as a result of changing shoes to comfortable ones.

If the pain in the legs and knees is severe, then you can suspect an injury - a bruise, dislocation or even a fracture.

But more often painful sensations and severity are due to vascular diseases of the legs - thrombophlebitis or varicose veins.

If the legs hurt very badly and this is accompanied by whitening of the limb, thromboembolism of the arteries or veins of the lower limb should be excluded.
With vascular diseases of the legs, in addition to pain, cramps may occur.

At venous stagnation caused by varicose veins, pain below the knee has stupid character, accompanied by swelling, heaviness in the legs, especially after prolonged walking or standing. These symptoms are the first sign of venous insufficiency.

Thus, if your legs hurt below the knees, this may be due to a number of factors. Specific reasons may be:

Important: if you are often bothered by pain in your legs below the knees, which is accompanied by swelling, redness, impairment general well-being or occur after injury, consult a doctor.

The specialist will find out the cause of the pain and prescribe the necessary treatment.

Diagnostics

To determine the cause of pain in the legs, use following methods research:

radiography;
arthroscopy, etc.

If you suspect vascular diseases of the legs, vascular CD, contrast angiography, and radionuclide diagnostics are performed.

Sometimes even when using modern methods examinations fail to identify the real reason pain in the legs below the knees. In this case, you can consult an osteopath. This specialist is engaged complex treatment, which is aimed not only at symptoms or a specific disease, but also at the entire body as a whole. After all, any disease causes changes in the activity of all systems and organs.

Treatment

Therapeutic tactics completely depend on the cause of the pain, to identify which an examination is necessary. Treatment can be carried out on an outpatient basis or in a hospital, depending on the severity of the disease. Therapy may include drug treatment, physiotherapy, physical therapy and other methods.

In some cases, surgery is necessary.

If pain and swelling in the legs appear at the end of the day, it is recommended give to the legs exalted position (for example, place them on a cushion or bench). This technique will improve the flow of blood from the veins below the knees. After rest, it is useful to take foot baths with sea salt.

Well relieves pain below the knees and eliminates the feeling of heaviness in the legs warm baths. To activate blood circulation, you can wipe your feet with a piece of ice wrapped in a cloth. You should wipe your shins, calves, ankles, ankles, and feet.

Many diseases of the bones and joints of the legs develop against the background of excess weight.

Therefore, it is worth adjusting your daily menu to normalize body weight. If you can’t lose weight on your own, then consult a nutritionist.

Sometimes you really need to know: find out everything possible reasons and diseases.

You can read about what a torn ankle ligament is in.

You can often hear the complaint that your leg hurts below the knee. But in most cases, no one pays attention to such a “petty” sign special attention, attributing their symptoms to overwork or walking in heels. Often this type of pain can be a sign of a more serious pathology. Therefore, you should always be critical of your condition.

When we talk about pain in the legs below the knee, we mean pain syndrome shins. The shin is the part of the leg from knee joint to the foot. Anatomically, the lower leg consists of the tibia and fibula, a large number of muscles, nerve fibers and vessels (arterial and venous). Accordingly, pain can occur with organic or functional damage to any anatomical structure of the lower leg.

Is there a danger?

It should immediately be noted that in some cases, pain in the lower leg can be dangerous not only to health, but also to human life. For example, pain below the knee may be a sign of deep vein thrombosis of the lower extremities, and such a condition, if not diagnosed in time, can lead to blood clot detachment and blockage pulmonary artery, that leads to instant death person.

Therefore, if you suffer from pain in your legs below the knee, especially if the pain is constant and recurrent, then be sure to seek help. medical care to find out the cause of this symptom so that treatment can be started on time.

