They become warm and heavy, feel bulging and pull strangely: especially on the legs, many people have non-specific pain. There can be serious diseases behind it.
W hen legs tingle, swell and feel heavy, it should be taken seriously. This can be due to circulatory disorders of the arteries and veins, but also to a narrowing of the spinal canal.
The causes can be manifold, because the legs are connected with several joints and traversed by numerous nerves, muscles and blood vessels. "For example, the arteries in the legs are much longer compared to those in the heart and neck, so more deposits can build up here," explains Professor Hermann Josef Steinkamp of the Angioclinic Vascular Center in Berlin. An overview:
Peripheral arterial occlusive disease
Back in the flow: After a knee artery occlusion (l.), the blood can flow again after a laser angioplasty (r.)
"In peripheral arterial disease, the pelvic, femoral and tibial arteries narrow due to deposits, so the leg muscles have poorer blood flow and receive less oxygen," Steinkamp says.
Affected persons notice the arterial constriction especially when walking. "Often they get such severe cramps in the buttocks, thigh or calf after walking less than 200 meters that they can no longer continue walking."
The predisposition is inherited. The complaints occur with increasing age. According to the German Society for Angiology, about ten percent of Germans between the ages of 55 and 65 suffer from arterial occlusion in the pelvic-leg area.
A balloon catheter is often used to allow the blood to flow freely again. "Using a thin wire, the doctor pushes a small balloon from the groin through the artery to the narrow point and inflates it there. This presses the deposits against the artery wall, so that the vessel is free again," says Steinkamp.
But with very tight deposits, the wire is in danger of not being able to get through. For a long time, amputation was the only option. Today, such occlusions can be vaporized with high-energy laser light, explains Steinkamp.
"The vessel walls remain undamaged, and the risk of reocclusion is lower, since deposits are no longer pressed against the vessel wall and thus cannot detach. In addition to back pain, tingling occurs. Numbness in the legs also occurs with spinal stenosis. The cause here, however, is not circulatory disorders but, among other things, the progressive wear and tear of the spine with increasing age.
"The spinal canal in the area of the lumbar spine narrows, so that the spinal cord nerves come under prere. This disturbs the flow of nerve information, which then manifests itself in leg pain," says orthopedist Nicolas Gumpert from Frankfurt am Main, Germany.
As a rule, spinal stenosis is first treated with medication. "While they don't widen the spinal canal, they reduce water and irritation at the constriction point, thereby relieving the spinal cord," says Gumpert.
Anti-inflammatory cortisones are often injected specifically into the narrowing in the spinal canal. Drug treatment is often accompanied by special physiotherapy.
Deep vein thrombosis
In addition to arteries and the spinal column, the veins also often lead to leg complaints: in the form of thrombosis in the deep veins.
"In this case, a blood clot obstructs the return flow of blood from the foot via the knee and groin to the heart," says Norbert Frings of the Capio Mosel Eifel Clinic for Venous Diseases in Bad Bertrich. Leg swells, becomes heavy and unusually warm. "However, the clot can also initially remain without symptoms."
This is treacherous because untreated leg vein thrombosis can lead to a life-threatening pulmonary embolism. "A piece of the clot can break loose and be flushed into a vessel in the lung, threatening acute heart failure," says Frings.
If thrombosis is suspected, affected persons should therefore consult a doctor or hospital as soon as possible. Treatment is usually with drugs that inhibit blood clotting. "At first, patients usually receive infusions or injections with the active ingredient heparin, later so-called coumarins in tablet form are used," says Frings.
In addition, those affected should wear compression stockings. "They exert a coordinated prere on the veins. This reduces fluid retention in the tie and improves blood flow," explains Frings.
In addition, regular exercise should be taken. "Good are endurance sports such as swimming, walking, cycling or hiking, unfavorable are sports such as tennis or weightlifting, which rely on sudden stops," says Frings.