B12-deficiency anemia of the elderly, or “old people always have cold feet”

Causes of the condition and accompanying symptoms

Weakness in the legs, like any other muscle weakness, is not an independent disease, but only one of the signs of a huge number of pathological conditions. In most cases, this is an alarming symptom that cannot be ignored. It can be caused by the development of various serious diseases, and often the patient needs urgent medical attention. We list the common causes of weakness in the legs.

Muscular dystrophies are a group of genetic diseases that include more than 30 pathologies in which muscle fibers are damaged and weakened. It is associated with a deficiency of the protein dystrophin, which is necessary for normal muscle function. The disease can appear at any age, although most often its signs become obvious in childhood. Boys get sick more often than girls. Symptoms of muscular dystrophy depend on the type. However, common to all pathologies is the appearance of weakness, including in the legs, difficulty walking, and decreased reflexes. Over time, other symptoms appear, such as difficulty breathing, swallowing, and so on1.

Myasthenia gravis is an autoimmune disease in which the body attacks acetylcholine receptors, resulting in disruption of neuromuscular transmission. The main signs of myasthenia gravis are weakness and fatigue of the striated muscles, including the muscles of the limbs. Manifestations of myasthenia gravis also include difficulty climbing stairs, facial paralysis, difficulty breathing, difficulty swallowing and chewing, hoarseness, drooping eyelids and other symptoms2.

Peripheral neuropathy is a condition in which damage to nerve fibers occurs against the background of various diseases and conditions, for example, trauma, systemic disease (diabetes mellitus, hepatitis), infection, congenital pathology. Today, more than 100 types of peripheral neuropathies are known, each of which has characteristics of its course and treatment. Weakness in the legs occurs when motor neurons, the nerve cells that provide motor coordination and maintain muscle tone, are damaged.

Pompe disease is a rare hereditary disease that can occur at any age: from 0 to 75 years and even older. It is inherited in an autosomal recessive manner and is manifested by a complex of symptoms. Characteristic signs of Pompe disease are general muscle weakness, weakness in the legs, decreased muscle tone, respiratory failure, shortness of breath even with minor exertion, hyperlorodosis, changes in gait, and unsteadiness when walking. sometimes - cardiac dysfunction (cardiomyopathy). In addition, patients may complain of drowsiness, increased fatigue, and hearing loss. Late-onset Pompe disease may present in adulthood, with the onset of symptoms usually gradual. Since the pathology is rare, difficulties often arise in establishing a diagnosis. Sometimes it takes years. To speed up diagnosis and select the right treatment, it is important to be attentive to your condition and analyze the entire range of symptoms4.

Graves' disease is an autoimmune disease that affects the thyroid gland. Graves' disease often leads to the development of hyperthyroidism. The symptoms of the disease are specific. Along with weakness in the legs and general muscle weakness, patients are worried about irritability, sleep disturbances, rapid heartbeat, heat intolerance, diarrhea, and unexplained weight loss. External signs of Graves' disease are bulging eyes and the appearance of a bulge in the neck (due to an enlarged thyroid gland)5.

Guillain-Barré syndrome is a rare autoimmune disease in which the immune system attacks part of the peripheral nervous system. Usually the syndrome develops after a bacterial or viral infection, sometimes the “trigger” is vaccination or surgery. It can develop at any age, but symptoms most often appear in adults. The first symptoms of the disease are weakness and tingling in the legs, which then spread to the face and hands. Sometimes this leads to paralysis. In some patients, the respiratory muscles are affected, causing breathing problems and difficulties with speech and swallowing6.

Multiple sclerosis is a chronic, progressive disease that affects various parts of the central nervous system. The reason remains unknown. It is assumed that the disease develops under the influence of genetic and external factors. In multiple sclerosis, the immune system attacks the protective covering of nerve fibers, myelin. The disease manifests itself as a complex of symptoms. Among the most common are muscle fatigue, spasms, muscle tremors, difficulty walking, pain7.