Pulmonary embolism often leads to sudden death

Causes of pain syndrome

The following reasons can cause pain below the knee:

lack of microelements in the blood such as calcium, magnesium, potassium (hypocalcemia, hypomagnesemia and hypokalemia), most often the cause of a decrease in the concentration of these microelements is diet, poor absorption in the gastrointestinal tract, leaching from the body;
long-term use of some medications(diuretics, medications that lower cholesterol levels in the body, glucocorticoid hormones);
tonic spasm of the lower leg muscles, which often occurs as a result of physical strain, long walking, playing sports, or standing;
traumatic damage to anatomical structures in the legs (fractures of small and tibia, sprains, ligament or muscle rupture);
inflammatory lesions of the muscles in the leg (myositis);
atherosclerotic disease with the formation of plaques in the arteries below the knee (obliterating atherosclerosis);
thrombosis of deep veins or arteries in the legs below the knee;
varicose veins of the lower extremities;
osteoporosis;
with arthrosis and arthritis of the knee, pain can be felt not only in the knee joint, but also in the legs below the knee;
osteomyelitis ( infectious lesion the inner part of the leg bones), occurs more often in children than in adults;
polyneuropathy – damage to nerve fibers in people with diabetes, chronic alcoholics, and smokers;
diseases of the arteries in the legs (vasculitis, periarteritis nodosa etc.);
rheumatic diseases (dermatopolymyositis, lupus, etc.);
compression of the soft tissues of the lower leg;
lymphostasis in the vessels of the legs;
benign and malignant tumors bones, muscles and other soft tissues below the knee;
cancer metastases various localizations V bone tissue;
compression of nerve fibers due to osteochondrosis or intervertebral hernia lumbar spine.

Below we will look at frequent and at the same time dangerous reasons leg pain.

Varicose veins of the lower extremities

On initial stages varicose veins of the legs may not be accompanied typical manifestations in the form of dilated convoluted superficial veins and is sometimes difficult to recognize. The first signs varicose veins can be:

feeling of heaviness in the legs;
swelling of the lower extremities at the end of the day;
monotonous dull pain in the leg that appears after a long stay in vertical position legs;
pain, heaviness and swelling disappear after resting horizontal position, especially if you put your feet on a pillow (raise them);
Sometimes convulsions are possible.

Vessel thrombosis of the leg

As a rule, such conditions develop acutely and are accompanied by severe clinical picture. There are features and differences between the signs of thrombosis of arteries and veins.

Venous thrombosis

begins gradually (over several days);
there is a feeling of heaviness in the legs and bursting pain from the outside or from the inside shins (depending on the location of the pathological process);
the limb changes color - it becomes crimson red and then bluish;
the lower leg swells significantly and its circumference increases;
the pain intensifies, the patient cannot step on the sore leg;
the leg is hot to the touch;
after some time (3-4 days), if medical assistance is not provided, necrosis and gangrene of the leg begin.

Venous thrombosis of the lower limb

Arterial thrombosis

pathology develops quickly (over several hours);
the first signs may be a feeling of numbness in the leg, coldness and severe pallor(blood flow through the arteries of the leg stops) or thrombosis often manifests itself in the form of a sharp, severe pain below the knee;
if not accepted urgent measures within 2-4 hours, the limb dies (gangrene begins).

Obliterating atherosclerosis

Pain in this disease is caused by disruption of the main blood flow through the arteries of the leg when they are damaged by atherosclerotic plaques and narrowing of the internal lumen. The pain syndrome is characterized by intermittent claudication. appears when walking long distances. She forces the patient to stop and rest, and after the pain subsides, the person continues on his way.

But as the disease progresses, distances become shorter, and pain begins to appear at rest. Trophic changes begin to develop ( chronic ulcers) on the legs, dry and flaky skin, pathological changes on the nails of the lower extremities. If you do not provide qualified surgical care, then this disease can lead to tissue necrosis and gangrene of the limb.

Micronutrient deficiency

Pain in the lower leg is often caused by a lack of trace elements in the body such as calcium, potassium and magnesium. The reasons for this pathological condition happens a lot. Pain syndrome is characterized by painful cramps in calf muscles. As a rule, such cramps occur in the middle of the night and wake up a sick person. They can be tonic or clonic in nature. They go away on their own after a few minutes. To relieve the pain, patients actively massage the area of the lower leg with a cramp.

Cramps in the calf muscles indicate a deficiency of microelements in the body

Polyneuropathy in diabetes mellitus

As is known, diabetes- this is very insidious disease, which slowly and steadily affects all organs in the body, including all nerve endings.

