The Shin Hurts In Front When Walking: What To Do?

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Video: The Shin Hurts In Front When Walking: What To Do?

Video: The Shin Hurts In Front When Walking: What To Do?
Video: Causes of Shin Pain - Biomechanics Explained 2024, March
The Shin Hurts In Front When Walking: What To Do?
The Shin Hurts In Front When Walking: What To Do?
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What to do if the shin hurts?

What to do
What to do

Pain in the lower leg when walking can indicate a developing pathology, or occur under normal conditions, for example, after or during excessive physical exertion. Diseases that provoke painful sensations can affect nerve fibers, blood vessels, and the spine. Most often, the pain in the lower leg goes away on its own, after a short rest, but this is possible only if its nature does not have a pathological basis.

Often, a person cannot himself determine the factor that provoked the painful sensations. In this case, you need to go to the doctor and be examined. Pain should not be treated with analgesics, as temporary relief can be severely worsened.

Content:

  • What can hurt in the lower leg?
  • Causes of pain in the lower leg
  • Calf pain diagnostics
  • What to do with leg pain?

What can hurt in the lower leg?

What can hurt in the lower leg
What can hurt in the lower leg

All structures of the lower leg are permeated with nerve fibers. Therefore, irritation or damage to any part of it will lead to painful sensations. This happens when the skin, muscles, ligaments or tendons, bone structures, joints, blood vessels and the nerve endings themselves are affected.

Pain-provoking factors:

  • Direct tissue damage due to trauma. The pain is acute. Once the source of the injury is removed, the pain will begin to subside.
  • Inflammation. This process is accompanied by tissue edema, expansion of blood vessels, an increase in the number of leukocytes in the affected area, compression of nerve fibers, which provokes pain.
  • Deterioration of the nutrition of the lower leg due to failures in the circulatory system. Normally, the blood continuously supplies nutrients to the lower leg and carries away metabolic products. If this process is disturbed, then the metabolic products settle in the tissues of the lower leg and cause pain. It is enhanced by oxygen starvation.
  • Damage to nerve fibers. Pain in the lower leg can be triggered by damage to the nerve trunks at the level of the spinal cord or in another area that is interconnected with its structures.

Causes of pain in the lower leg

Causes of pain in the lower leg
Causes of pain in the lower leg

There are several main reasons that can lead to painful sensations in the lower leg, among them:

  • Injury received.
  • Pathology of the bone apparatus of the lower leg.
  • Diseases of the muscle structures of the lower leg.
  • Vascular pathology.
  • Spine diseases.
  • Infections.
  • Tumor neoplasms.

Causes of pain

Possible diseases

Injury to any structures in the lower leg will lead to pain. Its intensity depends on the severity of the injury and on the nature of the injury. Major shin injuries:

  • Fractures. The pain is acute, intense.
  • Shin contusion (tissue damage with a blunt object). A person experiences maximum pain at the time of injury, after which its intensity decreases.
  • Stretching of the leg muscles with or without tearing. The pain is sharp, intense, stabbing, and has a tendency to increase during an attempt to bend or straighten the leg.
  • Sprained knee ligaments. At the time of injury, the pain is acute, often accompanied by edema and the rapid development of inflammation.
  • Dislocation of the ankle joint. During injury, the pain is acute, and in the future it only intensifies.

Pathology of the bone apparatus of the lower leg

Diseases that can affect the bones of the lower leg:

  • Osgood-Schlatter disease in which aseptic destruction of the tibia occurs. It develops during the period of active growth of the skeleton. Most often children who are involved in active sports suffer, which leads to permanent microtrauma of the tibial tuberosity. The painful aching, weak, increases during the extension of the leg, and disappears during the rest period. As the disease progresses, the pain becomes more intense.
  • Osteitis deformans, which is expressed by a decrease in the strength of the bone tissue, which leads to its frequent fractures, even with minor physical exertion. The pain can occur due to deformation of the lower leg bone, it is aching, dull, constantly pursues a person and intensifies at rest.
Diseases of the muscle structures of the lower leg

