What are the main symptoms of patellofemoral pain syndrome. How is patellofemoral pain syndrome diagnosed. What are the most effective treatments for patellofemoral pain syndrome. Who is at higher risk of developing patellofemoral pain syndrome. How can patellofemoral pain syndrome be prevented.

What is Patellofemoral Pain Syndrome?

Patellofemoral pain syndrome (PFPS) is a common knee condition characterized by pain around or behind the kneecap (patella). Often referred to as “runner’s knee,” this condition frequently affects individuals who participate in sports involving running and jumping. The pain associated with PFPS typically worsens during activities that put stress on the knee joint, such as climbing stairs, squatting, or sitting for extended periods with bent knees.

Key Characteristics of Patellofemoral Pain Syndrome:

• Dull, aching pain in the front of the knee
• Pain exacerbated by certain activities
• More common in adolescents and young adults
• Often affects runners and athletes

What Causes Patellofemoral Pain Syndrome?

The exact cause of patellofemoral pain syndrome is not always clear, but several factors may contribute to its development:

1. Overuse: Repetitive stress on the knee joint, particularly from running or jumping activities
2. Muscle imbalances: Weakness or imbalance in the muscles surrounding the hip and knee
3. Improper alignment: Inward movement of the knee during squatting or other activities
4. Previous injuries: Trauma to the kneecap, such as dislocations or fractures
5. Surgical interventions: Certain knee surgeries, especially those involving the patellar tendon

Are there specific anatomical factors that contribute to PFPS? Yes, some individuals may be more susceptible due to their anatomy. For example, having a wider pelvis can increase the angle at which the bones in the knee joint meet, potentially leading to increased stress on the patellofemoral joint.

Recognizing the Symptoms of Patellofemoral Pain Syndrome

The primary symptom of patellofemoral pain syndrome is a dull, aching pain in the front of the knee, around or behind the kneecap. This pain can be triggered or intensified by various activities:

• Walking up or down stairs
• Kneeling or squatting
• Sitting with a bent knee for prolonged periods
• Running or jumping

Is the pain always severe in PFPS? Not necessarily. The intensity of pain can vary from person to person and may range from mild discomfort to more significant pain that interferes with daily activities or athletic performance.

Who is at Risk for Developing Patellofemoral Pain Syndrome?

While patellofemoral pain syndrome can affect anyone, certain factors may increase an individual’s risk:

• Age: PFPS is more common in adolescents and young adults
• Gender: Women are twice as likely as men to develop this condition
• Athletic participation: Engaging in sports that involve running and jumping
• Sudden increases in training intensity or volume
• Obesity: Excess weight puts additional stress on the knee joints

Does being an athlete automatically put you at high risk for PFPS? While athletes, particularly runners and jumpers, are more susceptible to developing PFPS, it’s important to note that non-athletes can also experience this condition, especially if they have other risk factors or engage in activities that stress the knee joint.

Diagnosing Patellofemoral Pain Syndrome

Diagnosing patellofemoral pain syndrome typically involves a combination of clinical examination and patient history. Healthcare providers may perform the following:

1. Physical examination: Assessing knee alignment, strength, and flexibility
2. Medical history review: Discussing symptoms, activities, and previous injuries
3. Imaging tests: X-rays or MRI scans may be ordered to rule out other conditions

Are blood tests necessary for diagnosing PFPS? Generally, blood tests are not required for diagnosing patellofemoral pain syndrome. The condition is primarily diagnosed based on symptoms, physical examination, and imaging studies when necessary.

Effective Treatment Options for Patellofemoral Pain Syndrome

Treatment for patellofemoral pain syndrome often begins with conservative approaches and may include:

• Rest and activity modification: Reducing activities that exacerbate symptoms
• Ice therapy: Applying ice to reduce pain and inflammation
• Physical therapy: Strengthening and stretching exercises for the knee and hip muscles
• Pain relief medications: Over-the-counter anti-inflammatory drugs to manage pain
• Supportive devices: Knee braces or orthotics to improve alignment

Is surgery ever necessary for PFPS? In most cases, surgery is not required for patellofemoral pain syndrome. However, in rare instances where conservative treatments fail to provide relief, surgical intervention may be considered to address underlying structural issues.

Preventing Patellofemoral Pain Syndrome

While it’s not always possible to prevent patellofemoral pain syndrome, several strategies can help reduce the risk:

1. Maintain muscle strength: Focus on strengthening quadriceps and hip abductor muscles
2. Improve flexibility: Regular stretching of the leg muscles
3. Use proper technique: Ensure correct form during exercise and sports activities
4. Gradual training progression: Avoid sudden increases in workout intensity or duration
5. Wear appropriate footwear: Choose shoes with good support and shock absorption
6. Maintain a healthy weight: Reduce excess stress on the knee joints

Can dietary changes help prevent PFPS? While there’s no specific diet proven to prevent patellofemoral pain syndrome, maintaining a balanced diet that supports overall joint health and helps maintain a healthy weight can be beneficial in reducing stress on the knees.

When to Seek Medical Attention for Knee Pain

It’s important to know when to consult a healthcare professional about knee pain. Consider seeking medical attention if:

• Pain persists for more than a few days despite rest and home care
• Knee pain interferes with daily activities or sleep
• There’s noticeable swelling or redness around the knee
• You experience difficulty bearing weight on the affected leg
• There’s a history of previous knee injuries or surgeries

Should you immediately stop all physical activity if you suspect PFPS? While it’s important to avoid activities that exacerbate symptoms, complete cessation of all physical activity is not always necessary. Consult with a healthcare provider or physical therapist to determine which activities are safe and beneficial during recovery.

Living with Patellofemoral Pain Syndrome: Long-Term Management

For many individuals, patellofemoral pain syndrome can be effectively managed with proper care and attention. Long-term management strategies may include:

1. Ongoing exercise programs: Maintaining strength and flexibility in the legs and hips
2. Regular check-ins with healthcare providers: Monitoring progress and adjusting treatment plans
3. Activity modifications: Adapting exercise routines to minimize knee stress
4. Ergonomic considerations: Ensuring proper posture and workplace setup
5. Weight management: Maintaining a healthy body weight to reduce joint stress

Can PFPS recur after successful treatment? Yes, patellofemoral pain syndrome can recur, especially if underlying risk factors are not addressed. Continued adherence to preventive measures and maintaining good knee health are crucial for preventing recurrence.

Additional Considerations for Athletes with PFPS

Athletes dealing with patellofemoral pain syndrome may need to take additional steps to manage their condition:

• Sport-specific training modifications
• Proper warm-up and cool-down routines
• Regular assessment of training loads and recovery periods
• Use of supportive equipment during sports activities
• Working closely with sports medicine professionals

How can coaches help athletes prevent PFPS? Coaches play a crucial role in preventing patellofemoral pain syndrome by emphasizing proper technique, gradually increasing training intensity, and encouraging athletes to listen to their bodies and report any persistent pain or discomfort.

The Role of Physical Therapy in PFPS Management

Physical therapy is often a cornerstone of treatment for patellofemoral pain syndrome. A physical therapist can provide:

1. Customized exercise programs
2. Manual therapy techniques
3. Gait analysis and correction
4. Education on proper movement patterns
5. Guidance on returning to sports or activities

How long does physical therapy typically last for PFPS? The duration of physical therapy can vary depending on the individual’s specific condition and response to treatment. Some people may see improvement in a few weeks, while others may require several months of therapy.

Emerging Treatments and Research in PFPS

Research into patellofemoral pain syndrome is ongoing, with new treatments and approaches being explored:

• Advanced imaging techniques for more precise diagnosis
• Personalized treatment plans based on individual biomechanics
• Novel therapeutic exercises and equipment
• Investigation into genetic factors that may contribute to PFPS
• Exploration of regenerative medicine approaches

What role might wearable technology play in PFPS management? Wearable devices and sensors are being developed to provide real-time feedback on movement patterns and joint stress, potentially aiding in both prevention and management of patellofemoral pain syndrome.

The Psychological Impact of Chronic Knee Pain

Living with patellofemoral pain syndrome can have psychological effects, particularly for athletes or active individuals. It’s important to address these aspects of the condition:

1. Frustration with activity limitations
2. Anxiety about returning to sports or previous activity levels
3. Potential impact on self-esteem and body image
4. Stress related to chronic pain management
5. Importance of mental health support during recovery

How can individuals cope with the emotional challenges of PFPS? Developing a support network, setting realistic goals, practicing stress-reduction techniques, and working with mental health professionals when needed can all contribute to better emotional well-being while managing patellofemoral pain syndrome.

Patellofemoral pain syndrome – Symptoms and causes

Overview

Patellofemoral (puh-tel-o-FEM-uh-rul) pain syndrome is pain at the front of your knee, around your kneecap (patella). Sometimes called “runner’s knee,” it’s more common in people who participate in sports that involve running and jumping.

The knee pain often increases when you run, walk up or down stairs, sit for long periods, or squat. Simple treatments — such as rest and ice — often help, but sometimes physical therapy is needed to ease patellofemoral pain.

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Symptoms

Patellofemoral pain syndrome usually causes a dull, aching pain in the front of your knee. This pain can be aggravated when you:

• Walk up or down stairs
• Kneel or squat
• Sit with a bent knee for long periods of time

When to see your doctor

If the knee pain doesn’t improve within a few days, consult your doctor.

Causes

Doctors aren’t certain what causes patellofemoral pain syndrome, but it’s been associated with:

• Overuse. Running or jumping sports puts repetitive stress on your knee joint, which can cause irritation under the kneecap.
• Muscle imbalances or weaknesses. Patellofemoral pain can occur when the muscles around your hip and knee don’t keep your kneecap properly aligned. Inward movement of the knee during a squat has been found to be associated with patellofemoral pain.
• Injury. Trauma to the kneecap, such as a dislocation or fracture, has been linked to patellofemoral pain syndrome.
• Surgery. Knee surgery, particularly repair to the anterior cruciate ligament using your own patellar tendon as a graft, increases the risk of patellofemoral pain.

Risk factors

Factors that can increase your risk include:

• Age. Patellofemoral pain syndrome typically affects adolescents and young adults. Knee problems in older populations are more commonly caused by arthritis.
• Sex. Women are twice as likely as men are to develop patellofemoral pain. This may be because a woman’s wider pelvis increases the angle at which the bones in the knee joint meet.
• Certain sports. Participation in running and jumping sports can put extra stress on your knees, especially when you increase your training level.

