general description
Pain in the pelvis on the right or left is often complemented by an inflammatory process, pinching of the sciatic nerve or its irritation. In such a situation, the aching pain often spreads to the leg, thigh and buttocks. It becomes more pronounced during physical activity and when performing certain loads.
Painful sensations appear from the thigh and tailbone, spread to the muscles of the buttock, to the back of the thigh and calves, and radiate to the foot, without moving to the phalanges of the fingers. Pain is felt throughout the entire limb. Most often, this unpleasant symptom affects only one lower limb. In some cases, sciatica occurs on both limbs.
When pain occurs, especially if it lasts for a long time, the general condition of the body suffers, and a person’s gait changes. He tries to reduce the load on the diseased limb by transferring it to the healthy one. This is how lameness occurs.
Frequently asked questions about stiff legs
Why does stiffness in the legs occur with varicose veins?
Stiffness in the legs with varicose veins occurs due to the development of stagnation of venous blood in dilated and non-functioning venous vessels.
Is it possible to get rid of stiffness in the legs?
You can get rid of stiffness in your legs. It is necessary to find out the cause of stiffness in the lower extremities. To do this, you need to seek advice from specialized specialists: phlebologist and orthopedist. After the diagnostic measures have been taken, the doctor will prescribe appropriate treatment.
What diseases can cause stiffness in the legs?
In most cases, stiffness in the legs is caused by diseases of the veins and musculoskeletal system. Stiffness in the lower extremities can also be caused by neurological diseases.
How to treat stiff legs?
If stiffness in the legs is caused by vein pathology, you need to contact a good phlebology center. After the diagnosis, the doctor (phlebologist) will prescribe the necessary treatment. Modern methods of treating varicose veins make it possible to eliminate all the symptoms of chronic venous insufficiency without interrupting your normal life.
Causes of pain not related to joints
There are many factors that provoke pain in the pelvis, which extends to the lower extremities. To carry out the correct therapy, it is necessary not only to establish a diagnosis, but also to determine the reason why it appeared. Provoking factors for the appearance of pain can be pathologies of the articular apparatus or internal organs, or there may be other reasons.
In the event that there are no degenerative-dystrophic changes in the joint apparatus, the following factors can cause pain:
- The period of bearing a child. Unpleasant symptoms in the pelvis and lower back are triggered by changes in the body, pressure from the uterus on the internal organs, and compression of the joints. Often women during this period of life suffer from aching pain that radiates to the limbs.
- Diseases of an inflammatory or infectious nature that affect soft tissues and nerve fibers. The pain is sharp or aching in nature.
- Obesity. In this case, the spine experiences increased stress, and unpleasant symptoms occur in the pelvis and lower back.
- Hypothermia. Against the background of hypothermia, diseases of the joint and bone apparatus often begin to develop.
- Tumor-like processes in the spinal column of a benign or malignant nature.
- Diseases of the muscular system.
- Diseases associated with metabolic disorders. These are diabetes mellitus, gout, rheumatism.
Pain in the lumbar or pelvic area, which radiates to the lower limb, can cause sciatica. This pathology is accompanied by pinching of the sciatic nerve. Sciatica can be caused by prolonged exposure to an uncomfortable position, constant sedentary work, or hypothermia. Spinal diseases can also provoke this problem.
Causes of weakness in the legs
Neurological diseases
Pathology of the nervous system is a common cause of weakness in the legs. Impaired impulse transmission through central or peripheral motor neurons leads to an objective decrease in muscle strength - flaccid or spastic paresis. Only the lower extremities are affected or the process spreads to the arms. In practical neurology the following conditions are encountered:
- Strokes.
Local damage to the frontal cortex provokes central monoparesis. Loss of motor functions is accompanied by increased tendon reflexes in the lower extremities, pathological foot signs, and spastic hypertonicity. - Amyotrophic lateral sclerosis.
Degenerative motor neuron disease causes muscle weakness in the legs (one or both legs). There is awkwardness in the ankle joint, stiffness of the foot, gait changes, and patients stumble. - Guillain-Barre syndrome.
Acute autoimmune polyradiculoneuropathy begins with weakness of the buttocks and thighs with paresthesia of the toes. Flaccid paresis is accompanied by pain in the lumbosacral region and pelvic girdle, radiating to the leg, and signs of tension in the roots.
Paresis of the extremities occurs due to injuries and is the result of a violation of the integrity of the pathways (due to wounds, fractures, after operations). With unilateral damage to the spinal cord at the level of the lumbar segments, weakness occurs in one leg (lower monoparesis). When the peroneal nerve is damaged, patients notice a drop in the foot, and the gait takes on the appearance of a “rooster” or “chasing.”