A characteristic complication of diabetes mellitus is diabetic polyneuropathy lower extremities. It often happens that with type 2 diabetes (slow and imperceptible course) patients consult a doctor precisely because of pain in the legs. This pain is burning, constant, not associated with physical activity, and is accompanied by a feeling of numbness and chilliness in the legs.

Whatever the cause of pain in the legs below the knee, the first thing to do is seek medical help and undergo full examination, because such a symptom may signal serious illness, and not just about tired legs.

Patients' complaints that their legs hurt below the knees often manifest themselves at stages when the disease is already developing. In the initial period, few people paid due attention to this fact. These pains may occur at night or at evening time days, are not associated with overload of the body, and do not depend on weather conditions. Painful sensations can vary in strength and intensity, in sensations and perceptions. Whatever the reasons, it is necessary to seek qualified medical help.

Patients' complaints that their legs hurt below the knees often manifest themselves at stages when the disease is already developing. In the initial period, few people paid due attention to this fact. These pains can occur at night or in the evening, are not associated with overload of the body, and do not depend on weather conditions. Painful sensations can vary in strength and intensity, in sensations and perceptions. They affect both the foot and the lower leg, causing suffering. Why do my legs hurt below the knees? Let's try to figure it out.

Anatomical features

First of all, it should be noted that Bottom part leg limb consists of two large joints: ankle and knee, and on the foot - those associated with the fingers. The lower leg is divided by doctors into two sections: anterior and posterior. They are delimited in front by the tibia, its inner edge, and in the back by part of the fibula, which includes the ankle. The lower limbs are richly supplied with blood vessels, nerve endings, muscles and ligaments. Depending on the location of the pain, sensations, and associated complications, examination can find causes that reflect characteristic signs. What exactly can cause pain - only a specialist doctor knows the answer.

Physical exercise

Often, professional responsibilities force you to be in the same position. These are teachers, salesmen, machine workers, hairdressers. By evening, my legs swell and hurt a lot, especially below the knee. Due to stagnation associated with work, pain can bring unbearable torment.

Athletes who withstand extreme loads on joints and bones due to jumping, running, and strength training often experience pain. This pain can be acute or constant, aching. In these cases, only unloading the joints helps, frequent change body position. This is done to ensure proper distribution of blood flow within the body.

Traumatic injuries

Sometimes trauma that may have been experienced back in childhood, makes itself felt in the form of pain. Any mechanical damage particularly affects the structure of the bone and ligament. Over time they appear inflammatory processes in front or on the back of the leg, swelling is detected in place traumatic injury. Therefore, any injury must be treated and preventative procedures periodically carried out to avoid consequences.

Spinal diseases

These include osteochondrosis of all sections spinal column, sciatica, lumbodynia. If the lumbar region is damaged, especially if there is a herniation or protrusion of the disc, pain may occur along the nerve roots-branches, on the right or left leg. This type of pain intensifies when turning, bending, or awkward movements and occurs in the lower leg and can radiate to the foot. It is often accompanied by numbness of the limb, which in itself is an alarming symptom.

This form of cause can also include flat feet. If you do not wear special orthopedic shoes or insoles, the patient will experience pain not only in the foot, but also in the shin and knee. The development of flat feet must be monitored from childhood and timely treatment and preventive measures must be taken: gymnastics, massage, wearing arch supports.

Inflammatory processes

Arthrosis and arthritis of the lower extremities, bursitis of the knee joints is reflected in pain and swelling syndromes. There may be pain of different nature, very often accompanied by swelling, redness, occurs when moving or at rest, at night. The left or right half of the entire body suffers more, sometimes only the limbs. Morning pain more often occurs in people prone to rheumatoid arthrosis and gout. Severely restricting movement, it goes away only after warming up. Sometimes the patient has to spend a few minutes in bed to warm up and only then can he get up.

Stagnation in the venous vessels

Most pain below the knees occurs in people prone to stagnation in the veins. Such pains are pronounced, identical in manifestation:

starting gradually (up to 10 days), then acquiring a more pronounced and permanent character;
a feeling of heaviness appears in the legs, the pain becomes bursting on all sides of the lower leg, especially where there is an affected venous artery;
the limb changes color, becomes purple, the right or left side swells greatly;
the pain intensifies so much that it is impossible to step on your leg.