Prevention

Sometimes knee pain just happens. But certain steps may help prevent the pain.

• Maintain strength. Strong quadriceps and hip abductor muscles help keep the knee balanced during activity, but avoid deep squatting during your weight training.
• Think alignment and technique. Ask your doctor or physical therapist about flexibility and strength exercises to optimize your technique for jumping, running and pivoting — and to help the patella track properly in its groove. Especially important is exercise for your outer hip muscles to prevent your knee from caving inward when you squat, land from a jump or step down from a step.
• Lose excess pounds. If you’re overweight, losing weight relieves stress on your knees.
• Warm up. Before running or other exercise, warm up with five minutes or so of light activity.
• Stretch. Promote flexibility with gentle stretching exercises.
• Increase intensity gradually. Avoid sudden changes in the intensity of your workouts.
• Practice shoe smarts. Make sure your shoes fit well and provide good shock absorption. If you have flat feet, consider shoe inserts.

Feb. 05, 2021

Show references

1. O’Connor FG, et al. Patellofemoral pain syndrome. http://www. uptodate.com/home. Accessed Nov. 5, 2015.
2. Patellofemoral pain syndrome. American Academy of Orthopaedic Surgeons. http://orthoinfo.aaos.org/topic.cfm?topic=A00680. Accessed Nov. 5, 2015.
3. Bogla LA, et al. An update for the conservative management of patellofemoral pain syndrome: A systematic review of the literature from 2000 to 2010. The International Journal of Sports Physical Therapy. 2011;6:112.
4. Laskowski ER (expert opinion). Mayo Clinic, Rochester, Minn. Nov. 9, 2015.

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Patellofemoral pain syndrome

What Is Leg Pain? Symptoms, Causes, Diagnosis, Treatment, and Prevention

If your leg pain is severe or interferes with your daily life, it’s important to see a doctor for diagnosis and treatment. Your doctor will ask you about your symptoms and perform a physical exam.

Your doctor may also order imaging and other tests, including the following:

X-ray This test creates images of dense structures, such as bones.

Magnetic resonance imaging (MRI) This test uses a magnetic field and radio waves to create detailed images of areas of your body. These are often needed when detailed pictures of soft tissues and ligaments around the leg joints or back are needed.

Ultrasound This test uses sound waves to produce images of structures in your body, and can be useful to diagnose conditions affecting soft tissues, such as Achilles tendinitis.

Computed tomography (CT) scan This test combines many X-ray images to create a very detailed cross-section of structures. This test is good for larger surveys of the body and is cheaper and often faster than MRI. Unlike MRIs, CT scans use small amounts of radiation.

Venography This test involves injecting a dye into a vein in your leg and using X-ray imaging to detect blood clots.

Electromyography (EMG) This test involves inserting a needle electrode into muscles to measure their electrical activity, which can help detect damage to nerves leading to muscles.

Blood tests Your doctor may want to look for markers of inflammation, blood clotting, nutritional deficiencies, immune system abnormalities, diabetes, cholesterol, and other things that could be leading to your leg pain.

Prognosis of Leg Pain

How much your leg pain interferes with your life, and how long it lasts, depends on the underlying condition.

Some types of leg pain, especially if they’re caused by a muscle strain or another less serious injury, may respond well to self-care measures and not require extensive treatment.

But leg pain that’s due to a more serious injury, or involves nerve or tissue damage, may require ongoing treatment or surgery to resolve.

Nocturnal leg cramps in older people

Cramps are episodes of pain, usually lasting up to a few minutes, caused by sudden, intense involuntary contractions of muscles or muscle groups. Residual discomfort and tenderness may persist for hours afterwards. Nocturnal leg cramps, usually involving the calf muscles or the small muscles of the foot, are common and troublesome in older people. In a general practice based study of 233 people aged 60 years or more, almost one third had had rest cramps during the previous two months, including one half of those aged 80 years or more.¹ Furthermore, 40% of subjects had cramps more than three times a week, and 6% reported daily rest cramps. Another study of 350 elderly outpatients found that 50% had rest cramps, with 20% reporting symptoms for 10 years or more.²

Although cramps are generally a benign and transient problem, they can cause considerable distress for patients. Management can be difficult, and there has been considerable controversy about the safety and efficacy of quinine, which is widely used for this condition.

PATHOPHYSIOLOGY

The pathophysiology of muscle cramps is still uncertain. The “squatting” hypothesis suggests that the modern habit of sitting at rest or at toilet, rather than squatting like our ancestors, leads to muscle and tendon shortening and inadequate stretching and puts the individual at risk for developing leg cramps.³ Neurophysiological and electromyographic studies suggest that cramps result from spontaneous firing of groups of anterior horn cells followed by contraction of several motor units at rates of up to 300 per second.⁴ This is considerably more than occurs in voluntary muscle contraction. A distal origin in the intramuscular motor nerve terminals has been suggested.⁵ Mechanisms that may contribute to motor unit hyperactivity include spinal disinhibition, abnormal terminal motor nerve excitability, and enhanced muscle contraction propagation through cross activation of adjacent neurons. Pain may occur as a result of accumulation of metabolites or possibly as a result of focal ischaemia. Muscle cramps are a common consequence of unaccustomed vigorous exercise. Also, peripheral vascular disease is more common in patients with cramps than in matched patients without cramps.^2,6 Nevertheless, most nocturnal leg cramps occur independently of arterial circulation.⁵

AETIOLOGY

Although nocturnal cramps are idiopathic in most people, a large number of potential aetiological factors have been reported. Medications that have been reported to cause leg cramps include diuretics, nifedepine, β-agonists, steroids, morphine, cimetidine, penicillamine, statins, and lithium.^7–9 In one general practice based study, 53% of patients taking quinine for cramps were also taking one or more medications that potentially cause cramps.¹⁰ Medical conditions associated with muscle cramps include uraemia, diabetes, thyroid disease, hypomagnesaemia, hypocalcaemia, and hypokalaemia. Hence, it is sensible to check urea, creatinine, potassium, magnesium and calcium concentrations, random blood glucose, and thyroid function tests in patients with cramps.

DIFFERENTIAL DIAGNOSIS

The diagnosis of nocturnal leg cramps is based on a careful history and on the absence of physical signs or disease. Conditions that may mimic cramps includes simple muscle strain, dystonias, ischaemic or neuropathic claudication, nerve root disease, restless leg syndrome, and nocturnal myoclonus.

Muscle cramps are a feature of many myopathic and neuropathic conditions. Cramps due to myopathy or neuropathy diseases are not usually restricted to the nighttime or necessarily to the legs. Nevertheless, a careful examination of the neuromuscular system is essential in patients with troublesome cramps, and investigations such as creatine phosphokinase, aldolase, electromyography, and nerve conduction studies may be indicated in selected patients.

TREATMENT

A thorough explanation with emphasis on the benign nature of the condition is beneficial. Any disease that may precipitate cramps should be identified and treated. Cautious withdrawal or substitution of drugs known to cause cramps should be considered. Patients should be advised about general measures to improve sleep, such as not going to bed until sleepy, ensuring a comfortable environment for sleep, and avoidance of alcohol and caffeine-containing beverages before bed.

PHYSIOLOGICAL MEASURES

Physiological methods of terminating and preventing cramp deserve a therapeutic trial given that a completely safe and effective pharmacological remedy remains elusive.

Cramps can be aborted by making use of reciprocal inhibition reflexes, in which contracting a group of muscles forces relaxation of the antagonistic group.¹¹ Hence, forcible dorsiflexion of the foot with the knee extended can relieve calf cramps. Passive stretch or massage of the affected muscle may also help.

Similar approaches have been recommended to prevent cramps, but controlled trials to establish their efficacy are lacking. In an uncontrolled study of 44 patients, passively stretching the calf muscles three times a day for several days successfully prevented cramp.¹² Subjects stood three feet from a wall, leaning against it with arms outstretched and gently tilted forward with the heels kept firmly in contact with the floor until a non-painful stretch was felt in the calves. This position is held for 10 seconds and repeated after five second intervals three or four times. Raising the head of the bed and raising the feet on pillows have both been advocated; neither approach has been formally evaluated.^3,13

PHARMACOLOGICAL THERAPY

Pharmacological treatment of leg cramps may be necessary when symptoms are frequent and severe and where the above measures have failed.

Quinine

Quinine, an alkaloid originally produced from the bark of the cinchona tree, reduces the excitability of the motor end plate to nerve stimulation and increases the refractory period of skeletal muscle contraction. ¹⁴ It has been used to treat leg cramps since 1940, usually as quinine sulphate but sometimes as hydroquinine.^15,16

Trials examining the efficacy of quinine in nocturnal leg cramps have produced conflicting findings. A meta-analysis of six randomised, double blind controlled trials concluded that 200–300 mg of quinine sulphate at night resulted in a significant reduction in the number of cramps for a four week period compared with placebo (8.8 fewer cramps; 95% confidence interval (CI) 4.2 to 13.5).¹⁷ However, the results of a later meta-analysis by the same authors which included data from unpublished trials gave less impressive results; this study found that patients had 3.6 (95% CI 2.2 to 5.1) fewer cramps in a four week period when taking quinine compared with placebo.¹⁸ Quinine did not produce a significant change in the severity or duration of individual nocturnal leg cramps, and beneficial effects were only apparent after four weeks of treatment. In a double blind, placebo controlled trial, a combination of quinine and theophylline led to greater decrease in cramp frequency than placebo or quinine alone.¹⁹

Because it has been widely used for so long, doctors may underestimate the side effects of quinine. In 1995, the USA Food and Drug Administration concluded that the risks of quinine outweighed any possible benefit and ordered a stop to the marketing of quinine for prevention or treatment of nocturnal leg cramps.²⁰ The most serious complication of quinine use is development of potentially fatal hypersensitivity reaction, particularly quinine-induced thrombocytopenia. The Food and Drug Administration analysis of published and unpublished data suggested that thrombocytopenia affects between 1:1000 and 1:3500 users.²¹ There are no known factors that predispose people to the development of hypersensitivity to quinine, and it may occur after a single dose or after months or years of use. Other rare complications of quinine include pancytopenia, haemolytic uraemic syndrome, and hepatitis.^22,23

Key points

• Troublesome nocturnal leg cramps are common in older people.

• Cramps are associated with many common diseases and medications.