Spinal diseases
Among the causes of weakness in the legs, an important place is given to damage to the structures of the spinal column. Compression of the nerve roots is caused by osteophytes in osteochondrosis, intervertebral hernias, destroyed vertebral bodies - due to osteoporosis, tuberculosis, and metastatic process. This situation is observed with spondyloarthrosis, spondylolisthesis (displacement of vertebral segments).
Pain and weakness in the legs are typical signs of radiculopathy, and their location corresponds to the affected nerves. The characteristic pain syndrome is the type of lumbodynia and lumbar ischialgia, which intensifies with movement and lifting heavy objects. The picture is complemented by sensory disturbances (numbness, paresthesia), muscle atrophy, and vegetative-trophic changes on the affected side.
Endocrine pathology
Hormonal disorders often provoke weakness in the legs; symptoms can be caused by disorders of many types of metabolism - protein, lipid, carbohydrate, energy, electrolyte. Damage to muscles, myoneural connections or nerve pathways is observed. The cause of weakness in the legs should be sought among the following conditions:
- Hypercorticism.
It is characterized by a gradual decrease in strength and atrophy of the proximal muscles of the limbs, poor tolerance to physical activity. Additional signs are stretch marks on the skin, arterial hypertension, and weight gain. - Addison's disease.
It manifests itself as pathological fatigue, a long period of recovery after exercise, and cramps of the lower extremities. True muscle weakness with loss of strength is less common. - Hyperaldosteronism.
Neuromuscular disorders with increased secretion of aldosterone are accompanied by persistent weakness; with a protracted course of the disease, atrophy of the proximal areas occurs. - Hypothyroidism.
A deficiency of thyroid hormones causes weakness and pain in the legs (myalgia). The proximal muscles are involved, muscle spasms appear, and the processes of contraction and relaxation slow down. - Thyrotoxicosis.
Weakness and atrophy of the muscles of the proximal limbs are observed, although the patients themselves often do not feel discomfort. The disease can be complicated by myasthenia gravis and periodic paralysis. - Hyperparathyroidism.
Damage to the femoral and shoulder muscles is typical. Weakness and muscle atrophy are combined with increased tendon reflexes.
In long-term diabetes mellitus, symmetrical distal sensorimotor polyneuropathy is detected. Over time, sensory disorders (hypo- and paresthesias, pain) are accompanied by weakness of the small muscles of the foot, and the Achilles reflexes decrease or completely disappear. Involvement of the proprioceptive system is indicated by instability in the Romberg position.
Myopathies
Weakness in the legs due to muscle damage occurs not only with endocrine pathology. The etiological structure of myopathies is represented by immunopathological, infectious-inflammatory, metabolic disorders, and includes hereditary diseases. The following conditions cause myopathic weakness in the legs:
- Autoimmune.
Dermatomyositis or polymyositis affects the proximal muscles, with weakness ranging from difficulty climbing stairs to complete immobility. Characterized by myalgia, weight loss, fever. Raynaud's phenomenon and polyarthritis are often observed. - Infectious.
Accompanied by local or diffuse pain and muscle swelling. Weakness due to parasitic infestations (toxoplasmosis, trichinosis) can mimic polymyositis. Pseudohypertrophy of the pelvic girdle muscles is typical for cysticercosis. - Electrolyte.
Hypokalemia is characterized by myalgia, a feeling of tired legs, weakness; the symptoms of hypomagnesemia are associated with impaired neuromuscular conduction. An increase in calcium concentration provokes weakness and stiffness of movement, which is manifested by a “duck” gait. - Exchange.
Disorders of muscle glycogen and lipid metabolism are characterized by low tolerance to physical activity and weakness of the pelvic and shoulder girdle muscles. After prolonged stress, myalgia, convulsions, and myoglobinuria appear. - Mitochondrial.
Fatigue and proximal muscle weakness in the legs occur due to progressive ophthalmoplegia. Decreased muscle strength occurs in MERFF, MMC, NARP syndromes.
Granulomatous myositis in sarcoidosis is accompanied by slowly increasing weakness of predominantly the proximal muscles of the extremities and knots in the muscles. Any ARVI is manifested by aches and fatigue, myositis with muscle swelling and pain is possible. With enterovirus infection, a dermatomyositis-like syndrome is sometimes observed.