Muscle pathologies that can lead to pain in the lower leg:

  • Dyspnoea, which are characterized by damage to muscle structures with the formation of micro fractures on them. Diseases form after intense physical training. The pain is intense, preventing the damaged muscle from contracting completely. It lasts no more than a few days. The inflammation gradually subsides, the pain goes away and the muscle is restored.
  • Convulsions. Intense physical exertion or sudden hypothermia can provoke an involuntary contraction of the leg muscles. They painfully spasm, but after a few seconds the spasm goes away. In rare cases, it lasts more than a minute.
  • Shin splitting syndrome. Most often, it affects people who, without prior preparation, begin to engage in active sports and exhaust their body. This is especially true for runners and track and field athletes. The aching pain, most often moderate, occurs during training, and after its completion it stops.
  • Tunnel syndrome, which may include anterior sheath syndrome (pain worsens when the leg is bent) or posterior sheath syndrome (pain worsens when the leg is extended). The reasons for the development of this syndrome are varied: fractures, vascular pathologies, bruises, intense training. However, they all lead to the formation of edema and increased pressure inside the case, which compresses the muscles, disrupts their nutrition, pinches the nerve fibers and provokes pain.
Vascular pathology

Vascular pathologies that can lead to pain in the lower leg:

  • Atherosclerosis of the vessels feeding the lower leg. In this disease, cholesterol is deposited on the vascular walls of large and medium arteries. In the early stages of the development of the disease, until the lumen of the vessel is completely blocked by a plaque, pain can bother a person only during physical activity. As the artery narrows, the pain gains intensity, it begins to bother a person even at rest.
  • Obliterating endarteritis. With this pathology, the small arteries of the lower leg are clogged, which causes a deterioration in the blood supply to the tissues and their further necrosis. There are many risk factors for endarteritis, this includes: smoking, hypothermia, rheumatic diseases, vascular pathologies, etc. The disease is dangerous only by pain in the lower leg, but also by the formation of blood clots.
  • Varicose veins are considered a multifactorial pathology. It can develop due to hereditary predisposition, sedentary work, sedentary lifestyle, etc. Stagnation of blood in the lower extremities leads to deformation of the veins, their pathological expansion and aching pains. They intensify after prolonged load on the legs, when a person is in an upright position.
  • Thrombophlebitis leads to stagnation of blood in the veins of the lower parts of the leg due to the fact that they are blocked by a blood clot, which provokes pain. Thrombophlebitis risk factors: systemic infectious pathologies, vascular injuries, varicose veins, etc.
Spine diseases

The lower leg is laced with nerve fibers that extend from the sacral plexus. It, in turn, comes out of the spinal nerves that extend from the spinal cord. Therefore, diseases of the spine, concentrated in the lumbosacral region, can lead to pain in the lower leg.

These pathologies include:

  • Osteochondrosis, accompanied by a violation of metabolic processes and blood supply to the intervertebral discs. This leads to the fact that they are deformed, pinching the nerve fibers and causing pain in the lower back, which can radiate to the leg.
  • Protrusion of the intervertebral disc. This pathology is characterized by the exit of a part of the disc into the spinal canal and compression of the spinal cord. Pains are localized in the back, radiate to the leg. They are most often pulling, although they can be sharp.
  • Herniated disc. In this case, a rupture of the annulus fibrosus occurs, which holds the intervertebral disc and its contents begin to strongly press on the spinal cord. The pains become intense and haunt the person on an ongoing basis.
Infections

Infections that can lead to pain in the lower leg:

  • Formation of a boil on the lower leg.
  • Erysipelas, causing sharp burning pains in the area of its formation.
  • Phlegmon of the lower leg.
  • Gangrene of the lower leg.
  • Trophic ulcers on the lower leg, which are formed due to a violation of the blood supply to the tissues of the lower limb. Often a similar problem occurs in people with diabetes mellitus, with varicose veins, with obliterating endarteritis.
  • Osteomyelitis, in which an infection affects bone tissue and causes its destruction. The pain is oppressive, excruciating, sharp. Any movement becomes painful.
Tumor neoplasms

If a person develops a tumor, then the initial stages of its formation are most often not accompanied by painful sensations. They appear as the tumor grows in size.