• Physiological methods of preventing cramp have not been examined in controlled studies. Nevertheless, such methods deserve a therapeutic trial given that a completely safe and effective pharmacological remedy remains elusive.

• Quinine is moderately effective in preventing nocturnal leg cramps. However, there are significant concerns about the risk/benefit ratio with this drug.

• In patients with severe symptoms, a trial of 4–6 weeks’ treatment with quinine is probably still justified, but patients should be warned of the risks, and the efficacy of treatment should be monitored.

Warburton and colleagues noted a significant relationship between serum quinine concentrations and relief of leg cramps.¹³ However, toxic levels of quinine give rise to cinchonism, a condition manifested by tinnitus, visual disturbances, vertigo, nausea, vomiting, abdominal pain, and deafness. Severe toxicity can lead to permanent blindness, cardiac arrhythmias, or death. Chronic impairment of auditory, vestibular, and visual function have been reported even in subjects taking doses of 200 to 300 mg daily.²⁴ The frequency and severity of adverse effects may be greater in older people since altered pharmacokinetics with age results in a longer half life of quinine.¹⁴ Furthermore, the effects of quinine will add to those of pre-existing sensory defects in older people, while the latter may mask early signs of quinine toxicity. Also, quinine interacts with several widely used drugs in older people, such as digoxin.

Naftidrofuryl oxalate and orphenadrine citrate

Naftidrofuryl oxalate, a vasodilator, and orphenadrine citrate, an anticholinergic with muscle relaxant properties, have both been evaluated in small controlled trials. In a double blind, placebo controlled trial in 14 patients, naftidrofuryl oxalate, given as a slow release preparation 30 mg twice a day, significantly reduced the frequency of cramp and increased the number of cramp-free days by a third.²⁵ Orphenadrine citrate reduced the frequency of cramps by at least 30% in 90% of 59 patients with leg cramps in a double blind crossover trial.²⁶

Other treatments

In an uncontrolled study of eight cramp sufferers refractory to quinine treatment, seven patients reported an improvement in their cramp symptoms on verapamil 120 mg at night for eight weeks.²⁷ Despite promising results in uncontrolled studies, a randomised controlled crossover trial showed that vitamin E does not reduce the frequency of cramps. ²⁸

CONCLUSIONS

Troublesome nocturnal leg cramps are common in older people. The pathophysiology of such cramps remains uncertain, but they are associated with many common diseases and medications. Identification of potentially treatable factors is important in patients with cramps. There have been no controlled trials examining the efficacy of physiological methods of preventing cramp. Nevertheless, such methods deserve a therapeutic trial given that a completely safe and effective pharmacological remedy remains elusive.

Quinine is moderately effective in preventing nocturnal leg cramps. However, there are significant concerns about the risk/benefit ratio with this drug. In patients with severe symptoms, a trial of 4–6 weeks’ treatment with quinine is probably still justified, but patients should be warned of the risks, and the efficacy of treatment should be monitored, for example using a sleep and cramp diary. A trial of treatment with natridrofuryl or orphenadrine is a reasonable alternative, although further larger studies are needed to confirm the benefit with these agents. If patients do not respond to quinine, verapamil 120 mg daily may be tried, although controlled data are still lacking.

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   Eaton JM. Is this really a muscle cramp? Postgrad Med J1989;86:227–32.

8. McGee SR. Muscle cramps. Arch Intern Med1990;150:511–18.

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Top Caregiver Remedies for Foot and Leg Cramps in Seniors

Muscle cramps in the feet and legs can be very painful and typically become more common with age. These episodes often occur at night (known as nocturnal muscle cramps) and can interfere with a senior’s ability to get uninterrupted quality sleep. Experienced family caregivers share their tips for preventing and relieving cramps and muscle spasms in elderly loved ones.

How to Prevent and Relieve Muscle Cramps in Seniors

“I have periodic bouts of very painful foot cramps/spasms, and the podiatrist gave me a prescription for something to rub into my feet. You can still massage your loved one’s feet and legs to provide pain relief but ask their doctor for a prescription and use the ointment as a lubricant like you would lotion.” –Lolli47

“My mother complained of foot and leg pain, and she used to get cramps in the middle of the night when she was sleeping (Charley horses). I started her on magnesium supplements. No more pain, no more nighttime cramps.” –TooYoungForThis

“When my dad’s feet or legs cramp, massage helps the muscles relax. You can feel where the spasms are. Rub your hands together all over to warm them up, then start with the palm of your hand to broadly massage the foot. Get the whole area. Start below where the spasms are and work towards them. This should lessen the cramps. Then, with your fingers and palms, give a deep massage where the cramp is. Massage until the cramps are relieved. You can also give your loved one mustard or pickles to relieve the cramp. I know it sounds weird, but it works!” –kathyt1

“Magnesium and potassium deficiencies can cause wicked muscle cramps. My dear husband gets grapefruit-size, rock-hard knots in his leg muscles. The only way to relieve them is by having him take coconut water, Emergen-C in juice or water, and a magnesium glycinate or magnesium gluconate supplement. That takes those down very quickly. A deficiency in CoQ10 can also cause bad muscle cramps. When someone has bad muscle cramps, you can massage them till kingdom come, but they will keep coming back with a vengeance. You really need to get magnesium and potassium into them to help the muscles relax.” –Chimonger

“After I broke my leg in my late 40s, it would cramp up on a regular basis so badly that I would uncontrollably scream out in pain and could not walk. The only things that helped were acupressure and transcutaneous electrical nerve stimulation (TENS) therapy. I use the Tony Little TENS machine and I do my own acupressure at home. I was lucky because I happened on the acupressure point by accident and I knew about TENS therapy from previous injuries. Knowing where the cramps are coming from (at what point in the foot or leg they start) is important to know what pressure point to use or where to place the TENS pads. I highly recommend both. Each has virtually no side effects if done properly. You can consult a physical therapist for a while, just long enough to find out the pressure points and the place to put the TENS electrodes (and what strength to use). After that, you can do it at home with little to no cost after the initial purchase of the TENS machine.” –wa22or

“Hyland’s Leg Cramp Relief Tablets (available at Walmart and other places) work well for my husband. It also comes in a PM form for nighttime leg cramps.” –Judyjourneys

“It’s important for seniors to consume enough fluids each day. If toxins aren’t expelled from the body, then they build up and can cause some cramping. Zinc and magnesium are also important in muscle function, but I’d speak with your loved one’s regular doctor before adding a supplement just to make sure it doesn’t interfere with any of their medications or other medical conditions. Sometimes raising the affected leg and pointing the toes straight out can help. Standing on it or putting that foot on a stair or block and pushing down on the heel can ease the cramping as well. Everyone is different.” –terryjack1

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“I have had foot cramps and some calf cramps in the past. My foot doctor told me not to laugh, but to put a bar of soap at the end of the bed under the fitted sheets. I thought, ‘Hey, I will try anything to not have those cramps.’ I might still get a little cramp now and then, but nothing like I was. I still have the soap in place, and it’s been a couple of years. My husband uses a teaspoon of mustard for cramps, though. He swears by it. It’s got turmeric in it and that’s what does the trick. I’ve tried it and I say it tastes so bad that you forget about the cramping!” –pargirl

“My father used to eat a banana every day to keep his potassium levels up. His doctor had recommended it to prevent his nighttime leg and foot cramps, and it worked for him. ” –bweichbr

Tired Legs Muscles Sore Feet Symptoms in Older Adults

Many older adults dismiss their tired legs and sore feet as part of getting older. But why should you suffer if there’s a way to help relieve your symptoms? You’ve been accustomed to a certain quality of life, and there’s no need for that to change. While the aging process tends to bring some expected but unwanted symptoms, there’s a good chance that your tired legs and sore feet symptoms can find some relief. We’ll explore ways to help soothe the exhaustion and aches you’re feeling in your legs in feet.

Sore Feet and Tired Leg Muscles Symptoms Monitor

Some degenerative pain and worn-out feeling in your legs and feet are normal as you near retirement age. They’ve carried you all through the years and been there for you every step of the way.

At some point, though, many older adults experience tiredness in their legs that weigh them down. Your legs might also feel stiff and exhausted, even if you’ve done very little to account for your symptoms. Your feet might also ache and feel sore.

Depending on whether your discomfort is just from aging, or whether a medical condition is contributing to your symptoms, you may notice other symptoms as well:

• Throbbing pain in your legs. The pain may be felt in just one leg.

• A numb or dull feeling in your legs. The numbness can make your legs feel weaker than you’d like.

• Cold feeling in your legs. Your legs might also tingle.

• Swelling in one or both legs. If the blood in your legs isn’t circulating as it should, you’re more likely to have some swelling.

• Difficulty standing or walking. You might find this particularly troublesome later in the day.

• Visible veins at the surface of your skin. There could be some discoloration, and the area near the veins could turn pale, red, or blue.

You may notice that you only have tiredness in your legs on occasion. Or, your feet might only ache or feel sore when you’ve stood up most of the day. Those things are nothing unusual and probably nothing to worry about.

But, if your legs start to feel tired or heavy, or your feet begin to experience soreness or aching much of the time, it’s time to evaluate the problem. Chronic symptoms are likely to disrupt your life and cause you unnecessary suffering.

If your symptoms occur frequently, see your doctor so they can determine a cause and find a course of treatment.

What can cause tired leg muscles and sore feet symptoms in older adults?

Older adults experiencing fatigue in legs or aching in the feet may find it frustrating. The causes can be any number of things.

If it comes and goes, it’s probably just part of the process of getting older. But, if it happens more than you’d like, there’s probably a medical reason for it.

Here are some of the more common reasons for fatigue and muscle soreness in the legs and feet:

Varicose Veins

It’s not uncommon for the circulation in your legs to be inefficient as you get older. Unfortunately, one of the more common results of this slowed circulation is varicose veins. And, slower circulation will cause your legs to feel more tired than they should.

With varicose veins, blood tends to pool and stay stagnant in parts of your legs. Your veins lose their elasticity and tend to get knotty in places. The result is varicose veins, which are visible close to the skin.

While varicose veins aren’t generally serious, they can lead to something more serious. They’re a sign that your blood circulation can use some improvement. If you have varicose veins, you’re at an increased risk for blood clots in your legs.

If you develop a blood clot in your leg, it’ll swell near the area of the clot. You’d also likely experience a bit of pain. But, the risk is that the blood clot can break off and travel to your heart.

If you’re overweight, sit or stand too much, or don’t get enough exercise, you’re more likely to have varicose veins in your legs.