Sciatica develops due to pinching (compression) of the roots of the lumbar spine. This occurs due to damage to the discs or narrowing of the spinal canal. The main symptom is a sharp pain that spreads from the lower back to the limbs, usually on one side of the body. In addition, weakness or numbness in the legs may develop8.

Weakness in the legs can also appear with other diseases and conditions.

Types of muscle weakness

Doctors distinguish the following forms of myasthenia gravis:

• sensory: the sensitivity of muscle tissue on the extremities increases (numbness, tingling, burning is observed);
• motor: severe muscle weakness, due to which a person practically cannot lift an arm or leg - this ailment can lead to muscle atrophy;
• sensorimotor: there is a combination of symptoms of the first two types of myopathy - this is the most common form of the disease;
• vegetative: in parallel with muscle weakness, increased sweating is observed, the skin becomes pale, the head is constantly dizzy, digestion is disturbed, the heart beats faster, breathing becomes difficult;
• mixed: combines the symptoms of all the above-described ailments.

How to diagnose the disease?

The appearance of weakness in the legs is a reason to consult a general practitioner. He will conduct a clinical examination, study the medical history and, if necessary, refer you for consultation to specialized specialists, for example, a geneticist or a neurologist.

Since weakness in the legs can be caused by a number of diseases, a comprehensive examination is necessary to understand what exactly caused the clinical picture. This may include:

• Neurological examination;
• Laboratory diagnostics - general and biochemical tests of blood, urine, etc.;
• Genetic examination - if the development of hereditary muscular dystrophies is suspected;
• Instrumental diagnostics - ultrasound, radiography, magnetic resonance imaging, computed tomography, electroencephalography, electromyography, etc.

Possible causative factors for weakness

Legs can give way for various reasons. It is extremely difficult to diagnose the pathology based on the signs that have arisen, so specialists are forced to use a comprehensive examination to identify the root cause. Uncomfortable sensations and short-term vibration act as a signal of physical fatigue. Warning signs indicate an ongoing health hazard. Thus, when a person’s legs buckle or he feels a shaking in the knee joints, then he should not hesitate to contact a specialist.

Traumatologists argue that the described symptoms should be taken seriously. The main attention should be paid to the occurrence of discomfort in the knee area while walking, running, jumping. Because the absence of a pain sign sometimes does not mean that the joint is normal. The absence of pain and the presence of vibration in the joint indicates a destructive process.

What treatment is prescribed for weakness in the legs?

Therapy is prescribed after a thorough examination and diagnosis. Thus, for chronic diseases (myodystrophy, myasthenia gravis, multiple sclerosis), the goal of treatment is to improve the patient’s quality of life, alleviate the condition and slow down the progression. With Guillain-Barré syndrome, the nervous system recovers on its own, and the efforts of doctors are aimed at maintaining the functions of the body.

For peripheral neuropathies, the task is to optimally control the underlying disease and, if necessary, pain relief with non-steroidal anti-inflammatory drugs.

Severe pain and weakness in the legs, caused by a pinched nerve, goes away on its own after rest. Sometimes medications are prescribed to alleviate the condition - non-steroidal anti-inflammatory drugs, anticonvulsants and others.

Rehabilitation after treatment

Doctors at the Kuntsevo Medical and Rehabilitation Center pay special attention to rehabilitation, helping patients restore their lifestyle. This is due to the fact that due to lack of physical activity, muscles weaken over time. To restore mobility, doctors spend a long time working, and patients need to make a lot of effort. Additionally, therapeutic massage is provided for relaxation. Also, at the Kuntsevo Medical and Rehabilitation Center, many other measures are taken to rehabilitate patients with muscle weakness.

Prognosis and prevention

The prognosis depends on what disease caused the weakness in the legs. Preventive measures are based on compensation for diseases against which damage to peripheral nerves develops, primarily diabetes mellitus, and prevention of injuries.