In particular dangerous cases such phenomena can lead to gangrene and amputation of the limb. With this nature of the disease, it can often occur trophic ulcers with purulent discharge, which also requires immediate medical intervention. Similar symptoms may be associated with manifestations of cardiac pathology. The only difference is that swelling appears on both legs at the same time.

Obliterative atherosclerosis

Cardiovascular diseases, in addition to edema of the lower extremities and thrombophlebitis conditions, cause pain of an obliterating nature. This is a special type of vascular atherosclerosis circulatory system. If your legs hurt below the knees, this is a consequence of disruption of the main blood flow in the arteries, especially the lower leg. The lumen in them narrows due to plaques, the internal lumen becomes narrow. Intermittent claudication occurs and is observed. The disease does not allow long walks or walking distances, which forces the patient to sit down, rest and then pain signs are decreasing. If the disease develops, then over time the sensation of pain will not be left alone. Important sign- dry skin, flaking or hyperkeratosis. If you pay attention to such moments in time, you can avoid serious complications which will lead to surgery.

Metabolic disorders

Lack of vitamins (hypovitaminosis), especially if the patient is a fan of strict diets, can lead to pain in the legs, which is especially acute at night. They are accompanied by cramps in the calf muscles and in the top. This indicates a lack of the elements potassium, iron, and magnesium. This can be easily fixed using multivitamin complexes, proper balanced nutrition.

In general, whatever the reasons, it is necessary to seek qualified medical help in order to avoid consequences and choose treatment tactics.

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Leg pain can cause different reasons– from completely harmless overwork and lack of microelements in the body to severe joint damage and oncology. To figure out what exactly triggered this symptom, you need to visit a doctor and get a diagnosis.

Physical overload and micronutrient deficiency

Pain and cramps of the lower leg can be caused by intense sports, long walking and long standing on foot. People who are untrained and overweight are more susceptible to this.

Insufficient amounts of substances such as calcium, potassium and magnesium can lead to pain and cramps that occur mainly at night. Deficiency of microelements occurs against the background of strict diets or with their accelerated elimination as a result of taking sorbent drugs.

Assimilation useful substances significantly reduced when treating diseases gastrointestinal tract antacids and enveloping agents, preventing absorption. Too rapid utilization of minerals from the body is also observed with excessive sweating, working in a hot shop or under conditions high temperature, in case of abuse of thermal procedures (bath, sauna).

Potassium loss often occurs due to the use of potent diuretics. Unlike potassium-sparing analogues, such drugs significantly contribute to the massive excretion of potassium. To relieve pain under the knees and stop cramps, it is recommended to massage the muscles until the discomfort disappears.

Varicose veins of the lower extremities

Varicose veins mainly affect the legs and are manifested by thinning of the venous wall, an increase in the lumen of the veins and the development of aneurysm-like nodes. At the same time, the legs below the knees ache, the feet and legs swell, the veins swell, and cramps in the calf muscles appear at night.

Even before the appearance visual signs patients complain of severe fatigue and aching pain. One of characteristic features Varicose veins are swelling that appears when long stay on the feet and subsides when lying down.

Both congenital and acquired factors take part in the development of varicose veins

Deep vein thrombosis

With thrombosis, blood clots or blood clots appear in the veins, which impede normal blood flow. Symptoms depend on where exactly the clot is located. In about 50% of cases deoxygenated blood it passes through the communicating veins to the subcutaneous veins, and blood flow is partially restored. As a result, no pathological signs not visible.

In the remaining 50% of cases clinical symptoms is this:

bursting pain in the legs;
touching the affected vein is painful;
temperature skin elevated above the site of thrombus formation;
the skin of the affected limb becomes bluish;
superficial veins dilate.

Due to high risk complications, people with thrombosis of the veins of the lower extremities in mandatory are hospitalized and are prescribed strict bed rest, the affected leg is placed in an elevated position. To prevent the development of new blood clots, patients are advised to take Heparin for the first few days, then switch to mild anticoagulants (blood thinners).

Arthritis and arthrosis

Arthritis and arthrosis are joint diseases that have similar symptoms, but various reasons. With arthritis, the joints become inflamed, and arthrosis is characterized by gradual destruction cartilage tissue articulations.