The lower leg can suffer from the following benign tumors:

  • Fibroids.
  • Lipomas.
  • Leiomyomas.
  • Rhabdomyoma.
  • Chondromas.
  • Osteomas.
  • Neurinomas.
  • Angiomas.

However, tumors are not always benign. They can sometimes contain cancer cells. These tumors include sarcoma, melanoma, and squamous cell carcinoma of the skin. All malignant tumors tend to grow rapidly and spread metastases.

Calf pain diagnostics

Sometimes the cause of leg pain is obvious to a person, as is the case with injuries. With this development of events, it is necessary to immediately contact a traumatologist and get appropriate help. However, the causes of pain in the lower leg are not always on the surface. Often, their identification requires a comprehensive examination and consultation with various specialists (neurologist, angiosurgeon, infectious disease specialist, orthopedist, oncologist, etc.).

Type of disease

Diagnostic methods

Diseases of the bone tissue of the lower leg

To detect Osgood-Schlatter disease, an X-ray examination will be required, but it reveals pathological changes only in the late stages of the development of the disease. CT is indicated for early diagnosis.

Symptoms that are characteristic of this disease:

  • Pain and swelling in the soft tissue of the lower leg. To be more precise, the edema is localized just below the knee joint.
  • The pain intensifies during physical exertion on the leg.

To detect deforming osteitis, you need to donate blood for biochemical analysis. In this case, the patient will have a high level of alkaline phosphatase. X-ray of the bone allows you to reveal its curvature and deformation, and scintigraphy makes it possible to clarify in which parts of the bone overly active metabolic processes occur.

Osteitis symptoms:

  • Curvature of the shin bones.
  • Involvement in the pathological process of the ankle and knee joint, which causes limitations in its mobility.
  • Frequent fractures due to increased fragility of bone tissue.

Calf muscle diseases

If the pain in the lower leg is provoked by rare muscle spasms and does not bother a person on an ongoing basis, then you can not show any concern. However, when painful sensations follow a person for a long time, you need to consult a doctor:

  • With frequent seizures, it is necessary to donate blood for a general analysis and to determine the level of vitamins and trace elements in it, for example, vitamins of group B, calcium, iron, etc. Genetic research may be required to detect hereditary pathologies. Electromyography is an auxiliary diagnostic method.
  • To detect tunnel syndrome, an X-ray examination, ultrasound of the soft tissues of the lower leg are required. MRI allows you to assess the condition of all structures of the lower leg. In addition to pain in tunnel syndrome, the patient will experience lower leg swelling, numbness and muscle weakness.

Vascular pathology of the lower leg

Damage to blood vessels is always serious, therefore, you need to see a doctor as early as possible:

  • Atherosclerosis is accompanied by patients' complaints of numbness of the legs during physical activity, coldness and soreness. With an advanced form of the disease, trophic ulcers can form; there is no pulsation in the posterior tibial artery. Diagnostics is reduced to blood donation for biochemical analysis (high levels of total cholesterol, triglycerides and LDL, as well as a decrease in HDL, will be revealed). To clarify the diagnosis, doppler ultrasonography of the vessels with or without a contrast agent will be required. Since atherosclerosis affects the condition of the heart, patients are prescribed an ECG.
  • With obliterating endarteritis, patients complain of pain in the lower leg, rapid fatigue during walking, cold extremities, and numbness. The obvious sign of the disease is intermittent claudication, which is accompanied by cyanosis of the skin. With an advanced form of the disease, people develop trophic ulcers on the lower leg, which are complicated by the addition of infection. Diagnostic methods: rheovasography, capillarography, Doppler ultrasonography, angiography, thermography. All these research methods provide information about the state of blood vessels.
  • Varicose veins. This pathology, in addition to pain, is accompanied by symptoms such as heaviness in the legs, their swelling, cramps and cyanosis of the skin. Sore veins will be clearly visible under the skin. With an advanced form of varicose veins, the patient develops trophic ulcers. To detect pathology, ultrasound and Doppler ultrasound of the veins are performed. To complement the picture of the disease, you can use CT or MRI. If there is a threat of thrombosis, blood must be donated for an assessment of its clotting capabilities.
  • Thrombophlebitis is accompanied by compaction and redness of the skin of the lower leg in the area where the thrombus has formed. The leg becomes hot to the touch, swells. A general increase in body temperature is possible. To detect pathology, you need to donate blood for a general analysis (the level of leukocytes and ESR will be increased), blood for biochemical analysis (an increase in the level of D-dimer), blood to assess the work of its coagulation system. To clarify the location of the thrombus, dopplerography or MRI is performed.

Spine diseases

The earlier the pathology is detected, the higher the likelihood of the success of therapy. To identify osteochondrosis of the lumbosacral region, you need to focus on the patient's complaints:

  • Lumbar pain radiating to the thigh and lower leg.
  • Limitation of range of motion in the lumbar spine.
  • Deterioration of the sensitivity of the legs, with their frequent numbness.
  • Muscle weakness and deterioration of the organs located in the pelvis.

Instrumental examination methods include X-ray and CT of the affected area. For the diagnosis of disc herniation or protrusion, similar symptoms are characteristic. Diagnostic methods: CT and X-ray.

Infections

Infections affecting soft tissues with the formation of boils, phlegmon, gangrene, erysipelas or trophic ulcers do not cause diagnostic difficulties. Most often, an external examination of the lower leg is enough for the doctor to make a diagnosis. To clarify the nature of the disease, such studies are prescribed as:

  • General blood analysis.
  • LHC seeding from the affected area.
  • Serological research methods.

When a trophic ulcer is formed, blood is taken to determine the glucose level in it. If vascular pathology is suspected, angiography and Doppler ultrasonography are performed. Osteomyelitis requires an MRI or CT scan, which allows a detailed study of the condition of the lower leg bones.

Tumor neoplasms

Tumor neoplasms may not manifest themselves for a long time. Therefore, you should always pay attention to indirect signs that can indicate developing cancer. Early symptoms include:

  • General fatigue and weakness.
  • Weight loss.
  • Decreased appetite.
  • Mood swings.
  • An increase in body temperature to subfebrile levels. It lasts for several weeks or even months.

To find a tumor, you will need to undergo CT or MRI, scintigraphy or angiography. When a neoplasm forms on the bone tissue, it can be detected using X-ray examination. Histology of tumor tissues is performed to determine the presence of malignant cells in it, as well as to clarify the type of neoplasm.

What to do with leg pain?

What to do with leg pain
What to do with leg pain

Pain cannot be tolerated. This signal warns a person that something is wrong in his body.

Until the moment the diagnosis is made, the person is shown taking painkillers, which make it possible to alleviate his well-being.

These drugs include:

  • Drugs from the NSAID group (Diclofenac, Nimesil, Paracetamol, etc.), which are prescribed both for oral administration and intramuscularly. They are used to treat almost any type of leg pain.
  • Narcotic analgesics. These are drugs such as Morphine, Omnopon, Codeine. They are prescribed for severe pain, by mouth, subcutaneously, or intramuscularly. These drugs are available only by prescription, or are prescribed to inpatients, for example, to relieve pain after a bone fracture.

With leg injuries. The main aspects of the treatment of a leg injury are reduced to ensuring the immobilization of the limb. Before the arrival of the medical team, cold is applied to the site of injury or sprain. In difficult cases, such as fractures or ligament ruptures, surgery is required. During the period of pain, the patient is prescribed pain medications.

