Intermittent claudication - is symptomatic complex characteristic manifestation of which is the violation of the blood supply vessels, which are located in the lower extremities with manifestations of pain in the legs transient nature, as well as appearing in walk.Many vascular pathology, intoxication, infection, trauma are causes of the disease.As a result of spasm, which is formed in the peripheral blood vessels, there is insufficient blood supply to the muscles and / or nerves of the lower limbs, much less - upper.
Intermittent claudication usually runs a chronic, but there is an acute form of the disease.The medical sources described two types of diagnosis of intermittent claudication, namely for spinal and peripheral Dejerine by Charcot.
Intermittent claudication causes
This kind of symptom that accompanies diseases such as Leriche syndrome, occlusive disease, atherosclerosis, and posttromboticheskie postembolic occlusion.Intermittent claudication - a cons
in the development of intermittent claudication may participate and other diseases of the circulatory system, and sometimes diabetes, infections, intoxication and various limb injuries.
most basic factor, which stimulates the formation of intermittent claudication, is considered to be smoking.Several studies have found that there is a direct relationship between smoking and vascular occlusion.The toxic carcinogens contained in the smoke from cigarettes, provoke premature distortion of the structure of blood vessels, namely arteries, lead to the formation of atherosclerotic plaques in them and increase the risk of clot formation.
Intermittent claudication neurogenic character develops as a result of pathological processes in the spine, such as spinal stenosis, etc.
In addition to the risk factors of intermittent claudication is still possible to include alcohol abuse, physical inactivity, obesity, genetic predisposition and high blood pressure.
Intermittent claudication symptoms
Typically, intermittent claudication is characterized by pain in the lower extremities, which are beginning to develop in the process of walking as a consequence of abnormal blood flow, but disappear when you stop movement.
More often this symptom observed among men in middle age.But recently this syndrome has become manifest and women.This can be explained by the increase in smoking among women and the negative impact of nicotine on the body of the weaker sex.
long time, intermittent claudication does not manifest itself, that is, takes absolutely no symptoms.Patients with symptoms of intermittent claudication in the very beginning is experiencing a certain weakness, tired quickly, and then he had the first signs of paresthesias in the lower extremities.In the future, an increase in physical activity, deformed arteries do not give the ability to make normal blood circulation, so patients have the characteristic pain in the calf muscles.It is this feature is the main manifestation of the syndrome of intermittent claudication.In this case, the patient is forced to periodically make minor stops, and after decrease in pain attack, continue to make their move.
With the progression of the disease, the pain starts to grow, and then it becomes quite persistent.Pain in nature displays may be quite different.Sometimes they can be pulsed or burning character, and in some moments - and dull aching.Typically, the pain is characteristic of this disease often occurs when climbing up, or when driving long distances, so the patient has to walk with a limp.
pain may also occur in the hips and legs, as well as toes.All this is due to the fact, where there was a blockage or narrowing of blood vessels.This is not possible to palpate the pulse in the foot, and it is not detectable under the knee.Also, a change in the skin as blanching, and in an active phase progression of the pathological process appears cyanosis.In addition, the skin condition is getting worse, and the skin becomes dry.
Symptoms of intermittent claudication consists of lowering the temperature of feet, and in consequence the patient loses sensitivity in this part of the body.In addition to these symptoms there is soreness in the muscles of the calf, there is discomfort when the pressure on the nerve trunks in the lower legs.In rare cases, there trophic ulcers.For this symptom is intermittent claudication is characterized by a chronic course with periodic remissions of the disease.
pain can disturb the patient, as in the times of the progression of the disease, and in a state of complete rest.This painful attacks make people wake up, even at night.And gradually symptom, intermittent claudication is quite deteriorated, so the patient has to take a variety of painkillers to alleviate his condition.
This syndrome may indicate the formation of a serious disease of the arteries, such as occlusive disease.Severe form characterized by the appearance of intermittent claudication in the lower limbs of ischemic ulcers, and later formed gangrene with subsequent limb amputation.
In the absence of appropriate treatment in this disease may develop collaterals, which are capable of partially or fully compensate for the disease.But at the absolute blockage required emergency surgery.
Intermittent claudication basic sign
main symptom of intermittent claudication, which accompanies many diseases, is a pain in the muscles of the lower extremities.Pain usually appear during walking and at the beginning of the disease disappear during the holidays.A person with this diagnosis to have to stop to the pain disappeared for a while and then return to normal movement.