When the knee joint is damaged, pain and stiffness occur when moving. On early stages the patient can only feel that his legs below the knees are very tired and aching. If you suspect arthritis or arthrosis, you should see a doctor and start treatment as early as possible.

Osteoporosis, or “porous bone,” is a fairly common pathology of the musculoskeletal system, in which bones become brittle and brittle, acquiring a porous structure. The risk of fractures increases significantly, the bones heal poorly, as the pathology develops, the pain in the knees intensifies, and the joints and bones become deformed.

At first, the disease may manifest itself only as mild aching pain in the legs, especially when the weather changes. Then the intensity of the symptoms increases - it becomes difficult to walk, the pain intensifies. On late stages a person can no longer move independently, since the knees atrophy and the shape of the legs is bent.

Osteoporosis is a chronically progressive disease characterized by decreased bone density

Polyneuropathy

Diabetic polyneuropathy – symmetrical pathological process, which is localized first in the lower part of the legs and then spreads higher. Patients complain of a burning and tingling sensation under the knees, sometimes this is the first sign of diabetes.

With polyneuropathy due to diabetes, sensitivity is impaired - temperature, tactile, pain, and in some cases coordination worsens. To identify the disease, you need to visit an endocrinologist’s office and undergo an examination.

Osteomyelitis

When an infection occurs, the bone becomes inflamed (osteo) and Bone marrow(myelitis). Foreign microorganisms can penetrate bone tissue due to fractures or due to bullet wound together with the bloodstream or from neighboring organs.

Most often, osteomyelitis affects the bones of the lower extremities - the leg can hurt in the front, back or side. The first symptom of the disease is a deterioration in general health, similar to common cold- the temperature rises to 38-40°, the pulse quickens. Later, on the 2nd or 3rd day, local signs– the leg begins to hurt, swells and moves worse.

Post-traumatic osteomyelitis does not occur immediately; it develops within 7-14 days after mechanical damage. To prevent such a complication, you need to properly treat the wound and be sure to visit a traumatologist.

Obliterating endarteritis

The symptom of intermittent claudication occurs due to sudden pain in the calf muscles

Poor circulation as a result of inflammation of the peripheral arteries, leading to blockage of the lumen of blood vessels, tissue hypoxia and gangrene, is called obliterating endarteritis. The disease usually affects the feet and legs, the soft tissues of which gradually lose their functions and die.

IN in this case It is very difficult for a person to understand why their legs ache, since the disease manifests itself in different ways. Periodic exacerbations can occur from time to time, and only in the second stage of the disease does weakness in the legs, noticeable pain and lameness occur.

The danger of endarteritis lies in its progression; in the absence of treatment, a person not only loses the ability to independent movement, but may also lose his lower limbs. However, the most severe outcome - the death of the patient - is possible when the blood becomes infected as a result of the spread of irreversible changes to other organs and systems of the body.

Flat feet

When the shape of the foot changes as a result of the lowering of its longitudinal or transverse arch, as well as longitudinal-transverse deformation, flat feet occur. A defect like longitudinal flatfoot, is characteristic mainly of women. This is due to the fact that the greater the body weight, the greater the load on the foot.

The risk of developing flat feet increases during pregnancy because the body's center of gravity shifts due to weight gain. Due to the redistribution of the load on the lower extremities, the pressure in the knees and feet increases, which threatens overpronation stop.

Pain in the legs below the knee with flat feet occurs after a long walk or standing, wearing shoes on high heels or physical overload. Purchasing will greatly help reduce discomfort. orthopedic shoes or special inserts into it - insoles or heel pads.

A high heel increases the load on the transverse arch at the base of the toes, which often leads to hallux valgus deformity stop

What else can cause aching pain in the legs?

The calf muscles may respond with aching pain to long-term treatment medications such as diuretics, hormonal and anticholesterol drugs.

The reason may also be:

hernia of the lumbar spine;
osteochondrosis;
new bone formations;
rheumatic diseases;
bone metastases caused by a malignant oncological process of any location;
periarteritis nodosa;
vasculitis

When to see a doctor

It is necessary to visit a doctor and undergo an examination if the following symptoms appear:

leg pain continues for several days;
flexion and extension are difficult;
the limb is swollen, red, bruises or cyanosis appear;
climbing a flight of stairs causes discomfort and severe pain;
the pain below the knee intensifies and is accompanied by an increase in body temperature.

