Circulatory disorders are often accompanied by pain. First of all, it occurs in cases when ischemia develops due to circulatory disorders of the muscles of the limbs, which is especially manifested when walking, muscle work. Pain in the lower leg with severe circulatory disorders occurs during rest. Pain that appears or worsens while walking is called intermittent claudication.
Intermittent claudication is the most important symptom of a peripheral circulation disorder. While walking, pain in the lower leg is felt. Pain appears at various intervals, the duration of which depends on the severity of the disease. Pain in the lower leg often spreads to the entire lower limb, including the thigh and foot.
Pain in the leg when walking is accompanied by unpleasant sensations of tingling in the muscles, fatigue, numbness of the legs. The pain is often so severe that the patient is forced to stop while walking. Rest leads to a short termination of pain. As soon as the patient starts walking again, the pain resumes. Increased pain causes cold. To a certain extent, the severity of the disease can only be assessed based on how many steps the pain appears. Usually the first attack of pain after the start of walking appears earlier than after its further resumption. Therefore, the patient gradually gets used to dosed walking.
In severe cases, the pain in the lower leg does not stop and at rest, is cramping, very intense and especially painful in the supine position. In this case, the general condition of the patient is disturbed, insomnia develops. Such severe pains occur most often when, as a result of severe tissue ischemia, trophic ulcers and gangrene occur. In such cases, the pain in the lower leg is constant, intensifies in the warmth and weakens when the legs hang down. Treatment in case of gangrene development should be carried out promptly, with excision of necrotic tissue and possible amputation of a limb site.
The criteria for circulatory disorders, in addition to shin pain, include pallor of the skin , which is more pronounced when raising the leg. When the legs hang down, the skin acquires a cyanotic red color. In various positions, the color of the limb changes from redness and cyanosis to pallor. On palpation, weakening or complete absence of pulsation of the posterior artery of the foot and the posterior fibular artery is determined. At the same time, the presence of pulsation does not exclude the possibility of narrowing of these arteries, arteries of the fingers, and even the possibility of developing gangrene. To detect circulatory disorders, instrumental research methods are used: arteriography, Doppler ultrasound.
Atherosclerosis is usually the cause of circulatory disorders of the lower extremities in old age. In young and middle-aged people, the main cause of tissue ischemia is thromboangiitis obliterans, also called Vinivarter-Burger disease. A combination of these diseases is also possible.
With atherosclerosis, pain in the lower leg is accompanied by other symptoms of this disease. Patients with atherosclerosis often complain of constricting pain in the heart, shortness of breath, headaches as a result of unstable blood pressure, memory impairment, sleep. With atherosclerosis, there is hypercholesterolemia, often symptoms of diabetes mellitus, coronary heart disease, an increase in blood lipids, true hypertension, and an increase in the abdominal aorta are determined. Expressed inflammatory phenomena in arteries and veins testify to Buerger's disease.