References

1. Doronin V. B., Doronina O. B. Hereditary muscular dystrophies // Bulletin of Siberian Medicine - 2009. - T. 2. - No. 2. –P.72-76.
2. Shkolnik V.M., Kalbus A.I., Shulga O.D. Myasthenia: what do we know today? //Health of Ukraine (neurology, psychiatry, psychotherapy) – 2010. – No. 3. –P. 14.
3. Peripheral neuropathy. Mayo clinic. URL: https://www.mayoclinic.org/diseases-conditions/peripheral-neuropathy/symptoms-causes/syc-20352061. Access date 04/12/2019.
4. Nikitin S.S. et al. Late-onset Pompe disease: the first clinical description in Russia // Neuromuscular diseases - 2014. - No. 1. - P. 62-68.
5. Menconi F., Marcocci C., Marinò M. Diagnosis and classification of Graves' disease //Autoimmunity reviews –2014. – T. 13. – No. 4-5. – P. 398-402.
6. Guillain-Barre syndrome. World Health Organization. URL: https://www.who.int/ru/news-room/fact-sheets/detail/guillain-barr%C3%A9-syndrome. Access date 04/12/2019.
7. Gusev E.I., Demina T.L. Multiple sclerosis // Consilium medicum –2000. – T. 2. – No. 2. – P. 76-84.
8. Sciatica. MSD Handbook. URL: https://www.msdmanuals.com/ru. Access date 04/15/2019.

GZEA.PD.18.09.0435c

Causes of the disease

Among the main causes of muscle weakness are:

• constant stress, prolonged depression;
• presence of infectious diseases;
• severe intoxication of the body, food or chemical poisoning;
• hereditary, genetic pathologies;
• diabetes;
• varicose veins, arthritis;
• polio;
• scoliosis, intervertebral hernia;
• influenza, ARVI, acute respiratory diseases;
• taking certain medications.

Intoxication

Any poisoning or infection causes general poisoning of the body and failures in many systems. Even a common ARVI, not to mention a bacterial infection, is accompanied by general weakness. Sunstroke, harmful working conditions, stale food - everything can lead to weakness, and each reason needs to be dealt with. In many cases, long-term alcoholism is destructive to nerves and muscles.

CELT doctors, who have unique practical experience, will help to accurately determine the cause of the disease.

Make an appointment through the application or by calling +7 +7 We work every day:

• Monday—Friday: 8.00—20.00
• Saturday: 8.00–18.00
• Sunday is a day off

The nearest metro and MCC stations to the clinic:

• Highway of Enthusiasts or Perovo
• Partisan
• Enthusiast Highway

Driving directions

Preventive actions

The manifestation of the disease in the form of weak knees can be avoided by timely implementation of preventive measures:

1. Blood pressure control.
2. A healthy lifestyle and its timely adjustment, proper alternation of work and rest, avoidance of nervous fatigue. Regular walks in the fresh air, sports activities, refusal to take drugs and alcoholic beverages, and smoking.
3. Introduction of fresh foods, vegetables and fruits into the diet.
4. Timely consultation with a doctor if the first signs of ill health appear.
5. Timely treatment of infectious processes in the body.

In old age, it is recommended to eliminate physical inactivity, perform physical therapy exercises, and take massage courses for weak legs.

Existing measures for safe walking - canes, walkers - should not be ignored.

Therapeutic measures

Weakness in the lower extremities, pain in the knee joints and heels, which arise due to fatigue, do not require special therapy.
In this case, it will be enough to just change your shoes to comfortable ones, or rest and relax for a certain time, and the discomfort signs will immediately disappear. With increasing weakness of the trunk, it is necessary to exclude the possibility of developing a stroke. Muscle weakness or developing limb paresis can be a sign of a serious illness. Therapy here should be aimed at eliminating the underlying pathology and includes:

• Surgical intervention - excision of a hematoma, tumor neoplasm, abscess.
• Antibacterial treatment of infectious processes of the brain or spinal cord.
• Appropriate pain treatment.
• Antidote treatment.
• Taking medications that improve neuromuscular transmission.
• The use of medications aimed at improving cerebral circulation.
• Developing muscles through special therapeutic exercises.