Diagnosis and treatment

To determine how to treat the disease and what medications to prescribe, the doctor sends you for examination. To find out the causes of the disease, the following methods are used:

X-ray examination;
magnetic resonance and computed tomography;
color duplex scanning;
angiography;
scintigraphy;
arthroscopy (used for both diagnosis and treatment of joint diseases).

The scintigraphy procedure is reminiscent of MRI; the diagnostic technique is based on visualization of the processes that occur in tissues

Medicines for leg pain are prescribed depending on the results of the examination. When treating leg pathologies, the following are used:

anti-inflammatory non-steroidal drugs;
muscle relaxants to reduce muscle tone;
steroids and cytostatics for connective tissue diseases;
anticoagulants to reduce blood viscosity;
antidiabetic agents;
medicines to improve blood circulation in lower limbs– angioprotectors, venotonics;
vitamin and mineral complexes containing calcium, magnesium, vitamins B and D.

Physiotherapy

Physiotherapy helps reduce pain, relieve inflammation and improve blood circulation. For leg pain, the following procedures are effective:

ultraphonophoresis;
magnetic therapy;
red and infrared medical laser;
low-frequency wave or shock wave therapy;
compresses with paraffin;
balneo- and mud therapy.

The healing properties of mud help to cure many ailments; mud applications are very effective for diseases of the musculoskeletal system

Folk remedies

Proven remedies based on folk recipes can also help with leg pain:

foot baths with herbs. Chamomile, Bay leaf, Linden blossom added to water will help eliminate heaviness and discomfort in the legs;
You can lubricate your feet with honey before bed to reduce inflammation and swelling. To avoid staining your underwear, wrap your limbs with a bandage;
Apply a compress of black radish, grated or in a blender, to the sore spot;
Mix eucalyptus or menthol essential oil with fresh juice aloe, and use for rubbing;
pour ½ liter of alcohol or vodka into pine nut shells and leave for 3 weeks. Take daily for 21 days, starting with two drops and adding to each next dose one more drop. Then drink the tincture for another 21 days, and count down in the opposite direction, reducing the dose by a drop per day;
pumpkin jelly will help with salt deposits. pumpkin juice, gelatin and raspberry syrup, mix, pour into small containers and put in the refrigerator. Eat one serving daily for a week.

Thus, pain in the legs below the knees can be caused by various reasons. Why your legs hurt and how to deal with this condition will become clear after diagnostic measures. If the painful sensations do not go away for a long time or intensify, a timely visit to the doctor will help prevent further development illness and avoid complications.

Often the legs hurt from the knee to the foot due to physical activity, long walks or incorrectly chosen shoes. However, such pain may be an early symptom serious pathologies: varicose veins, thrombosis and even cancer.

Why do my legs hurt from the knee to the foot?

The lower leg anatomically consists of two bones (tibia and fibula), lower leg muscles, neurovascular bundles and soft tissues (skin and subcutaneous fat). Each of these structures can cause pain.

Thus, pain in the bones can be associated with injuries (fractures, cracks), degenerative diseases and a lack of microelements (osteoporosis - decreased bone density), bacterial lesions (osteomyelitis - purulent melting of the bone), as well as benign or malignant neoplasms(osteosarcomas, prostate cancer metastases, etc.).

Sometimes pain can radiate (spread) to the lower leg from the joint area, for example, in the presence of a popliteal hernia - Baker's cyst. When the latter ruptures, the contents spread to the lower leg, which causes pain and swelling.

If the cause of soreness is the muscles, then fatigue due to heavy physical exertion may be suspected ( muscle spasm) or incorrectly chosen shoes (high and unstable heels). The cause may also be sprains and tears of the ligamentous apparatus or the muscles themselves, inflammation (myositis), as well as tumor diseases(rhabdomyomas).

Pain associated with vascular damage causes atherosclerosis (plaques in the arteries), inflammation vascular wall(vasculitis or periarteritis), varicose veins (dilation of the veins of the lower extremities), thrombosis and embolism (blockage of blood vessels with blood clots, gases, fat, etc.).

