Joints hurt. Who to contact and how to treat? Network of medical centers and MC “Health” in Moscow.

Causes of leg pain

The most common causes of leg pain are:

mechanical damage to joints, muscles and tendons (trauma);
pathologies of the vascular system (obliterating endarteritis, varicose veins, thrombophlebitis);
neurological diseases (myasthenia gravis, polyneuropathy of various nature);
joint damage (rheumatism, arthritis, deforming osteoarthritis);
general fatigue.

Injuries

dislocations;
fractures;
sprains;
bruises.

You can injure your leg not only during an impact or fall. In some cases, people are injured during surgery or during physical activity.

Vascular diseases

thrombophlebitis;
vein thrombosis;
venous insufficiency;
phlebeurysm.

All these diseases provoke the appearance of pain in the legs both at complete rest and after physical activity. Most often they are accompanied by bulging veins and a change in skin color.

Neurological diseases

This is a group of diseases that are also characterized by painful sensations in the legs. Leg pain may be accompanied by:

muscle weakness;
trembling;
tingling;
convulsions.

Joint damage

Joints can be involved in the pathological process for various reasons - an autoimmune factor, microbial exposure, constant injury, degenerative destruction, etc. Establishing the true mechanism of the pathology is important for selecting the most rational therapy.

Fatigue

Often pain in the legs is a consequence of normal overwork of the body. It can occur after prolonged walking, running, or staying in one position. This affects sellers and hairdressers who are forced to constantly be on their feet. In this case, lactic acid accumulates, which irritates the nerve endings, causing pain.

Educational program on medical specialties. When to contact a traumatologist?

Who will help with a burn? Will it fix flat feet? Will the most complex dislocation be reduced? Will the fracture be cast?

We visited a doctor who will help in all these, as well as many other situations. What does an orthopedic traumatologist treat and what symptoms should you contact him for?

Dmitry Borisovich Belanov, a traumatologist-orthopedist at the Expert Tula Clinic, answers these and other questions.

— Dmitry Borisovich, if a person receives a wound, a surgeon stitches it up; if it is necessary to hide a defect after receiving an injury, a plastic surgeon comes to the rescue, and what pathologies are within the competence of a traumatologist? What kind of doctor is this and when do you contact him?

A traumatologist is a doctor who diagnoses, treats, and prevents injuries.

What do patients come to us for? With various bruises, wounds, dislocations and fractures, ruptures, burns and frostbite, deformities of the spinal column and other parts of the skeleton.

What to do if a child has scoliosis? Children's orthopedist-traumatologist at the Expert Clinic Smolensk, Natalya Aleksandrovna Zakharova, tells

— Why is your specialty written with a hyphen: traumatologist-orthopedist?

Because the doctor of this profile also deals with orthopedics. This area of medicine studies pathologies of the musculoskeletal system of congenital and acquired (including due to injury) origin. Together with traumatology, it forms a single specialty.

— Are there differences in pediatric and adult traumatology?

Yes, definitely. For example, if the skeleton of an adult is represented by 205 bones, a newborn has 270. This is explained by the fact that during the process of growth and development, some of the child’s bones fuse into one.

The skeleton in childhood has greater elasticity. Therefore, the incidence of severe injuries (for example, bone fractures, ligament tears) is less.

Read the material on the topic: How to correct flat feet in a child?

Treatment in children takes on average less time; they undergo operations on bones and ligaments significantly less often.

— What symptoms require an urgent visit to a traumatologist?

It is necessary to urgently consult a doctor if a person receives a deep wound(s), falls, cuts himself, gets into an accident, or has an accident at work; in case of pain that does not subside in connection with these cases, deterioration of the general condition, sudden changes in the damaged organ (for example, swelling, change in shape, crunching sound, dysfunction.

For example, a person twisted his leg. He feels pain, swelling in the ankle joint and lameness. This could be a torn ligament or broken ankle. In this case, an urgent x-ray is required to clarify the diagnosis.

Why are x-rays dangerous? Yulia Aleksandrovna Rutskaya, head of the radiology department of the Expert Clinic Kursk, tells

— What does a traumatologist-orthopedic surgeon do during an appointment? What diagnostic methods help him not to make a mistake in diagnosis and prescribe the correct treatment?

An appointment with an orthopedic traumatologist begins with a detailed interview and examination of the patient. Sometimes the diagnosis can be made already at this stage.

Then instrumental studies are performed. In traumatology and orthopedics, radiological diagnostic methods (radiography, computed tomography) remain relevant. These methods are valuable when studying bone tissue.

Read the material on the topic: Is MRI informative for injuries?

Thanks to MRI, it became possible to study the condition of soft tissues and joints. This method significantly expands the doctor’s capabilities for injuries and other pathologies of the musculoskeletal system.