Progressive muscular dystrophies
Many myodystrophies begin with weakness of the leg muscles - hereditary diseases caused by mutations in the genes responsible for the synthesis of certain structural proteins. With Duchenne dystrophy, the muscles of the hips and pelvic girdle are first affected - the gait becomes “duck-like”, it is difficult for children to climb stairs or stand up from a squatting position. Muscle tone decreases, pseudohypertrophy and flexion contractures occur.
The same symptoms, but with later development and slow progression, are characteristic of Becker muscular dystrophy. The juvenile form of Erb-Roth also debuts with damage to the pelvic girdle and weakness of the gluteal muscles. Deep reflexes of the lower extremities gradually disappear. With Davidenkov's myopathy, the muscles of the foot suffer: flexors, abductors. First, difficulties appear when running, then - a “rooster” gait, the inability to stand on your heels.
Myasthenia gravis
Severe weakness in the legs and fatigue are observed with myasthenia gravis. The disease is based on autoimmune aggression against acetylcholine receptors at the myoneural synapse. Symptoms increase with exertion, decrease after rest, and return again from repeated stress. The proximal legs and arms are most often involved, with tendon reflexes remaining unchanged.
The development of myasthenia gravis is associated with tumor and hyperplasia of the thymus, autoimmune diseases - thyroiditis, rheumatoid arthritis, lupus erythematosus. Predisposing factors include infectious pathology and surgical interventions. Taking certain medications plays an important role: aminoglycosides, calcium channel blockers, quinine.
Vascular disorders
Leg weakness as a symptom of vascular disorders accompanies varicose veins, obliterating endarteritis, and atherosclerosis of the lower extremities. Dilatation of the saphenous veins of the leg is accompanied by increased fatigue, a feeling of heaviness and fullness, and swelling, which intensifies in the evening. Pain along the affected veins and cramps in the calf muscles often occur.
Typical signs of occlusive arterial disease are rapid fatigue of the legs when walking, “intermittent claudication.” Tissue ischemia is manifested by pain, a feeling of numbness and compression in the muscles under load. After rest, the symptoms gradually disappear, but when walking resumes, they develop again. With obliterating endarteritis, weakness is observed in the left or right leg, while atherosclerosis is usually a bilateral process.
Intoxication
Sometimes the cause of weakness in the leg muscles is damage to the nerve and muscle tissue by toxic substances. Organophosphorus compounds and carbamates (insecticides), which inhibit cholinesterase activity, have a negative effect on the myoneural synapse. The function of nerve fibers and ganglia is disrupted by heavy metals: lead, thallium, mercury, arsenic, tellurium.
Alcoholic polyneuropathy, which primarily affects the lower extremities, deserves special attention: the legs first hurt, then weakness appears. Paresis is characterized by muscle hypotonia with a sharp decrease in proprioceptive sensitivity, loss of tendon and periosteal reflexes, and ataxia. Muscles quickly atrophy.
Types of pain
Painful sensations while walking can vary in intensity and type. This is due to the provoking factor in the development of diseases, the individual pain threshold, and the stage of development of the disease.
Painful sensations can be severe or moderate. The nature of the pain is aching, sharp, stabbing, dull, pulling. When visiting a doctor, it is very important to establish the nature of this symptom; this will help to make a more accurate diagnosis and begin timely treatment.
The main types of unpleasant symptoms are:
- Acute pain. It is intense but short-lived. It is most pronounced in the pathologically changed area. In this case, the leg and buttock hurt slightly. Such pain is easier to cope with.
- Aching pain. In this case, the unpleasant sensations spread evenly throughout the entire limb, especially in those areas that are in close proximity to the damaged area. The pain can be aching and pulling, in this case diagnosis is difficult.
- Chronic pain. It is long lasting and is present over a long period. It is very difficult to get rid of it.
Joint diseases and their characteristic symptoms
With the development of joint diseases, pain occurs that radiates to the lower limb.
Arthritis of the hip joint
This disease is typical for older people. The main symptom is aching pain in the pelvis. If arthritis develops in the bone apparatus, a person feels discomfort and unpleasant sensations. With the development of arthritis of the periarticular structures, sharp, cutting pain appears during walking. Localization - anterior thigh. Complemented by stiffness of movements. In this case, the use of hormonal drugs, non-steroidal anti-inflammatory drugs is required, followed by physiotherapy, massage, and manual therapy.
Coxarthrosis of the hip joint
This pathology begins to develop after the age of 45. At the initial stages of development, symptoms practically do not appear. This is the insidiousness of the disease, since it can be determined already at the stage of irreversible changes.