At the recovery stage, physiotherapeutic treatment is indicated: electrophoresis, UHF, magnetotherapy.

Video: What to do if the periosteum is ill (bone in front below the knee):

For tissue diseases. For the treatment of Osgood-Schlatter disease, it is necessary first of all to provide the affected limb with complete rest. The patient is advised to give up sports. It is recommended to use elastic bandages during physical activity.

Anesthetize the leg with NSAIDs. To eliminate the acute stage of the disease, UHF and magnetotherapy are prescribed. The operation is performed only when the tibial tuberosity is severely deformed.

With osteitis deformans, the patient should adhere to bed rest, take medications: calcium supplements, drugs from the NSAID group, Pamidronic acid, Alendronic acid.

Another point of treatment is the implementation of exercise therapy, which is made up for each patient individually.

For diseases of the leg muscles. If your leg pain is caused by a cramp, then you need to sit down or lie down so as not to lose balance. With hypothermia, the muscle needs to be warmed up. To prevent the occurrence of seizures, you need to eat right, perform regular massage of the lower leg, and increase physical activity.

Shin splitting syndrome and tunnel syndrome are treated with NSAIDs. It is imperative to refuse to perform those exercises that caused painful sensations, or reduce physical activity on the lower extremities.

With vascular pathologies. If the pain in the lower leg is caused by atherosclerosis, then it is imperative to reconsider your lifestyle, increasing physical activity, quitting smoking and junk food. To improve microcirculation in tissues, the patient is prescribed Trental and Actovegin. The drugs Simvastatin and Pravastatin help to reduce the level of cholesterol in the blood. Vascular surgery is performed in severe cases, only with severe tissue hypoxia with necrosis.

Therapy of obliterating endarteritis is reduced to taking medications. For vasodilation, No-shpa is prescribed, and means are also shown to reduce the viscosity of blood. When infectious complications join, the patient is prescribed antibiotics. Massage and physiotherapy (UHF, thermal procedures, electrophoresis) have a good effect. The operation is indicated for severe pathology, but it does not solve the problem, but brings only temporary relief.

To get rid of varicose veins, you need to eliminate the factor that led to its development. First of all, this concerns hypodynamia. Therefore, all patients with varicose veins need to increase their physical activity. Medical correction is reduced to taking NSAIDs. It is better to give preference to Aspirin, which not only eliminates pain and relieves inflammation, but also thins the blood, preventing blood clots from forming. In addition, patients are prescribed anticoagulants and angioprotectors. Compression garments can be worn to prevent veins from overflowing. To treat severely damaged collaterals, sclerosis or vein removal is required.

If a patient develops thrombophlebitis, then he is urgently hospitalized, since when a blood clot breaks off, the likelihood of death increases. The patient is prescribed anticoagulants, antiplatelet agents, angioprotectors and anti-inflammatory drugs. In severe cases, surgical treatment is indicated with the removal of the affected veins or their cauterization.

With infectious diseases. Therapy for infectious diseases requires the use of antibiotics. Their choice depends on what kind of pathogenic flora the purulent process was provoked. Preference should be given to drugs with a wide spectrum of action (penicillins, tetracyclines, cyphalosporins). If antibiotic therapy does not allow you to get rid of the problem, then surgery is indicated with the removal of purulent masses and dead tissue.

Amputation of a limb is an extreme measure taken in order to save the patient's life.

Treatment of tumor neoplasms involves the following types of medical care:

  • Chemotherapy.
  • Radiation therapy.
  • Operative intervention.

They are often combined with each other. When metastases spread, the patient is provided with palliative care aimed at improving his quality of life.

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Author of the article: Sokov Andrey Vladimirovich | Neurologist

Education: In 2005 completed an internship at the IM Sechenov First Moscow State Medical University and received a diploma in Neurology. In 2009, completed postgraduate studies in the specialty "Nervous diseases".

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