Intermittent claudication develops in the presence of some factors that contribute to the formation of this symptom.These include smoking, obesity, advanced age, and diabetes mellitus.
Symptoms of this syndrome is largely dependent on the stage at which there is intermittent claudication at this moment.Typically, there are four stages of the disease.
At the very beginning, and this is the first stage of the disease process, patients fail to carry out palpation of the major blood vessels in the lower extremities, namely in the groin, popliteal fossa and on foot.The absence of pulse in these areas will depend on the blockage of arteries.
For the second stage is characterized by the appearance of pain in the buttocks, thighs and calf muscles.These painful attacks become so intense that forces patients to undergo transitions even for short distances (up to a hundred meters), with periodic stops to rest.
In the third step, intermittent claudication occurs in the patient in the form of severe pain in the rest or at night, and their intensity increases each time.In addition, the patient has a feeling of cold and numb toes.The skin becomes pale hue, marked slowing of hair, and later he disappears.It is also rather slow start growing toenails.
One of the most dangerous and serious stages of the disease is considered to be the last stage, the fourth.In this phase of intermittent claudication in a patient characterized by attacks of severe pain in the lower extremities, which are always present, and in motion, and absolute rest.Patients in this period of the disease is almost can not do any physical activity, because it is in this stage of disturbed nutrition of soft tissues, causing the development of necrosis and gangrene.
Intermittent claudication treatment
The disease, if the patient's complaints to the characteristic pain in the legs, the doctor fails to diagnose even if the initial examination to establish the diagnosis and intermittent claudication.This is confirmed by the characteristic symptoms of the disease and the lack of a pulse at the appropriate points in the lower extremities.If necessary, additional investigations prescribed examinations using ultrasound on the permeability of the arteries and angiography.This diagnosis allows to determine the degree of circulatory disorders in the lower limbs.If you suspect that the occlusion of the arteries carrying prescribed angiography, which fully to determine the status of intermittent claudication.
Almost 20% of patients have the severe form of the disease, which is developing quite rapidly and urgently require hospitalization and surgery.Depending on the specific characteristics of a symptom, intermittent claudication carry out reconstruction or angioplasty.But, as in the most extreme cases, with gangrenous limbs able to carry out her amputation.
pharmacological means claudication is the same as with many other vascular diseases.For this first prescribed drugs that enhance blood flow processes.Simultaneously use the drugs that reduce cholesterol levels and improve the body processes in the body.In this case, it is recommended intravenous saline solution to 10 ml of the solution pilocarpine, insulin, or Padutina Depot padutina, nicotinic acid, pahikarpin.Favorable outcome is possible to reach the introduction perirenal novocaine blockade.Sometimes injected intra-preserved blood vessels in those who are located on the affected limb.
also widely used physiotherapy treatments for intermittent claudication.Among them, they use a steam pressure chamber, UHF, diathermy, various therapeutic baths with radon and hydrogen sulfide, as well as mud.
important point in the treatment of intermittent claudication is a complete cessation of smoking and alcohol consumption.You also need to avoid hypothermia and wearing tight shoes.Also, it is necessary to carefully follow the foot hygiene, avoid cracks, scratches.And patients with underlying disease diabetes should adhere to an appropriate diet and monitor the performance of sugar in the blood.
also with symptoms intermittent claudication practice treatment in a dosage of walking, which improves blood circulation in the lower extremities.In this case, it is desirable to go up until appear pain in the legs.Then the need to rest and continue on foot.Striping should be carried out in several stages.Good dynamics observed after exercise physiotherapy, foot massage and a contrast shower.
But with the progression of symptoms of intermittent claudication, sometimes resorting to the introduction of the catheter into the arteries to expand them in order to restore blood flow.Among the surgical methods of treatment offer periarterial sympathectomy, adrenalectomy or limb amputation.
important point in the treatment of the syndrome remains a proper diet with planned distribution of work and rest, as well as mandatory monitoring of blood pressure fluctuations.
effective method of treatment of intermittent claudication is a herbal treatment in the form of foot baths before bedtime.In addition, it is recommended to brew and drink herbal infusions in the form of immortelle, birch buds, St. John's wort, rose hips, have anti-inflammatory effects.
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