— What injuries are most common in Tula residents?

Bruises and ligament damage are more common. In the warm season, there are many injuries caused by working with various tools (grinder, hammer, axe).

In winter, fractures of the shin and forearm bones occur.

There are types of injuries for which I do not note a clear seasonality. This is, for example, a fracture of the femoral neck in elderly people due to falls.

— Can you name the leading causes of injuries among residents of Tula? What is it: inattention, negligence or an accident that they say is fate? In a word, who is to blame?

I would say that all factors are present to a certain extent. A significant contribution to injury statistics is made by fractures and sprains that occur during the cold season - due to snow and ice.

How can MRI help a patient with a traumatic brain injury and its consequences? Yuri Andreevich Podlevskikh, executive director of Clinic Expert Orenburg, tells

— What can we do to reduce injuries at all levels: residents, cities, countries?

Educational work is important - both through the media and through individual work with the patient.

At the workplace and at home, it is necessary to adhere to the recommended safety rules when working with potentially traumatic means and factors (tools, electric current, high and low temperatures, mechanical forces, etc.). Use appropriate protective equipment (gloves, goggles, etc.).

Occupational hygiene should be observed and sufficient rest should be taken to avoid overwork and the associated deterioration in concentration.

It is necessary to take into account the peculiarities of climatic conditions in our country. For example, in the winter season, wear high-quality shoes with non-slip soles, be careful on the road, and try to avoid roads with slopes and inclines.

— What specialty can a doctor replace a traumatologist if necessary? Who should I contact if there is neither an emergency room nor a traumatologist nearby?

Historically, traumatology has separated from surgery. At a certain stage in the development of medicine, some surgeons began to specialize in providing more specialized care - in particular, related to wounds with cold weapons, severe bruises, hematomas, and later - with firearms. Then traumatology began to take shape.

Therefore, if there is no traumatologist, you can contact a surgeon. This doctor can provide first aid, and in some cases, carry out full treatment.

— Today is World Traumatologist Day. Tell us how you got into your specialty?

I wanted to become a doctor when I was in junior high school. Soon after entering university, I realized that it was helping the sick, associated with working with my hands, that would make me happier. This includes all surgical specialties. In relation to traumatology, this is the application of plaster casts, operations, the ability to detect the source of damage and pain by touch and palpation.

Of the entire arsenal of medicine, the most interesting thing for me was studying fractures, methods of treating them, reading x-rays, etc. This is how my passion for this field began, which later became my specialty.

— What gives you satisfaction from work?

First of all, these are, of course, satisfied patients. And, of course, my own work. A feeling of satisfaction from the process of providing assistance: applying a cast, reducing a dislocation. A patient's happy look and smile is what brings joy.

You can make an appointment with a traumatologist in your city here

Please note: consultations are not available in all cities

— What would you like to wish your colleagues and patients on your professional holiday?

I would like to wish patients to pay more attention to their health, no matter how “hackneyed” this phrase may seem. It is very important to consult a doctor in a timely manner and not self-medicate.

I wish my colleagues patience, and also to listen more to the patient - including not only about the problem that directly concerns the patient.

How to reduce leg pain on your own?

You can cope with painful sensations in the legs at home with the help of:

contrast shower,
recreation,
wearing compression garments,
massage,
analgesic tonic ointments and gels.

In order to properly learn how to cope with leg pain, you must first establish the exact cause of their occurrence. To do this, you will need to see a doctor and undergo a comprehensive examination, which will help identify the nature of the origin of the pain syndrome.

What does a traumatologist treat?

The profession of a traumatologist combines two specialties - traumatology and orthopedics:

Traumatology is in most cases used for emergency measures, as it was created specifically for the diagnosis and treatment of injuries to the musculoskeletal system.
Orthopedics, as a rule, deals with planned treatment, since the field of activity of an orthopedist includes the study, diagnosis, treatment, and selection of methods for the prevention of diseases and deformations of the musculoskeletal system - both congenital and acquired.

The list of diseases and deformities that the specialist deals with is quite impressive. The most common problems with which people turn to a traumatologist are fractures, sprains, flat feet, scoliosis, arthritis, arthrosis, hip dysplasia, valgus deformities, and intervertebral hernia.

Treatment methods

Doctors at the Sanmedexpert clinic prescribe treatment for leg pain only after a complete examination of the patient and identification of pathological processes. Therapeutic therapy can be either medication or surgery.

If the legs hurt due to neurological diseases, the patient is prescribed physiotherapeutic procedures, physical therapy, massage, wearing bandages and corsets. When identifying vascular diseases, the use of special medications is required, the action of which is aimed at increasing vascular tone and improving blood circulation, as well as therapeutic exercises and reducing physical activity.