Initially, mild pain occurs in the pelvic area, which gradually spreads to the limbs while walking. As the disease progresses, intra-articular cartilaginous structures are destroyed, and pain radiates to the limb. The pathological process is complemented by compression and pinching of nerve endings and ligaments in the pelvis. The pain is constant and is accompanied by shooting pain in the groin and knee areas. In addition to conservative treatment of hip pain, physiotherapy is prescribed depending on the cause.
Bursitis of the hip joint
The hip bone is surrounded by a special cavity - the articular capsule. When it becomes inflamed, bursitis is diagnosed. There are two types of the disease - vertical and ischiogluteal bursitis. It is difficult for a person to lie on the side where the joint capsule is inflamed, as he experiences severe pain and discomfort. Treatment of bursitis involves the administration of glucocorticosteroids by injection. It is also necessary to limit physical activity during an acute pathological process.
Tendinitis
Most often, this pathological process develops in people who engage in heavy physical activity or in those who play professional sports. In this case, the ligaments are affected and the mobility of the articular apparatus is limited. A person experiences severe pain when trying to lean on the affected limb.
Osteomyelitis
The disease is characterized by damage to the long tubular bones of the limb. This is an infectious process that is accompanied by swelling, joint deformation, local hyperthermia, redness of the inflamed area and severe pain.
Description and symptoms of pathologies of the articular zone of the musculoskeletal system
Prolonged manifestations of pain are the reason for an MRI of the hip joint. The bone joint itself is not penetrated by nerve fibers, so some diseases can be asymptomatic for a long time. Soreness appears at the stage of damage or compression of the nerve canals passing in the “hinge” region of the body. At the initial stage of the appearance of disorders, unpleasant sensations arise in a limited area of the connection of the femur with the pelvis. If the disease is ignored, the source of inflammation grows and spreads to neighboring tissues: muscle and tendon fibers, cartilage formations, nerve and blood tracts.
A person may experience the following sensations:
- prolonged radiating pain that does not go away within several days, the cause of which can be identified on an MRI of the hip joint;
- night pain leading to insomnia;
- the desire to change positions as often as possible in order to relieve the pelvic joint with constant discomfort in it.
These signs serve as a reason for a thorough diagnosis, and emergency clinical care is required if the patient complains of the following conditions:
- Irradiation to the groin. Through the conductive canal of the nerve, pulsating sensations spread to the lower abdomen and groin area; with inflammation of adjacent fibers, the sciatic nerve is affected.
- Shootings in the lower part of the back. They can be both sharp and dull, pulsating, leading to limited movement of the body and pelvis.
- Spread of pain to the leg, including the knee area. It may manifest itself as muscle weakness or itchy sensations in the skin.
- A “hinge” clutch that prevents free movement of the limb. It is a sign of arthritic and arthrosis lesions.
- Partial or complete lack of mobility associated with the destruction of pelvic tissues or trauma experienced.
- Lameness associated with low intensity pain. It requires correction, since a change in motor habit leads to deformation of the entire musculoskeletal system.
Most patients describe the phenomenon of crunching sounds when changing body position or movement. A kind of crunching sound is produced by individual ligaments. If the sound is not accompanied by unpleasant sensations, there is no need to worry. Additional pain requires contacting a medical specialist.
Diagnosis of pathology
Painful sensations can occur in the presence of various diseases. It is not recommended to try to get rid of unpleasant symptoms on your own. It is very important to establish the correct diagnosis, and then undergo the prescribed treatment for hip joints in Moscow in a specialized clinic.
To determine the provoking factor in the development of unpleasant symptoms, doctors use various diagnostic methods. First, a visual inspection and palpation of the painful area is performed. The doctor also collects medical history data.
Based on patient complaints, diagnostic procedures are prescribed:
- Laboratory testing of blood and urine.
- Biochemical blood test.
- Radiography.
- Tests for rheumatoid factor.
- Proteinogram.
- CT scan.
- Magnetic resonance imaging.
- Determination of vascular patency.
- Ultrasonography.
Diagnosis of diseases using hardware and MRI of the hip joint
The first step in identifying disorders in the joints of the musculoskeletal system is to contact an orthopedic traumatologist. If necessary, the doctor will resort to the participation of other highly specialized specialists: surgeons, oncologists, rheumatologists or neurologists. At the initial stage, it is necessary to do standard laboratory tests that will determine whether an inflammatory process is occurring in the body of the person being examined.
MRI of the hip joint is rarely performed as a primary hardware study. The area is first checked using radiographic imaging and ultrasound scanning. These diagnostic methods help to detect obvious anomalies occurring in the bones and soft tissue adjacent formations. Most often, this is the result of injuries, fractures, muscle or tendon ruptures.