Chronic Venous Insufficiency

One of the more common causes of heavy, tired legs is chronic venous insufficiency. The blood in your veins is affected by gravity, just like anything else. It’s easier for blood to flow downward than it is to go back up. When you’re younger, it can accomplish both better.

The normal process of blood flow in the legs is that the heart pumps blood to your legs to help them function. Then the blood flow returns to the heart, and the process repeats itself.

In your 20s, 30s, and 40s, your heart and circulatory systems tend to work at their optimum. As you get older, your heart isn’t as efficient as it used to be. Your veins and arteries aren’t as resilient either and become weaker.

It’s more work for the blood in your veins to flow upward as you age. So, in essence, fighting gravity becomes more strenuous for your body, and it’s harder for veins to push blood back up to the heart.

Your legs also have valves in them that are designed to keep blood from returning down into your legs. With chronic venous insufficiency, not only do your veins become weaker, but so do these valves.

The result is that blood doesn’t return to the heart like it’s supposed to. If this happens, you’re likely to have tired legs, sore feet, swelling, and a feeling of heaviness. You’ll also notice spider veins in your legs.

Risk Factors for Chronic Venous Insufficiency

• Standing for long periods of time
• Carrying around extra weight
• A sedentary lifestyle or lack of exercise
• Getting older
• A poor diet

Peripheral Artery Disease (PAD)

Peripheral artery disease (PAD), also known as Peripheral Vascular Disease (PVD), is another common condition experienced by older adults, smokers, and people with certain medical conditions. PAD impacts millions of Americans and affects the arteries when fat deposits build up on the artery’s walls, narrowing and hardening the blood vessels. This can stop the blood flow altogether or makes it hard for blood to pass, resulting in a lack of oxygen to the feet and legs.

PAD commonly affects the legs and can cut off circulation to both the feet and legs. This can result in a heavy, tired, and aching feeling in your legs. You can also experience cramps, especially when you walk or when you sleep at night (night cramp).

If you have PAD, your feet and legs may also feel colder. You may also notice that your legs feel weaker and might even feel numb or tingly. If you get a sore on your leg or foot, you may notice that it heals slower than normal. You might also see that your legs or feet have an unusual color to them.

Risk Factors for PAD:

• High cholesterol
• High blood pressure
• Diabetes
• Over 50
• Obesity
• Smoking
• Sedentary (inactive) lifestyle

The larger risk if you have PAD is that it could be a sign that the arteries leading to your heart and brain are also narrowed. This can lead to a heart attack or a stroke.

Diabetes

If you have diabetes, you’re naturally more disposed to experiencing sore feet or tired leg symptoms because you’re more at risk for developing the previous conditions.

Diabetes affects how your entire body works together. High blood glucose levels damage blood vessels. Plague builds up and narrows the arteries, slowing circulation.

This can lead to PAD and venous insufficiency, and you’re more likely to have aching in your feet. Your legs may swell more and feel tired.

Risk Factors for Diabetes

• Being overweight
• Family history of diabetes
• Being 45 years or older
• Have high blood pressure or low levels of good cholesterol and high levels of triglycerides
• Sedentary lifestyle
• Previous history of a stroke or heart attack

Additional Considerations

If you’re experiencing tired leg muscles or sore feet, see your doctor. There are many things that can cause your symptoms. The list provided is not a comprehensive list.

If you have any of the conditions that commonly lead to your legs feeling more tired than they should, carefully follow your doctor’s advice in treating your condition. This is the best thing you can do to control your condition and treat any symptoms associated with it.

If you have new, onset soreness in your feet or tired legs, contact your doctor. He or she can evaluate your overall health and discover if there’s a medical cause for your discomfort.

Finding relief for your tired leg muscles and aching feet

It’s vital to heed your doctor’s advice in treating any medical condition that causes your symptoms.

Aside from that, ask him or her about these actions that could help you experience better relief from fatigue and soreness in your legs and feet.

Elevate your legs

Sitting or lying down for too long can make your blood circulation and lymphatic system sluggish. If you elevate your legs, the heart doesn’t have to work as hard to pump blood to and from your legs. When you sit in your recliner while watching television or lay down to sleep at night, elevate your legs and feet just above your heart. This could help relieve the heavy pressure you feel in your legs that can result in your legs feeling tired. It also helps replenish your legs with fresh blood. While you’re at it, wriggle your toes so they can feel more refreshed too.

Reduce your sodium intake.

If your doctor thinks it’s a good idea, eat foods with less salt or shake a little less salt on your food. This might reduce the symptoms that accompany swelling in your legs. Your legs might feel less fatigued and lighter. Depending on which medication you’re taking, your doctor might offer different advice concerning your salt intake.

Alter your body position frequently.

This means you’ll want to avoid too much standing or sitting for an extended time. This could make your legs and feet feel more tired and heavy because it’ll reduce the amount of circulation in your legs. Changing positions, on the other hand, will help improve circulation and could offer a little relief for your symptoms.

If you smoke, try to break the habit.

Smoking increases your risk of PAD, chronic venous insufficiency, and cardiovascular disease. All of these negatively affect circulation in your body. Poor circulation brings on symptoms of tired legs, sore and aching feet, and swelling to your lower extremities. If you stop smoking or even greatly reduce your habit, you may help relieve some of your symptoms.

If you’re overweight, lose a few pounds.

Unfortunately, carrying a few extra pounds is a contributing factor in developing the conditions that can cause heavy, tired legs and soreness in your feet. If you lose weight, it’s possible to dramatically reduce your symptoms because your body will contend with less pressure.

Give your feet a soak.

You can revive your sore, achy feet with a good soak in Epsom salt and warm water. Epsom salt can help reduce inflammation and flush out toxins from your body. It can also help improve circulation in your feet. Since Epsom salt does have magnesium in it, you may want to check with your physician to be sure you’re not on any medications or have any medical conditions that contraindicate whether or not you can use magnesium as a natural therapy. This is especially important if you have diabetes or you’re on a diuretic. Either way, warm water itself does wonders all on its own.

Boost blood circulation in your body.

There are a few ways to do this. Ask your doctor if it’s okay for you to exercise. A mild walking program or even swimming therapy can help your body pump blood better. This can even have good side effects like, losing weight and lowering your blood pressure. Some products can help boost circulation in your legs while you relax at home. While a mild exercise program is always a good idea for, sometimes your activities are more restricted than you’d like them to be. A circulation-boosting product can fill in the gap during those times.

Final thoughts

No doubt, you want the most you can get out of life. No one wants tired legs or sore feet to slow them down. An active life is a fulfilling life.

While it’s important to respect any limitations you might have, there are likely a few things you can do to help improve your discomfort.

Your physician knows best how to treat any medical conditions you have. Follow their advice. In the meantime, ask them if there are things you can do at home to improve your health, relieve your tired legs, and reduce the soreness in your feet.

Disclaimer: This content is not intended as medical advice. We believe in helping people to make informed decisions about their health. We hope to empower you to ask your physician the right questions so you can both agree on a treatment plan that’s right for you.

When walking makes your legs hurt

Four conditions for leg pain causes that can affect you when walking

When walking is supposed to be good for you, why do you have to suffer with leg pains? And what causes the pain in your legs when walking? Fitness experts used to stress the benefits of heavy-duty aerobic exercise — the kind that makes you breathe hard and gets your heart going. But the message changed to moderation after a number of studies showed that physical activity that’s far less taxing is associated with lower rates of heart disease, some cancers, and several other illnesses — if it’s done regularly. Plain old walking usually tops the moderate-intensity exercise list because it’s easy, convenient, and free, and it requires minimal equipment — a comfortable pair of shoes.

The trouble is that walking isn’t so easy for everyone. Indeed, the leg pain is agony for many. And forget the “brisk” pace of three to four miles per hour advised for health and fitness.

With age — and occasionally without it — a number of conditions can result in leg pain after walking and make walking difficult. Some are very familiar, such as arthritis that makes knees and hips creaky; others, such as peripheral artery disease, aren’t.

This article looks at four nonarthritic conditions that cause leg pain and may affect walking, and some ways to treat and manage them — no need to limp and bear it!

Leg pain causes and conditions

We’re discussing these conditions that may cause leg pain separately, but people may have two or more of them at the same time, which complicates diagnosis and treatment.

1. Peripheral artery disease

Peripheral artery disease is a form of atherosclerosis, the same condition that leads to most strokes and heart attacks. Fat- and cholesterol-filled plaque narrows arteries, and blood clots can collect on the plaque, narrowing them further. In peripheral artery disease, the arteries affected by atherosclerosis tend to be the ones that supply the leg muscles. The risk factors are similar to those for heart disease and stroke: smoking, high cholesterol levels, high blood pressure, and especially diabetes.

The classic symptom is cramping, tight pain that’s felt in muscles “downstream” from the narrowed artery. It can occur in the buttocks, thigh, calf, or foot, but occurs most often in the calf. The pain tends to come on with walking, gets worse until the person stops walking, and goes away with rest. Similar to angina, the pain caused by peripheral artery disease comes from working muscle cells that are “starved” for oxygen because of obstructed blood flow. The medical jargon for this kind of pain is intermittent claudication, from the Latin claudicatio for limping. Many people with peripheral artery disease have other sorts of pain, though. Sometimes their legs are heavy, or they tire easily. And it’s common for people to cut back on their activity level without realizing it, which can mask the problem.

Signs of peripheral artery disease include a diminished pulse below the narrowed artery, scratches and bruises in the lower leg that won’t heal, and pale and cool skin. The diagnosis usually depends on the ankle-brachial index, which compares the blood pressure at the ankle to the blood pressure at the arm. They’re normally about the same, but if there’s a blockage in the leg, blood pressure will be lower in the ankle because of low blood flow.

Peripheral artery disease by itself can be serious and debilitating, but it may also serve as an important warning of even more serious trouble. Atherosclerosis in the legs often means there’s atherosclerosis elsewhere, and people with peripheral artery disease are six to seven times more likely to have a heart attack, stroke, or transient ischemic attack than people without it. A peripheral artery disease diagnosis should prompt a concerted effort to rein in cardiovascular disease risk factors.

Walking hurts, so a “just do it” attitude about exercise isn’t helpful. But researchers have found that tightly structured, supervised exercise programs can help people increase the amount they can walk before their leg pain kicks in. These programs usually involve walking ’til it hurts (which may be only for a few minutes), resting ’til the pain goes away, and then walking again. These walk-rest-walk sessions are most effective if people do them for about 30 minutes at least several days a week.

