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The alternating lameness
February 10, 2014
The alternating lameness is pain in legs which develop when walking owing to blood circulation disturbance, and at rest stop.
How the alternating lameness is shown?
Most often the alternating lameness develops at men of middle age. However many cases of manifestation of this syndrome at women are noted recently. Specialists are inclined to explain this fact with a negative impact of smoking on a female organism.
Throughout a long time the illness proceeds asymptomatically. The patient at whom the alternating lameness is shown initially feels low, exhaustion, it shows paresthesias in legs. Later at a strong exercise stress the narrowed arteries do not allow to strengthen a blood stream in the lower extremities. As a result, there is pain. This feeling — the main symptom of the alternating lameness. When walking the person should stop often for several minutes, and only after that pain abates, and he can move further.
When the alternating lameness progresses, pain becomes a rack. Character of pain can be a miscellaneous. Sometimes a thermalgia and pulsing, sometimes – stupid, aching. Pains at the alternating lameness often arise at rise on a ladder, when overcoming long distance. The person is forced to limp. Pain can develop in hips, a shin, in foot fingers. It depends on that, vessels are corked or narrowed where exactly. On foot pulse disappears, sometimes it is also not listened in a popliteal space. Skin color changes: she turns pale, and at active progressing of a disease cyanosis can appear. The condition of skin worsens, it becomes drier.
Symptoms of the alternating lameness are shown also by fall of temperature of foot and toes, decrease in its sensitivity. Painful feelings in gastrocnemius muscles develop, also the patient feels discomfort and pain if there is pressure upon nervous trunks on the lower extremities. Sometimes on feet trophic ulcers develop. The alternating lameness proceeds chronically, periodically at the patient remissions are noted.
If the illness continues to progress, then pain can periodically disturb the person and at rest. Often she forces the patient to wake up at night. Gradually the condition of the patient worsens so that it should accept anesthetics.
Charcot's syndrome you can confirm development of a serious illness of arteries of an organism — an obliterating endarteritis. At a severe disease standing at first there can be ischemic ulcers, and gangrene develops later and the subsequent amputation of a leg is made.
If treatment of the alternating lameness is not carried out timely, then formation of collaterals – bypass vessels which either completely, or partially compensate an illness is possible. But if the vessel is corked completely, it is necessary to carry out surgical intervention at once.
Why the alternating lameness is shown?
The alternating lameness is a consequence of atherosclerosis, that is formation of plaques and obstruction of vessels. At atherosclerosis of a plaque appear both in an aorta, and in small and average arteries. Obstruction of vessels leads to insufficient intake of blood and oxygen in the lower extremities. As a result, the ischemia causing pain is observed.
Depending on weight of damage of peripheral arteries, the obstruction location, intensity of pain and weight of other symptoms depends. Very often emergence of atherosclerotic plaques happens initially in those arteries which are strongly remote from heart.
Can be connected by the reasons of development of the alternating lameness with other vascular diseases, and also with intoxications, infections, a diabetes mellitus, injuries.
The important factor provoking development of the alternating hoarseness is smoking. It was conducted a number of researches which results testify to a feedforward of smoking and obstruction of vessels. Influence of harmful substances which contain in a cigarette smoke provokes a senilism of vessels, in particular arteries, leads to development in them atherosclerotic plaques, increases risk of formation of blood clots.
The neurogenic alternating lameness arises at backbone pathology, in particular – at a stenosis of the vertebral channel. Patients to a stenosis have a squeezing of nervous trunks bone growths or a hernia nuclei pulposi.
How to get rid of the alternating lameness?
If the patient complains of an onychalgia, then at suspicion on the alternating lameness the doctor often manages to make the diagnosis already during primary survey. In the presence of the corresponding symptomatology and in the absence of pulse in the lower extremities.
If additional researches are necessary, carrying out an angiography, ultrasonography of passability of vessels can be appointed. Such researches give information on extent of disturbance of a blood-groove in lower parts of an extremity. At suspicion on obstruction of vessels to the specialist the X-ray contrast angiography allows to see the fullest picture.
Approximately at 20% of patients severe forms of the alternating lameness develop very quickly therefore urgent surgical treatment is required. Depending on specific features of a course of a disease reconstruction or plastics of vessels is carried out. In the most hard cases at a gangrenosis it is necessary to carry out amputation of an extremity.
Drug treatment of the alternating lameness practices same, as well as at other diseases of vessels. To the patient the course of treatment drugs which improve process of a blood-groove is appointed. Also complex treatment includes administration of drugs which improve a lipometabolism in an organism and lower cholesterol level.
If the person is ill a diabetes mellitus, he needs to adhere surely to a diet to normalize the content of sugar in blood. It is necessary to watch carefully hygiene of legs, not to allow emergence of big scratches, cracks, it is correct to select footwear that its carrying was the most convenient.
At the alternating lameness treatment by the so-called dosed walking practices. It is a peculiar physiotherapeutic method of treatment by means of which it is possible to improve blood circulation of legs considerably. Every day the patient has to go so long, yet not appear an onychalgia. After that it is necessary a few to have a rest and continue to go. It is necessary to alternate walking and rest repeatedly.
People who have the alternating lameness should refuse surely smoking, not to drink alcoholic beverages, to try to lose excess weight. Favorably regular use of an alternating douche, physiotherapy exercises, foot massage influences a condition of the patient.
If the disease progresses, then the doctor can appoint procedure during which the narrowed arteries extend a catheter which into them is entered.
It is important to observe the correct mode of rest and work, to prevent jumps of arterial pressure.
Treatment of the alternating lameness folk remedies can be carried out after consultation with the specialist. Trays for legs which need to be done before going to bed can be effective. For such bathtub it is necessary to make two handfuls of needles in two liters of water and after half-hour insisting to add five tablespoons of salt to broth. It is necessary to make two trays of the received solution – hot and cold and to serially dip into them legs. It is necessary to do such bathtub until hot water cools down.
It is recommended to make herbal teas from the medicinal plants possessing antiinflammatory properties. It is possible to prepare infusions from a St. John's Wort, birch kidneys, seeds of fennel, an immortelle, etc. It is useful to use Tinctura Crataegi, dogrose broth.