The treatment technique for leg pain is determined individually depending on the nature of its origin. But in any case, you should not delay treatment, because the disease is easier to treat at an early stage.

Rheumatological complex

Rheumatological diseases in humans are most often associated with joint diseases, although various organs and systems may be affected. How can one suspect a rheumatological disease and what tests need to be taken?

Rheumatological diseases represent a large group of diseases that affect the connective tissue of the body. They are also called autoimmune or systemic diseases. Autoimmune - because the immune system loses the ability to recognize “self or foe” and produces antibodies against its own cells and tissues. Systemic - since connective tissue is contained in all organs and vessels, therefore all body systems are affected to one degree or another. The cause of rheumatological diseases is not completely clear. But the consequences are serious, and early recognition is important for timely treatment and prevention of complications.

How can one suspect a rheumatological disease?

Severe tiredness, fatigue, general malaise - signs similar to those at the beginning of a cold;
Muscle and/or joint pain
Swelling of the joints, changes in the tissue around the joint, up to deformation
Pain when pressing on a joint or muscle
Episodes of mild or prolonged fever
Random detection of elevated ESR in a clinical blood test or C-reactive protein.

The above signs can occur with a number of other diseases, although often they are the only “alarm signals” to start an examination.

In fact, changes often occur in the heart, lungs, kidneys, nervous system and other internal organs, but they do not have clear manifestations. Sometimes you notice signs of skin damage - in the form of various rashes. Redness of the facial skin in the shape of a “butterfly” occurs with systemic lupus erythematosus; thickening of the skin of the fingers with scleroderma.

How is the diagnosis made?

In order to establish a rheumatological disease, the doctor evaluates 2 criteria:

Manifestations during the collection of complaints, examination and instrumental methods (X-ray, ultrasound, CT). In medical parlance, this is called a “clinical criterion.”
Laboratory signs

Only on the basis of a joint assessment of clinical and laboratory criteria is it possible to establish a diagnosis of a rheumatological disease and distinguish which disease from the whole group occurs. No criterion is used in isolation!

For your convenience, the main laboratory tests are combined into the “Rheumatological, advanced” complex.

What is included in the complex?

C-reactive protein is the main indicator of inflammation; in rheumatological diseases it increases significantly, but does not allow us to understand what kind of disease has developed.
Uric acid increases in the blood and accumulates in the joints during gout.
Antistreptolysin-O – increases with rheumatism.
Rheumatoid factor (total antibodies) and Antibodies to cyclic citrullinated peptide are markers of rheumatoid polyarthritis - the most common rheumatological disease, which mainly affects the small joints of the hands with morning stiffness and rapidly developing deformation of the joints when detected late.
Antineutrophil cytoplasmic antibodies, IgG (ANCA, Combi 6) - are used to diagnose vasculitis. This is an inflammation of small blood vessels, when the kidneys (glomerulonephritis), lungs and upper respiratory tract are mainly affected.
Antinuclear antibodies, immunoblot - includes the determination of autoantibodies to 14 different antigens. Depending on the identified antigen, the doctor will be able to understand what disease the patient has: systemic lupus erythematosus, scleroderma, Sjogren's syndrome, polymyositis.
Antibodies to Chlamydia trachomatis, IgG - their determination is important for assessing immunity to chlamydia and excluding Reiter's syndrome. This is an immunological lesion of the urethra, eye tissue and joints, which develops as a result of a long-standing chlamydial infection.

What do you need to take and how to prepare for the study?

To test for rheumatological complex, venous blood is donated in the morning on an empty stomach or 3 hours after a light meal. It is recommended to give up alcohol the day before.

Rheumatological disease is well treated in the early stages. Pay attention to your health, be attentive to yourself and get examined in a timely manner!

How does an appointment with a traumatologist proceed?

In case of serious injuries complicated by blood loss, respiratory failure, loss of consciousness, immediately developing infections, cardiac arrest, the specialist acts as an emergency doctor.

In all other cases, as a rule, you make a scheduled appointment with a doctor at a time convenient for you. However, if the symptoms are serious, then there is no need to delay the visit, so as not to aggravate the situation.

At the doctor's appointment, a conversation is first held, during which the patient must talk about his state of health and express complaints. There is no need to try to make a diagnosis on your own. Then an inspection is carried out. The doctor makes a preliminary diagnosis, refers for tests, and prescribes additional examinations - most often x-rays and MRI.

It should be taken into account that a traumatologist treats both on an outpatient basis and refers for hospitalization, so in the second case you will have to undergo mandatory tests, including a coagulogram, ECG, general urine and blood tests.

In order for the first visit to be fruitful, you need to bring with you an extract from your outpatient card, MRI or X-ray images of problem areas.