Low dose aspirin (75 mg to 81 mg) is often recommended to reduce the risk of heart attack and stroke. Clopidogrel (Plavix), another drug that makes blood clots less likely by making platelets less sticky, is an alternative for people with aspirin allergy. Cilostazol (Pletal) can help people walk longer distances without pain.

Serious cases of peripheral artery disease can cause leg pain even when the person isn’t walking. This “rest pain” most often occurs in the feet. Even more serious are cases when the condition leads to tissue death and gangrene.

If peripheral artery disease is serious, or isn’t improving with exercise and medication, doctors can reopen the blocked artery with angioplasty or use part of a blood vessel from elsewhere in the body to reroute circulation around the blockage. But the track record of these revascularization procedures is mixed, and some studies suggest that the results from a structured exercise program can be as good, or even better.

2. Chronic venous insufficiency

Like peripheral artery disease, chronic venous insufficiency is a condition of poor circulation, but it involves the veins and the blood’s return trip back to the heart and lungs.

Our arteries are springy and help push blood along, but our veins are relatively passive participants in circulation. Particularly in the legs, it’s the muscles surrounding the veins that provide the pumping power that drains the vessels near the surface of the skin and then push the blood up through the “deeper” vessels that travel toward the heart. Tiny valves inside the veins even out the pressure and keep the blood from flowing backward.

In people with chronic venous insufficiency, the valves are damaged, so blood tends to pool in the legs and feet instead of traveling “north” to the heart. It’s often a vicious cycle: if the valves aren’t working, pressure from the blood collecting in the veins increases, so the veins stretch out. As a result, the valves don’t close properly, so even more blood flows backward, adding pressure.

Symptoms include swelling, inflammation of the skin (dermatitis) and the connective tissue underneath (cellulitis), and ulcerated, open wounds on the bony “bumps” of the ankle. Legs may feel achy or heavy. And when people walk, they may feel a tight, “bursting” pain, most often in the groin or thigh. The leg pain will stop with rest but may take longer to ease up than the pain from peripheral artery disease.

The symptoms from a mild case of chronic venous insufficiency can be helped by lying on your back and using a pillow to elevate your legs so blood flows downhill to the heart. If you’re sitting for long periods, pointing your toes up and down several times can flex the vein-pumping leg muscles.

More serious cases needed to be treated with compression stockings that squeeze harder at the ankle than at the knee. For the stockings to work, they must be much tighter than the “antiembolism” stockings people routinely wear in the hospital. But because they are so tight, people often have a hard time getting them on. Washing a new pair can help. Some people coat their skin with talcum powder or wear thin, regular stockings underneath. Devices called “wire donners” hold the stockings open so people can push a foot and leg into it.

There are no specific medicines to treat venous insufficiency. Surgical procedures have improved significantly over the years. Nowadays varicose vein therapy has moved very far away from the old-fashioned saphenous vein stripping. That procedure involved making an incision in the groin and leg, inserting a stripping device into the vein, and pulling the vein out of the body. It usually required general anesthesia, an overnight hospital stay and weeks of recovery.

Today, physicians usually close the vein permanently rather than remove it. They use one of several minimally invasive techniques, performed through catheters inserted into the veins under ultrasound guidance. These treatments are performed in outpatient settings under local anesthesia, and the patient can walk immediately after treatment.

3. Lumbar spinal stenosis

Stenosis (pronounced ste-NO-sis) is a medical term for any kind of narrowing. Spinal stenosis can occur anywhere along the spine as a result of the vertebrae, the disks between them, or their supporting structures impinging on the tube-like spinal canal that holds the spinal cord and the roots of the nerves that branch off of it. Pain comes from the mechanical pressure, and perhaps also from the pinching off of blood flow to nerves.

The lumbar region of the spine consists of the five large vertebrae that form the small of the back. When spinal stenosis occurs in the lumbar region, lower back pain can be a symptom but often it’s the legs that are affected. The pain can resemble the pain caused by peripheral artery disease: cramping tightness that increases with walking, although it’s often felt in the thigh rather than the calf. The legs may also feel weak and numb.

In the past, the leg pain caused by lumbar stenosis was called pseudoclaudication because it was unrelated to blocked arteries, and doctors didn’t understand that it could be caused by spinal problems. Now the preferred medical term seems to be neurogenic (which means originating from the nervous system) claudication.

The diagnosis starts with discussion of symptoms and medical history. One important clue is whether the pain eases when the back is curved forward, or flexed. That posture tends to take pressure off the lumbar region, and it’s the reason some people with lumbar spinal stenosis find it easier to walk when leaning on a grocery cart or a walker.

An MRI or CT scan will often be ordered to confirm a diagnosis, but imaging studies shouldn’t be used to make one. Many people have spinal stenosis that shows up on an imaging study but doesn’t cause any symptoms.

Treatment usually begins with physical therapy and exercises aimed at strengthening back and abdominal muscles. Pain relievers may help. Growing numbers of older patients are getting corticosteroid injections into the spine, which worries some experts. Evidence that the shots are effective is mixed.

If the pain persists, surgery is an option. The most common procedure is a laminectomy, which involves cutting away part of a vertebra to create more space for the spinal cord and nerves. Bone spurs and portions of the disks and facet joints can also be removed to relieve pressure. Study results for surgery are murky. The majority of patients seem to feel better for the first year or so, but the advantage over a nonsurgical approach seems to wear off after several years. A second operation is sometimes needed. On the other hand, for some, surgery greatly reduces the pain and discomfort.

4. Diabetic neuropathy

People with diabetes are prone to nerve damage, or neuropathy. Exactly why is uncertain. High blood sugar levels may damage the tiny blood vessels that supply nerves, creating “nerve strokes”: nerves starved for oxygen (ischemic) because of damaged vessels. Diabetes may also deplete the body’s store of neurotrophic peptides, chemicals that normally repair and regenerate nervous tissue.

Diabetic neuropathy affects the upper and lower legs in different ways. In the upper leg, the pain from ischemic nerves can come on suddenly and be felt in just one leg. In the lower legs and feet, where it is more common, the symptoms are typically numbness or tingling, and are usually felt about equally in both legs. The numbness often dulls painful sensations, so sores on the feet go unnoticed and get worse. Diabetic neuropathy can make walking difficult, but leg pain may improve with exercise.

People with diabetes can reduce their chances of developing neuropathy by keeping their blood sugar down. It’s less certain that tight blood sugar control is helpful once nerves have been damaged. Still, it’s an important goal for many other reasons. Pain relievers, tricyclic antidepressants (amitriptyline, desipramine, duloxetine), and anticonvulsants (carbamazepine, gabapentin, pregabalin) are used to control the burning and tingling sensations from neuropathy.

image: © lzf | Dreamstime.com

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Leg pain – related symptoms, causes and treatments

On this page

What is leg pain?

Leg pain can be described as any feeling of pain or discomfort in the area between your groin and ankle.

Depending on the cause, leg pain can vary from moderate to severe, and the symptoms may be continuous (non-stop) or intermittent (come and go).

Leg pain can be acute, meaning it comes on quickly and then goes away. Or it can last for weeks or months. Then it is called chronic leg pain. For some people, chronic leg pain can last for years and can affect their lives.

What symptoms are related to leg pain?

Leg pain can affect just a small area of the leg, or it can cover a wide area or even the whole leg. The pain can be dull or sharp, or it might be burning, tingly or numb. You might also have pain in your buttock, lower back or spine, or foot. Make a note if both legs look the same, or if one is different from the other.

Other signs and symptoms that can occur with leg pain include:

• swelling
• varicose veins
• sores or ulcers
• redness, swelling or warmth
• feeling generally unwell, if you have an infection or fracture
• changes in the colour of the leg or feet if it’s a problem with your nerves
• a slow healing wound

CHECK YOUR SYMPTOMS — Use our leg pain Symptom Checker and find out if you need to seek medical help.

What causes leg pain?

There are many different causes of pain in the leg. They include:

• a cramp
• a minor injury such as a knock, bump or bruise
• a fracture
• an infection
• pain from wear and tear, overuse, or injuries in joints or bones or in muscles
• pain from using your leg too much, such as muscle strains and soreness
• pain from using your leg too little, such as pins and needles or muscle stiffness
• pain from infection, such as ulcers and infected blisters
• pain from problems with blood vessels, such as blood clots and poor circulation
• pain coming from your back, such as sciatica and nerve pain
• pain from problems with nerves, such as the pain of diabetic nerve troubles
• growing pains (in children)

Pain in the leg can also be a part of chronic conditions like rheumatoid arthritis and gout.

How is leg pain treated?

Treatment for leg pain depends on the cause. It can often be treated at home, but if pain is sudden, severe, or persistent, or if there are other symptoms, medical attention may be necessary.

If you suddenly develop pain from an injury, use the RICE method:

• Rest: avoid putting weight on your leg where possible.
• Ice: put an icepack on the sore area for 20 minutes at a time, using a covered icepack or bag of frozen peas. Repeat every 2 to 3 hours for 2 to 3 days.
• Compression: use compresses and bandages.
• Elevation: keep it up when you’re resting.

You can take simple painkillers like paracetamol or anti-inflammatories like ibuprofen.

If you have muscle cramps, gently stretching the muscles should help. This is true for many other types of leg pain, too.

If you have pins and needles, just moving around should ease the discomfort.

If the pain doesn’t go away, your doctor might involve a physiotherapist, podiatrist or other health professional, depending on the cause. You might need medication such as antibiotics or anti-inflammatories, and some people may need surgery.

When should I see a doctor?

Sometimes, leg pain can signal something more serious like a fracture, deep vein thrombosis or compartment syndrome.

Seek medical attention urgently if:

• the leg is swollen
• it looks deformed or you can’t use it properly
• it is unusually cool or pale
• it is numb and weak
• it is red and warm
• both legs are swollen and you have breathing problems
• the pain is getting worse

See your doctor as soon as possible if you have signs of infection, like a fever, calf pain after going on a long journey, or any serious symptoms that come on with no explanation.

Can leg pain be prevented?

You can prevent strains and injuries by always warming up before exercise and cooling down and stretching afterwards. Build up physical activity gradually and don’t take on too much too quickly.

It’s a good idea to replace worn out shoes and wear appropriate footwear for the activity you’re doing.

Looking after your health generally — getting enough sleep, drinking enough water, getting some regular exercise, not smoking, being a healthy weight — might also help.