Do not forget that in addition to blood vessels, the lower leg is rich in lymphatics. They can also cause pain, for example, with lymphostasis (stagnation of lymph).

Nerve fibers cause pain from the knee to the foot when they are pinched at the level of the knee joint (with), polyneuropathy ( multiple lesions nerves) or tumor processes (neurinomas, neurofibromas, etc.).

Sometimes pain in the lower leg is associated with damage to soft tissues (cuts, bruises) or compression (improper postures, etc.).

Possible diseases

Let's take a closer look at each of them possible pathologies, due to which patients have pain in their legs below the knees.

Injuries. When traumatized, pain occurs locally (at the site of the injury). It is often aching in nature, accompanied by redness and swelling. When bones are broken, the pain is sharp, at the time of injury there is a characteristic “crunch”, the leg bends, swelling, hematomas (collections of blood) and unusual depressions/bulges appear on the lower leg.
Intraosseous pathologies. Osteomyelitis manifests itself as severe bursting pain against the background general inflammation(increased body temperature, etc.). It is observed more often in children, sometimes in adults (when installing prostheses or treating fractures). Whereas osteoporosis occurs mainly in older people with a lack of microelements and age-related changes in the hormonal system. The disease manifests itself as a dull pain along the bones and their fragility. Be careful! Osteoporosis and osteomalacia (softening of the bone) may be side effect taking diuretics.
Muscle hypertonicity. Hypertonicity (increased tone) of muscles occurs under static load (in a standing position, for example, surgeons during operations) or dynamic (in motion: athletes, waiters). The pain is usually aching and occurs in the position that provoked its occurrence. After rest, as a rule, they disappear. A variant of muscle soreness is soreness. It occurs the day after the big day physical activity and is associated with the accumulation of under-oxidized substances in the muscles - lactic acid. Inflammatory lesions muscle tissue– myositis – also characterized by pain, but it is constant, muscle strength weakens, and general state accompanied by elevated temperature and chills.
Atherosclerosis. Atherosclerotic lesion popliteal artery manifests itself as periodic aching pain along the lower leg, cramps, numbness of the foot, pale skin, and in advanced cases, hair loss and splitting of nails. A characteristic symptom atherosclerosis is intermittent claudication - the occurrence/intensification of pain during movement (“compresses” the lower leg), which forces the patient to stop. After a 5-minute rest, the pain disappears/subsides. The cause of the disease is a violation of lipid (fat) metabolism, due to which cholesterol accumulates in the vessels in the form of plaques.
Vasculitis. Vasculitis - inflammation of the vascular wall - can affect vessels of different sizes. Usually they manifest themselves as mild pain, as well as small pinpoint (sometimes confluent) purple spots - hemorrhages.
Thrombosis and embolism. Thrombosis and embolism are a group of diseases associated with blockage of blood vessels by blood clots or emboli (fat, gases, etc.). With blood clots in the veins of the lower extremities, patients complain that their legs hurt below the knees, that swelling appears, and that the lower leg turns red. This pathology is dangerous due to its complications, which can lead to death. Therefore the disease requires urgent appeal to an angiosurgeon.
Varicose veins Varicose veins - dilatation of the veins of the lower extremities - are characterized by heaviness in the legs, periodic burning pains along the veins, cramps in the calf muscles and swelling. In this case, convoluted dilated veins are observed under the skin. The disease is provoked by incompetence of the vein valves and blood stagnation in the lower extremities, which leads to sedentary lifestyle life and/or hereditary predisposition.
Lymphostasis. With lymphostasis (stagnation of lymph; elephantiasis), patients feel dull pain from knee to foot and swelling. The latter usually disappear after sleep, but later stages become persistent, the skin thickens, and ulcerations appear. Common reasons lymphostasis are oncological diseases.
Neurogenic pain. A variant of neurogenic pain may be polyneuropathy. She appears sharp pains in the foot and lower leg, muscle weakness, twitching, decreased sensitivity, sometimes swelling and excessive sweating. The disease is often provoked by heredity, deficiency of B vitamins, trauma and type II diabetes. Pain in the lower leg can appear due to osteochondrosis (pinched sciatic nerve). In this case, a shooting pain or burning sensation appears.
Oncological diseases. Oncopathology can be observed in all anatomical structures of the lower leg: bones, muscles, soft tissues etc. It is usually painless, and an extraordinary examination or visible formation allows one to suspect the disease. However, in the later stages of the disease, pain syndrome appears, which can be of various nature (aching pain, sharp, etc.).