If the cause of pain is more complex processes that are not detected by traditional diagnostic methods, the pelvis is scanned using tomographic methods - CT and MRI. Visualization using a computer scanner allows you to specifically study the condition of the skeleton, the inner surface of the “hinge” zones, the degree of integrity of the blood and nerve channels, as well as recognize the presence of tumors of various natures. An examination using a nuclear resonance unit allows you to assess the condition of muscles, cartilage and other less dense fibers. The layering of bones will not interfere with MRI imaging of the hip joint.
Features of the treatment of pain of different types
Treatment methods are selected depending on the established diagnosis. To temporarily relieve pain, you can take a painkiller. It will only act for a short time. Since the cause is not eliminated, the unpleasant sensations return again.
Most often, for diseases of the articular system, doctors prescribe conservative therapy. Medications are prescribed - steroidal or non-steroidal anti-inflammatory drugs, vasodilators, chondroprotectors, vitamin complexes. Additionally, physiotherapeutic procedures are prescribed.
If the disease is at an advanced stage of development, conservative therapy may be ineffective. In such a situation, doctors consider the advisability of surgical intervention. For bursitis, removal of fluid from the periarticular bursa is indicated. For infectious diseases, in addition to basic therapy, antibacterial drugs are prescribed.
Treatment of pain in the hip joints
Therapy is prescribed by a doctor after a pre-established diagnosis. For the drug treatment of hip joint diseases, the following scheme is used:
- Non-steroidal anti-inflammatory drugs. Their main goal is to relieve an acute inflammatory process, reduce the severity of pain, and eliminate swelling. Such medications include Indomethacin, Ibuprofen, Dicrofenac.
- Muscle relaxants. Designed to eliminate muscle spasms and relieve pinched sciatic nerves. Such drugs include Movalis, Tolperil, Meloxicam.
- Glucocorticosteroids. Designed to relieve inflammation and relieve pain. This is Prednisolone, Dexamethasone.
- Chondroprotectors. The task of these drugs is to restore damaged cartilage structures. These are Artra, Chondroxil, Chondroitin Glucosamine, Theraflex.
- Vitamin complexes – Milgamma, Neurobeks.
If conservative treatment is ineffective, surgery may be used. At an advanced stage of diseases of the articular apparatus of the hip area, joint replacement is performed, which consists of completely replacing the damaged part of the hip. After such treatment, rehabilitation is carried out. Its result is relief from pain and unpleasant symptoms that arise during the development of degenerative diseases.
With proper and timely treatment, diseases of the hip joint that are accompanied by severe pain can be cured.
Diseases
Joint problems often arise due to diseases. Conventionally, they are all divided into arthrosis and arthritis. Arthrosis
A huge number of types of this disease are diagnosed in many patients.
Over the course of the disease, the joint gradually deteriorates. At first, small cracks appear on its surface, which are difficult to see even on an x-ray. This is the first stage of the disease, and as a rule, it does not bother the patient. Only sometimes can he feel a slight pain in the affected part of the skeleton, however, due to the fact that most often it manifests itself at the end of the day, it is most often perceived as ordinary fatigue. That is why the first degree of arthrosis is rarely diagnosed due to the patient’s ignorance of the presence of a destructive process. However, if the patient consults doctors, degenerative changes during this period can only be detected using an MRI machine. “The subsequent progression already causes more unpleasant sensations. In the morning, after getting up, a person feels difficulty in mobility - for correct work it is necessary to warm up well. The pain intensifies and begins to bother you, but goes away with rest. A characteristic crunch appears in the thigh.” Arthrosis of the 3rd degree is already visible to the naked eye. The affected area swells, the pain does not go away even at night when the person sleeps. Movement is limited, and warming up does not help restore mobility. Stage 4 is characterized by complete destruction of the cartilage tissue surrounding the joint. When examined on x-rays, exposed bone may be visible in some areas. Pain becomes a constant companion, the joint does not move and swells greatly. The only solution in some cases is endoprosthetics. If it is not carried out, the person remains bedridden. Arthritis
This disease is characterized by a disruption in the functioning of the immune system, as a result of which the body perceives joint cells as hostile, viral, and gradually destroys them. Like arthrosis, arthritis has 4 stages and many varieties. Pain in the hip joint indicates arthritis only in the later stages, and before that the problem can easily be confused with arthrosis, since the signs are almost identical - pain, stiffness, crunching and swelling. Later, redness of the skin appears on the thigh, possibly a local or general increase in body temperature.