90,000 Advice for foot care in old age

Foot care is important at any age, but it is of particular importance in the elderly. If you do not adhere to a number of rules, this can cause painful sensations, lead to difficulties in choosing shoes and even significantly limit movement.

The chief freelance gerontologist of the Ministry of Health, head of the Republican Gerontological Center (active longevity) Lyudmila Zhilevich shared the secrets of proper foot care in old age with the information portal “Healthy People”.

Age changes

Aging affects the entire body, but it is a natural process. Over time, muscle tone changes, the level of collagen produced by our skin decreases, skin elasticity deteriorates, and blood circulation problems appear. In old age, the skin does not retain moisture well, which makes it drier and prone to flaking. As a result, microcracks may appear, which serve as a kind of gateway for infection, including fungal infection.Joints and soft tissues become less mobile. In some cases, hallux valgus even begins on the legs – the appearance of the so-called bone and the deviation of the thumb outward.

Lyudmila Zhilevich Chief Freelance Gerontologist of the Ministry of Health, Head of the Republican Gerontological Center (Active Aging):

– Seniors have certain health problems that are related to physiology.There is an involution of the whole organism; over the years, some organs and systems change. Most often, changes in the vascular system occur, which, among other things, leads to a deterioration of blood supply in the lower extremities, namely in the feet. And this is already the reason for the decrease in muscle strength, slow nail growth and poor wound healing.

Due to age-related changes that occur in the body, the volume and air permeability of the lungs decrease. As a result, gas exchange decreases – and the body suffers from a lack of oxygen.And again, the periphery is in the risk zone, which means the legs and feet.

The metabolism slows down. Excess weight appears, which creates an additional load on the musculoskeletal system. The deformity of the spine leads to a significant increase in the load on the joints, including the joints of the feet. Injuries received at a young age also make themselves felt.

A separate item is pathological changes in the body, provoked by existing diseases. The most formidable are the processes associated with diabetes.Metabolic disorders, fragility of blood vessels, a decrease in the oxygen content in the blood, a decrease in collagen production – all these processes are accelerated exponentially.

Lyudmila Zhilevich Chief Freelance Gerontologist of the Ministry of Health, Head of the Republican Gerontological Center (Active Aging):

– The immune system, the protective properties of which decrease with age, weakens even more in diabetes mellitus.The processes of regeneration are slowed down, that is, the natural renewal of skin cells. Because of this, cracks and abrasions that may appear on the foot do not heal for a long time. In these places, there is a very high risk of contracting an infection and, as a result, the appearance of non-healing ulcers and even the development of gangrene.

Shoe selection

It is no secret that many problems with feet could have been avoided if more attentive to the choice of shoes in youth and to give preference to comfortable shoes, rather than an ultra-fashionable, but uncomfortable model.

By the way, the appearance of corns and deformation of the toes is also a consequence of improperly selected shoes.

Lyudmila Zhilevich Chief Freelance Gerontologist of the Ministry of Health, Head of the Republican Gerontological Center (Active Aging):

– With age, it is better to give preference to more comfortable shoe models. It should be free and preferably made from natural materials.When choosing, you need to take into account all the physiological features of the foot, for example, flat feet or deformation of the toes. Orthopedic insoles should be used if necessary. The heel is comfortable and not higher than 5 cm. Do not forget that due to the deformation of the spine, the pressure on the foot is not distributed correctly, this contributes to calcification or hyperkeratosis – the formation of corns. These places are less well supplied with blood, more susceptible to infection and fungi, the appearance of painful cracks. This means that you will be limited in movement and physical inactivity will give an impetus to the development of many heart diseases.

The most common problems: flat feet, a “bone” on the toe and spurs

Flat feet. Because of this pathology, it becomes difficult for a person to walk, the risk of curvature of the fingers, subluxation and dislocation of the foot is high. There is a feeling that the legs are filled with lead. Often, flat feet are already acquired over the years, a disease that has developed as a result of wearing too tight shoes. In this case, it is useful to walk on an uneven surface, for example, on wet sand or grass, to perform special exercises.

Calcaneal spur. These formations are spike-like salt deposits. Their appearance can cause quite severe pain.

Hallux valgus (bone). Causes the big toe to move to the side towards the other toes, causing them to bend. If the deformity is severe, it can lead to pain when walking and even immobilization. In severe cases, the only solution is surgery.

There are situations when leg pain is associated with the state of the cardiovascular system.In this case, the main symptom is pain when walking – the so-called intermittent claudication. Feeling of heaviness in the legs, swelling or swollen joints in the area of ​​the foot. Inflammation of the bursa may be the cause of these conditions. All these problems cannot be solved by choosing the right shoes; a doctor’s consultation is necessary.

Foot Care

Decreased collagen and sebum production leads to dry and flaky feet. The skin is susceptible to various infections and negative factors.Due to poor blood supply, nails are also subject to changes. The nail plate becomes thinner, becomes fragile and brittle, the direction of its growth may change. Therefore, in old age, daily foot care is so important.

1. When returning home, you should examine the skin of the feet for damage, calluses or chafing.
2. Then wash your feet with warm water (not hot!). You can make a light soapy solution.
3. Pat dry with a towel, but do not rub.Don’t leave your skin damp.
4. Then, if necessary, you can lubricate the feet with a cream with a high content of oils or use a special product for the skin of the feet.
5. Calluses or hardened skin must not be steamed and then treated with pumice stones or special files. You can remove a layer of skin that is too thick and cause ulcers. This procedure should only be carried out dry.
6. It is better to trim the nails after the feet have been steamed.Some do it right away in the bath, which is absolutely not true. This can cut them too short and injure the skin under the nail. In order to prevent ingrowth of the nail, it is necessary to trim it, following the pattern of the edge of the nail plate, without cutting the corners. If whitish spots, growths appear on the nails, the nail plate has become “shaggy”, do not pull – go to the doctor. It is likely that the nails were infected with a fungus.

Lyudmila Zhilevich Chief Freelance Gerontologist of the Ministry of Health, Head of the Republican Gerontological Center (Active Aging):

– If suddenly you have a small sore or crack that begins to swell or turn red, this indicates that this place is infected.In this case, it is better to consult a doctor. This is especially important if you have diabetes.

Article: Tips for foot care in old age.

Osteoarthritis in the elderly

Osteoarthritis is one of the most common diseases of the musculoskeletal system, usually observed among the elderly. People with osteoarthritis experience joint pain and movement restrictions, which, of course, interfere with their daily life.Osteoarthritis mainly affects the cartilage as well as the pericartilaginous bone and synovium. Osteoarthritis affects the hands (cartilage of the fingers), spine, neck, knees and hips.

Despite the fact that osteoarthritis is more common in the elderly, but young people can also suffer from this disease, the reason for this can be damage to the joint, a genetic defect in the articular cartilage, overweight, etc. Symptoms of the disease appear in the form of joint crunch, it occurs due to the friction of the bones against each other, the joint may begin to ache, and in the case when the layer is completely destroyed, the person cannot move the joint.

People with osteoarthritis usually experience joint stiffness after sleep, getting out of bed, or after prolonged sitting. Pain can occur when going up and down stairs, strenuous physical activity, or being in uncomfortable positions. Swelling and redness around the knee or ankle is also possible. If the disease runs, the joint can deform, changing its shape.

Physiotherapy and medication can help reduce pain and improve joint function.But if the disease is advanced, the patient may need surgery.

The first thing you need to pay attention to is your own weight, reducing it will reduce the load on the joint. Weight control, exercise will help relieve the symptoms of osteoarthritis.

If you are affected by this illness, contact a professional physiotherapist for an exercise program. Avoid aerobic exercise that puts a lot of stress on problem joints, especially when it hurts or swells.

For more information contact the Orthopedics Department

90,000 Mental health and older people

Older people, that is, people aged 60 and over, make an important contribution to society as family members, volunteers and active workers. While most older people have good mental health, many older people are at risk of developing mental disorders, neurological disorders or substance use problems, and other health conditions such as diabetes, hearing loss, and osteoarthritis.In addition, as they age, people are more likely to have multiple health problems at the same time.

Problem

The world’s population is aging rapidly. Between 2015 and 2050, the proportion of the world’s elderly is estimated to double from about 12% to 22%. In absolute terms, the number of people over 60 is expected to increase from 900 million to 2 billion. Older persons face special physical and mental health problems that need to be recognized.

More than 20% of adults aged 60 and over have a mental or neurological disorder (excluding headache disorders), and 6.6% of all disabilities (disability-adjusted life years – DALYs) among people over 60 years caused by neurological and mental disorders. These health disorders among the elderly account for 17.4% of the years of life lived with disabilities (ABI). The most common neuropsychiatric disorders in this age group are dementia and depression, affecting about 5% and 7% of the world’s older population, respectively.Anxiety disorders affect 3.8% of older people, problems caused by the use of psychoactive substances – almost 1%, and about 25% of deaths from self-harm occur in people aged 60 years or older. Problems caused by substance use among the elderly often go unnoticed or are misdiagnosed.

Health workers and older people themselves do not pay enough attention to mental health problems, and the stigma associated with mental illness makes people reluctant to seek help.

Risk Factors for Mental Health Problems in Older People

At any point in a person’s life, there are a variety of risk factors at risk for mental health. Older people, in addition to the usual stressors in the lives of all people, may also be affected by factors more characteristic of old age, such as significant and sustained deterioration in ability and decreased functionality. For example, older people may experience limited mobility, chronic pain, decrepitude, or other health problems that require some form of long-term care.In addition, events such as the loss of loved ones or a decline in socioeconomic status after retirement can occur much more often in the lives of older people. All of these factors can lead to isolation, loneliness or psychological distress, which may require long-term care.

Mental health affects physical health and vice versa. For example, older people with conditions such as heart disease have higher rates of depression compared to those in good health.Conversely, not treating depression in an older person with heart disease can negatively impact the outcome of a physical illness.

In addition, older people can experience abuse, including physical, sexual, psychological, emotional, financial and material abuse, neglect, neglect, and severe disregard for human dignity and disrespect. The evidence to date suggests that one in ten older people is experiencing abuse.Elder maltreatment can cause not only physical harm, but also serious, sometimes long-term, psychological consequences, including depression and anxiety.

Dementia and depression in the elderly – a public health problem

Dementia

Dementia is a syndrome, usually of a chronic or progressive nature, in which memory, thinking, behavior and the ability to perform daily functions are deteriorated.