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Treatment

There are many reasons why legs hurt, which requires a specific method of treatment for each.

Injuries. Bruises do not require treatment; it is enough to apply cold to the site of impact for 10-15 minutes. If there is a suspicion of a fracture, x-ray diagnostics is necessary. If the diagnosis is confirmed, it is possible to apply a plaster cast or perform osteosynthesis (installation of special titanium bracket structures).

Intraosseous pathologies. Osteomyelitis is treated with antibiotics wide range actions (Cefotaxime, Oxacillin) and detoxification therapy (blood plasma transfusions). Osteoporosis is regulated by diet, vitamins and microelements (vitamin D and calcium). Also possible hormone therapy(estrogens for women in menopause or calcitonin - the hormone thyroid gland, increasing the calcium content in the bones).

Muscle hypertonicity. Increased tone muscles does not require treatment, it is only necessary good rest. But muscle inflammation - myositis - needs correction with the help of anti-inflammatory drugs (Ibuprofen, Paracetamol) and ointments that eliminate muscle spasms (Apizartron based on bee venom).

Atherosclerosis. With atherosclerosis, the patient needs to adjust his diet, giving up “bad fats.” Drugs that reduce cholesterol production (Mevacor, Vasilip) are also prescribed. If an atherosclerotic plaque occupies more than 70% of the lumen of the vessel, significantly impairing blood circulation, surgical intervention (plaque removal, etc.) will be required.

Vasculitis. Treatment of vasculitis is carried out with powerful anti-inflammatory therapy: corticosteroids (Hydrocortisone, Prednisolone) and cytostatics (antitumor drugs - Methotrexate).

Thrombosis and embolism. In case of thrombosis, thrombolytics (drugs that break down blood clots - Alteplase, Streptokinase) and anticoagulants (drugs that reduce blood clotting, thereby preventing new thrombus formation - Enoxaparin, Warfarin) are urgently prescribed. If therapy is ineffective, use surgical methods treatment (removal of a blood clot).

Varicose veins. At varicose veins veins are prescribed special stockings - compression underwear, as well as venotonics (drugs that tonic the veins - Phlebofa, Detralex). However, it is most effective surgical treatment– removal of the affected vein.

Lymphostasis. Therapy for lymphostasis requires surgical intervention– creating drainage lymphatic vessels V venous system. At the same time, the treatment is complemented by massage, wearing compression stockings and physical therapy.

Neurogenic pain. Pain associated with damage or irritation of the nerves is treated depending on the cause that caused it. However, therapy is usually supplemented with lipolic acid preparations (Espa-lipon) and B vitamins, which stimulate the restoration of nerve fibers.

Oncological diseases. Pathologies of this group require clear diagnosis for malignancy, as well as individual scheme treatment. The latter may consist of chemotherapy and/or surgical treatment.

Preventive measures

To prevent pain, you need to normalize your lifestyle:

give preference to what is right and healthy eating(reduce body weight if it is overweight);
increase the value of the diet in terms of microelements: calcium, magnesium, potassium – daily use fruits, vegetables and dairy products;
reduce the amount of salt consumed to 5-6 grams per day (including that used in cooking);
establish physical activity(avoid a sedentary lifestyle and excessive exercise);
control existing chronic diseases(arterial hypertension, diabetes mellitus, etc.);
engage in timely and proper treatment injuries of bones and joints;
control the hormonal state of the body (especially necessary for postmenopausal women);
correctly and effectively treat bacterial and viral diseases;
stop inflammation of any etiology;
choose the right shoes (comfortable heels or orthopedic ones);
give up bad habits: smoking and drinking alcoholic beverages.

These preventive measures will help patients not only protect their health, but also prevent the development of many diseases, including: atherosclerosis, arthrosis, arterial hypertension, varicose veins and many others.