An estimated 50 million people worldwide live with dementia, with 60% of people with dementia living in low- and middle-income countries.The total number of people with dementia is projected to increase to 82 million in 2030 and 152 million in 2050.

Dementia is associated with significant social and economic problems in the form of direct costs of medical, social and informal care. In addition, physical, emotional and economic hardships can cause significant stress to family members and caregivers. The health, social, financial and legal systems must support both people with dementia and those who care for them.

Depression

Depression can be very distressing and leads to limited functioning in everyday life. Unipolar depression affects 7% of all elderly people and accounts for 5.7% of total disabilities (DALYs) among people over 60 years of age. In primary care settings, depression is underdiagnosed and not all patients receive treatment. Symptoms of depression in older people are often overlooked and treated as they overlap with other problems in older people.

In primary care settings, depression is underdiagnosed and not all patients receive treatment. Symptoms of depression in older people are often overlooked and treated as they overlap with other problems in older people.

Treatment and Care Strategies

It is important to prepare health workers and the community to meet the special needs of older people, including:

• training health professionals in old age care;
• prevention and management of age-related chronic diseases, including mental, neurological and disorders associated with the use of psychotropic substances;
• Developing sustainable policies for long-term and palliative care; and
• creating age-appropriate services and conditions.

Health education

The mental health of older people can be improved by promoting active and healthy aging. Health education for the mental health of older people is about creating living conditions and environments that promote well-being and enable people to lead healthy and integrated lives. Mental health promotion depends mainly on a strategy that ensures that older people have the necessary resources to meet their basic needs, such as:

• ensuring safety and freedom;
• suitable housing due to favorable housing policy;
• social support for the elderly and those who provide them with assistance;
• health and special programs targeting vulnerable groups of people, such as the lonely, those living in rural areas, or those suffering from chronic or recurrent mental or physical illnesses;
• programs to prevent violence or elder abuse; and
• community development programs.

Interventions

Rapid recognition and treatment of mental, neurological and substance use disorders in older adults is key. Both psychosocial interventions and medications are recommended.

There is currently no cure for dementia, but much can be done to support and improve the quality of life of people with dementia, their caregivers and their families, in particular:

• early diagnosis, so to promote early and optimal disease management;
• optimization of physical and psychological health and optimization of well-being;
• identification and treatment of concomitant physical diseases;
• Identification and management of problematic behavioral and psychological symptoms;
• Providing information and long-term support for caregivers.

Community care

Good general health and social care is essential to help improve the health of the elderly, prevent disease and manage chronic disease. Therefore, training all health care providers to deal with the problems and disorders associated with aging is essential. Effective community primary care for the elderly is a critical element. Equally important is the emphasis on long-term care for the elderly with mental disabilities and the provision of education, training and support to caregivers.

Providing the highest quality services for people with mental illness and their caregivers requires an appropriate and supportive legal environment based on internationally accepted human rights standards.

WHO work

WHO supports governments in achieving the goal of promoting and promoting mental health among older people, integrating effective strategies into policies and plans. In 2016, the World Health Assembly adopted the Global Strategy and Plan of Action on Aging and Health.One of the goals of this global strategy is to align health systems with the mental as well as physical health needs of older people. It includes, inter alia, the following measures: orientation of health systems towards internal capabilities and functionality; organizing and providing affordable access to quality and comprehensive clinical care for the elderly; and ensuring a stable composition of a properly trained, employed and managed health workforce.

Comprehensive mental health action plan 2013–2020. represents a commitment by all WHO Member States to take concrete measures to promote mental well-being, prevent mental disorders, provide health care, accelerate recovery, strengthen human rights and reduce mortality, morbidity and disability for people with mental disorders, including the elderly. It has four key objectives:

• to strengthen effective leadership and leadership in mental health;
• Provide comprehensive, integrated and responsive health and social care at the primary level;
• Implement mental health promotion and prevention strategies;
• Strengthen mental health information systems, evidence and research.

Depression, psychosis, suicide, epilepsy, dementia and substance use disorders are included in the WHO Mental Health Gap Action Program (mhGAP), which aims to improve care for mental, neurological and disorders associated with substance use by providing guidance and tools for organizing health care in resource-poor areas.The mhGAP package includes measures to prevent and treat each of these priority conditions in non-specialized health care settings, including those for the elderly.

WHO recognizes dementia as a public health problem and has published Dementia: a public health priority, which calls for action at the international and national levels. In March 2015, WHO organized the first Ministerial Conference on Global Action Against Dementia, which raised awareness of the public health and economic challenges of dementia, promoted a better understanding of the roles and responsibilities of Member States and stakeholders, and led to the adoption of the Call to action ”, supported by the conference participants.

In May 2017, the World Health Assembly approved the Global Public Health Action Plan for the Response to Dementia 2017–2025. The Plan provides a comprehensive program of action for policy-makers, international, regional and national partners and WHO in areas such as raising awareness of dementia and developing initiatives to create an enabling environment for people with dementia; reducing the risk of dementia; diagnostics, treatment and care; research and innovation; and support for carers of people with dementia.The plan’s goal is to improve the lives of people with dementia, their carers and their families, while reducing the impact of dementia on individuals, communities and countries. As part of efforts to operationalize the Plan, the Global Dementia Observatory was created, an international surveillance platform for policy-makers and researchers to facilitate the monitoring and exchange of information on dementia policy, service delivery, epidemiological conditions and research.

Weakness in the legs is one of the symptoms of many diseases

The feeling of weakness in the legs is familiar to many, if not almost all people. Weakness in the legs can be caused by a variety of disorders in the human body, and also be one of the manifestations of quite serious diseases. Therefore, it is especially important to note other symptoms accompanying this phenomenon (for example, dizziness, nausea, other pain) for a timely diagnosis and subsequent treatment.

Symptoms most commonly associated with leg weakness:

• Dizziness
• Headache
• Faintness, light-headedness
• Nausea
• Increased fatigue
• Increased body temperature
• Shivering legs
• Numbness of limbs
• Swelling
• Pallor or blue discoloration of the skin on the legs
• Weakness in the back
• Low back pain
• Convulsions

Since the causes of weakness in the legs can be a variety of diseases, it is advisable to first consult a physician.A specialist, taking into account all the available symptoms, may consider it necessary to carry out such diagnostic procedures as: general blood and urine analysis, ECG, ultrasound of the heart, angiography of the vessels of the legs, X-ray of bones.

Weakness in the legs is quite often a manifestation of circulatory problems. Including it can be one of the symptoms of such dangerous diseases as stroke and heart attack. An early warning of the risk of stroke can be severe weakness in one or more limbs. At the same time, weakness in the legs lasts no more than an hour, but can occur several times a day.The clear signs of a stroke develop later, so it is important to pay attention to possible symptoms on time.

Sudden weakness in the legs combined with even a slight heartache, dizziness and lightheadedness can speak of another deadly disease – a heart attack. In this case, you should immediately seek emergency medical help.

In old age, one of the most common causes of weakness in the legs is a decrease and blockage of blood vessels with cholesterol plaques – atherosclerosis.In this case, directly weakness in the legs can cause not only atherosclerosis of the vessels of the legs, but also atherosclerosis of the cerebral or coronary arteries. In addition to problems with blood circulation, a sudden change in blood pressure – hypotension can lead to weakness in the legs.

Another dangerous disease manifests itself in weakness in the legs, this is diabetes. With prolonged development of diabetes, neuropathy of the feet may occur. A high level of glucose in the body leads to a malnutrition of the nerves, their oxygen starvation.Diabetic neuropathy manifests itself in numbness of the feet, loss of their sensitivity, heaviness when walking.

Weakness in the legs can be one of the symptoms of diseases of the central nervous system, as well as concussion. This is usually accompanied by headaches, nausea, and general weakness. If, with weakness in the legs, visual impairment is also noted, then this may serve as a signal of the development of multiple sclerosis. In this case, a timely appeal to a neurologist is necessary.

If weakness of the legs is combined with a feeling of numbness, tingling, and pain in the extremities is added, then spinal lesion can cause such a symptom.The most common causes of these symptoms are: osteochondrosis, arthritis, spondylitis, trauma or swelling of the spine.

Feeling weak in the legs can signal bone problems, including closed foot injury, osteoporosis, and bone tumors.

Weakness in the legs is very often the result of an increase in body temperature. The reason for the increased temperature, in turn, can be: a cold or SARS, viral, bacterial or fungal infection, food poisoning, overheating or sunstroke.

Psychological problems and stress can be a serious factor in the development of weakness in the legs, especially in old age. Panic attacks, neurosis, depression can be behind the general weakness in a person, and in particular for the frequently occurring weakness in the legs. Contacting a specialist psychologist, and in some cases, a psychiatrist will provide timely necessary assistance.

90,000 All about seizures in the elderly

12/16/2020

About 50% of older people are faced with a problem such as cramps – muscle spasms that occur mainly at night.Pain sensations can be insignificant and short-term or pronounced and last from 2-3 to 30-40 minutes. Even short-term severe pain causes sleep disturbances, and sometimes – the development of inflammatory processes. Most often, the muscles of the legs are susceptible to cramps, but spasms also affect the muscle tissues of the hands, feet, abdomen, and chest.

Muscle cramps are not an essential feature of old age. They do not pose a serious threat to health, but they do create discomfort. Sometimes they are idiopathic (occur spontaneously), and in some cases they become one of the symptoms or complications of diseases.

No need to endure, waiting out the painful attacks. The causes of seizures should be identified and therapy should be selected that will reduce their intensity and frequency.

Causes and First Aid

Convulsions in the elderly occur:

• after intense physical activity;
• for neurological disorders – motor neutron disease or peripheral neuropathy;
• high levels of toxic substances in the blood – one of the symptoms of liver disease when it does not fully perform its functions;
• dehydration – a decrease in the level of electrolytes in the blood leads to involuntary muscle contractions;
• due to the use of certain drugs – diuretics for hypertension, heart and renal failure, raloxifene and nicotinic acid, which lower blood cholesterol levels, nifedipine;
• with varicose veins;
• due to a lack of vitamins D or B6, calcium or magnesium.

To help an elderly person experiencing a muscle spasm, you need to stretch the muscles if the pain prevents him from doing it on his own. The numb muscle can be pricked with a sewing needle or pin, after having disinfected them with an alcohol-containing solution or doused with boiling water.

If there is no pin or needle, you can stretch the calf muscle by gently pulling on the big toe to reduce the severity of the spasm. A few sensitive tweaks will give a good effect.

If the elderly person can move but is in pain, suggest walking barefoot. To enhance the effect, place a towel soaked in cold water under your feet. If the pain is severe, apply a cold compress by wrapping ice or other items stored in the freezer in a towel.

When urgent medical attention is required

As a rule, seizures resolve on their own after a few seconds or minutes. But sometimes they are symptoms of dangerous diseases in which intensive treatment is urgently required.

You need to call an ambulance if convulsions are accompanied by:

• loss of consciousness;
• sharp muscle hypertonicity;
• profuse salivation or foam on the lips;
• twitching of the limbs;
• sudden onset of strabismus, other visual disturbances.

Symptoms are typical for seizures of epilepsy, stroke, and some other dangerous diseases. The doctor should examine the patient as soon as possible, make a preliminary diagnosis and provide first aid, so that later he can conduct an in-depth examination.

Prevention

To avoid muscle cramps at night, older people need to be especially careful about their lifestyle. Do not overwork, exhaust yourself with intense training, tedious work around the house or in the country. If muscle fatigue is felt in the evening, before going to bed, you need to take a warm bath or immerse your feet in a basin with warm (but not hot) water for 10-15 minutes. It is useful to periodically take massage courses.

It is important not to dehydrate the body.Drinking just before bedtime is undesirable, you need to drink a sufficient amount of liquid throughout the day. The diet should contain foods rich in magnesium and calcium: cereals, nuts, cheese and cottage cheese, prunes, figs, blueberries.

For a good assimilation of minerals, the body needs vitamins D and B6. Consult your doctor to select a vitamin complex taking into account age, region of residence, health status, as well as the season.

Folk remedies

Traditional medicine offers a large number of recipes for the prevention and relief of muscle spasms in the elderly.If cramps occur frequently, you should drink healing tea within 2 weeks:

• from raspberry shoots – they are boiled for 30 minutes, the broth is filtered and drunk before bedtime;
• from linden – 1.5 tbsp pour dried inflorescences with a glass of boiling water, leave for 20 minutes, drink 3 times a day, 1 tablespoon;
• from thyme ordinary – for the treatment of spasms of a neurological nature, take 15 g of thyme, pour a glass of boiling water, leave for 30 minutes, drink 3 times a day, 1 tbsp.l.

To relieve pain during muscle spasm of the foot, it is recommended to rub with lemon juice, and rubbing numb muscles with mustard oil. Reduces the frequency and intensity of seizures by taking garlic (1 clove) – it needs to be crushed and mixed with 1 tsp. honey, consumed daily within 2 weeks after meals. Before bed, you can have a soothing tea with mint, lemon balm, or motherwort.

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Magnesium for muscle cramps | Cochrane

Review question

We reviewed the evidence for the effects of magnesium supplementation on muscle cramps and included as wide a range of studies as possible. This meant that studies were included for everyone who suffered from muscle cramps, regardless of their cause.This also meant the inclusion of studies in which magnesium was given by any of the methods available. This includes swallowing as a tablet or liquid, slowly injecting it directly into the blood over several hours (“intravenous infusion”), and injecting it into the muscles (“intramuscular injection”). We included studies that compared magnesium with placebo, compared magnesium with no treatment, and compared magnesium with other existing therapies for seizures. We found 11 studies in total.To evaluate the benefits, we examined the effects of magnesium on seizure frequency, seizure pain and seizure duration, and looked at a number of participants who had a 25% or more reduction in seizure frequency. To assess potential harm, we looked at how often major and minor adverse health events occurred.

Relevance

Muscle cramps are common and occur in a wide range of conditions. Elderly and pregnant women often complain of leg cramps when resting, athletes may experience cramps when they exceed their endurance limit, and some people develop muscle cramps as a symptom of other conditions.One potential way to prevent muscle cramps already on the market is to supplement with magnesium. Magnesium is a common mineral in our diets, and additional oral supplements from this mineral can be purchased either online or at health food stores and pharmacies (usually in the form of tablets or powders to dissolve in water). We wanted to combine the studies to get the best estimate of the effects of magnesium on seizures. We also wanted to study the effect of magnesium on various categories of people suffering from seizures, in case it can work in some conditions, it cannot in others.

Research characteristics

We searched for all high quality published studies evaluating magnesium’s effectiveness in preventing muscle cramps and found five studies in older adults, five studies in pregnant women, and one study in people with cirrhosis. Studies in older adults included 271 participants (61.6-69.3 years), and studies in pregnant women included 408 participants.The only study in people with liver cirrhosis included only 29 people, not all of whom had seizures. There have been no studies of people who have had seizures while exercising. Magnesium was compared to placebo in nine out of 11 studies, as well as calcium, vitamin E, vitamins B₆ and B₆, and no treatment in two studies in pregnant women. The duration of the included studies ranged from 14 to 56 days. Magnesium was administered orally in 10 of 11 studies and as a four-hour intravenous infusion for five consecutive days in one study.Funding for the included studies came from the magnesium tablet manufacturer in two studies, independent sources in three studies, and was not provided in six studies.

Key results and certainty of evidence

The combined results of five seemingly reliable studies suggest, with moderate certainty, that magnesium is unlikely to reduce the frequency or severity of muscle cramps in older adults.In contrast, five studies in pregnant women that have significant limitations in their reliability (both in study design and presentation of results) did not show consistent results in terms of benefits and could not be pooled. As a result, we are very uncertain whether pregnant women with muscle cramps will benefit from magnesium. The only study in people with cirrhosis found no difference in the frequency or intensity of seizures, but it was too small to draw conclusions.

More research is needed on the use of magnesium in pregnant women. The same is true for those who suffer from seizures associated with illness or exercise. However, older adults with seizures are unlikely to benefit from this therapy. Significant side effects were rare, and participants dropped out of the study with the same frequency when taking magnesium or a placebo. However, minor side effects, mainly diarrhea (as you would expect from magnesium salts) and nausea, were common and affected approximately 11% (10% in control) and 37% (14% in control) of participants.

This review is current as of September 2019.

Swelling of the legs in the elderly, causes, signs of appearance

The accumulation of fluid in the tissues causes discomfort and discomfort. In old age, this problem is aggravated: the thinning of the walls of blood vessels, a sedentary lifestyle lead to constant swelling, and the lower extremities suffer the most. Swelling of the legs is a serious symptom that may indicate a particular disease. It cannot be ignored.The sooner the cause is identified, the more chances a person has for recovery and improvement in well-being.

Signs of edema

Many older people complain of leg pain when walking. Some do not even think that swelling may be the cause. Adding the feeling of tight shoes to fatigue is another warning sign. After a walk, it is recommended to pay attention to whether there are any sock marks on your feet – pronounced stripes and dents indicate a serious accumulation of fluid.A sign of pathological edema is a change in skin color. In this case, the visit to the doctor can no longer be postponed.

The most “harmless” edema occurs from tight, uncomfortable shoes or from eating salty, spicy, fatty foods. Avoiding unhealthy foods and buying comfortable shoes or shoes can bring back a feeling of lightness in your feet and relieve puffiness. Physiological edema often occurs due to alcohol consumption, respectively, alcohol should also be excluded.If these simple measures do not help, there is no need to experiment with the body. Only a specialist will be able to determine the exact cause of the ailment and prescribe an effective treatment.

Causes of edema

Pathological edema is much more dangerous than physiological. The body thus signals a disease. The most common causes of leg edema in older people are:

• Varicose veins;
• Renal failure;
• Diseases of the thyroid gland;
• Diseases of the cardiovascular system;
• Damage to the lymphatic system;
• Thrombophlebitis.

With varicose veins, swelling does not appear immediately. The patient begins to feel pain in the legs, aches, in the evening the legs swell a lot, and in the morning, after sleep, the limbs look normal. Varicose veins can lead to a violation of vascular trophism, so the disease cannot be started.

If the kidneys do not cope with their work, the fluid is retained in the tissues. There is a puffy face, urine changes its color to dark, edema appears.Renal failure is a serious pathology that cannot be cured with folk remedies, especially in old age. A doctor’s consultation is required.

In patients with thyroid dysfunction, edema appears due to a violation of the water-salt balance and changes in the concentration of hormones involved in the metabolism of proteins, carbohydrates, lipids. Hormonal imbalance is treated with medication.

The so-called “heart” edema is one of the most dangerous. Legs not only swell, they become cold to the touch and become bluish.Unlike renal edema, which develops rapidly, cardiac edema appears gradually.

In diseases of the lymphatic system, the ankle and areas at the base of the fingers (often only on one leg) swell. If you postpone treatment for a long time, an irreversible process will begin: the connective tissue will grow, the skin will become dense, rough, and will acquire an unhealthy color. The difference between a healthy limb and a sick limb can reach 50 cm in severe cases!

The leg is severely swollen, reddened, and pain occurs when feeling? Perhaps this is an attack of thrombophlebitis – an extremely life-threatening condition.Edema occurs due to blood clots in the vessels, an elderly person needs emergency medical attention, possibly surgery.

There is another reason for the appearance of edema – diabetes mellitus. If an older woman or man notices that the legs are constantly swollen, it makes sense to monitor the blood sugar level.

Swelling of the legs after injuries

Older people are more prone to injuries and bruises than young people. If, after a blow or fall, edema forms on the leg, this indicates subcutaneous hemorrhage.Contacting the emergency room is mandatory: the doctor must rule out a fracture or dislocation and prescribe ointments, creams or gels to improve blood flow. The injured limb must be provided with rest, this is also an important condition for recovery. Ignoring puffiness can lead to the development of serious diseases.

Among the most common folk remedies: iodine net, decoctions of medicinal herbs (tansy, St. John’s wort, plantain), gentle massage.

Prevention and treatment

In adulthood, it is difficult to deal with edema: most often they are pathological in nature and are the result of some kind of disease.But there are a number of recommendations that can reduce the manifestations of puffiness. If you follow them strictly, you can get rid of serious water stagnation in the tissues.

First of all, you need to change the diet, excluding spicy, salty, smoked foods, alcohol from the diet. By the way, a salt-free diet is shown to many elderly people, so a simple, perhaps slightly bland menu will not only help in the fight against edema, but also improve the general condition of the body.

A balanced diet is the main condition for normalizing weight, and this will also have a beneficial effect on the condition of the limbs, since extra pounds contribute to fluid retention.