Weakness in the legs: fatigue, arthrosis or something else?

Weakness occurs with many diseases, so it is almost impossible for a non-specialist to immediately determine what happened. Weakness in the legs is a very nonspecific symptom that can accompany disturbances in the functioning of many organs and systems. However, such a symptom should never be ignored, since even after heavy physical activity, weakness should go away after a short rest. If weakness in the legs occurs for no apparent reason, much less repeats repeatedly or its severity intensifies, you should consult a doctor immediately.

As mentioned earlier, there are many reasons for weakness in the legs; accordingly, the patient is faced with the question - what specialty should he see a doctor? Most often, such a specialist becomes a neurologist, and a little less often a therapist and an orthopedic traumatologist.

At CELT you can get advice from a neurologist.

• Initial consultation – 3,500
• Repeated consultation – 2,300

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Causes of weakness in the legs

Conventionally, the reasons can be divided into several groups:

• damage to the vascular system;
• muscle damage;
• damage to peripheral nerves;
• diseases of the central nervous system (brain or spinal cord);
• psychological and mental problems;
• joint diseases;
• diseases of the spine;
• intoxication.

During the initial examination and history taking, special attention is paid to the dynamics of the process - whether the weakness arose suddenly or gradually increased, whether it is constant or intermittent, and so on. It is important to find out not only the events that preceded the appearance of weakness in the legs, but also the accompanying symptoms: pain, swelling, convulsive twitching, dizziness, change in skin color, trembling, fever, degree of movement impairment, and the like.

A comparison of clinical and laboratory data allows you to quickly understand which disease of which organ or system caused weakness in the legs. CELT doctors have at their disposal an excellent diagnostic base, with the help of which they can determine not only the disease itself, but also how long it has existed, as well as its severity and prognosis.

Rehabilitation after treatment

Doctors at the Kuntsevo Medical and Rehabilitation Center pay special attention to rehabilitation, helping patients restore their lifestyle. This is due to the fact that due to lack of physical activity, muscles weaken over time. To restore mobility, doctors spend a long time working, and patients need to make a lot of effort. Additionally, therapeutic massage is provided for relaxation. Also, at the Kuntsevo Medical and Rehabilitation Center, many other measures are taken to rehabilitate patients with muscle weakness.

Our doctors

Pankov Alexander Rostislavovich

Neurologist

41 years of experience

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Novikova Larisa Vaganovna

Neuropathologist, Candidate of Medical Sciences, doctor of the highest category

40 years of experience

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Belikov Alexander Valerievich

Neurologist, Candidate of Medical Sciences

22 years of experience

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What to do to restore strength after coronavirus?

It is necessary to find out the reason why a recovered patient experiences weakness and increased fatigue without obvious positive dynamics - this can be either ordinary long-term physical inactivity in isolation (the habit of bed rest), or diseases of internal organs without obvious symptoms. If the diagnosis reveals the latter, it is necessary to consult a specialized doctor who will prescribe therapy.

Patients who have suffered viral pneumonia with lung damage need to restore their previous lung capacity - it is recommended to do breathing exercises (see, for example, Strelnikova’s set of exercises), walk in the fresh air, and engage in moderate physical activity (yoga, cycling).

The patient's diet after pneumonia should be rich in antioxidants and vitamins. Swimming in the pool, cold water pond and bathhouse (sauna) is prohibited. Spending time in the sun will help raise the level of important vitamin D. A stay at a sanatorium is recommended.

Drinking alcohol and smoking for a patient with signs of viral pneumonia (even if there is no longer a virus in the body) significantly inhibits recovery processes, suppresses the immune system and can lead to the development of complications such as pulmonary fibrosis.

Circulatory disorders

Vascular diseases of the nervous system, which can result in stroke and heart attack, are becoming more common among patients. In this case, situations of so-called transient ischemic attacks are possible, when a “flickering” of symptoms occurs - weakness occurs acutely, but quickly passes. After such an incident, you cannot be complacent and assume that everything turned out okay. It is necessary to identify the cause of the incident as quickly as possible and take appropriate preventive measures.

Stroke and heart attack can occur not only in the brain, but also in the spinal cord. A spinal stroke that occurs at any level can leave a person disabled or require a long and incredibly labor-intensive recovery. It must be said that due to the structure of the spinal cord, recovery after a spinal stroke is rarely successful, even in comparison with a stroke that affects the brain.

Weakness in the limbs may result from myocardial infarction, in which case gastrointestinal symptoms are often associated - nausea, abdominal pain, bloating. Some forms of heart attack thus remain undiagnosed, since the clinical picture is not typical and “imitates” an acute disease of other organs (for example, acute pancreatitis).

The veins or arteries of the lower extremities may be affected. Chronic venous insufficiency not only reduces physical strength, leads to pain and causes aesthetic problems, but also threatens the formation or separation of a blood clot (which, if the circumstances are unsuccessful, can block the pulmonary artery - pulmonary embolism is often a fatal condition). Blood stagnation also occurs in chronic heart failure, when swelling appears in the legs.

The formation of atherosclerotic plaques in the lumen of the vessel is a common cause of gait disturbance in the elderly. The so-called “intermittent claudication” develops.

Obliterating endarteritis also manifests itself as intermittent claudication, when the lumen of the vessels gradually narrows. Raynaud's disease is manifested by changes in skin color, weakness and swelling, the trigger for which is often hypothermia or frostbite. Menopause and premenstrual syndrome can also cause transient leg weakness.

Diagnosis of the disease

If muscle weakness occurs, it is better to contact a general practitioner or pediatrician, who, if necessary, will refer the patient to a neurologist and other specialized specialists. In any case, making a diagnosis is a complex process that includes examination, history taking, laboratory and instrumental examinations.

If hereditary dystrophic diseases are suspected, a genetic study is prescribed. To assess muscle function, electromyography is used to determine the electrical activity of muscle fibers. If necessary, a muscle biopsy is performed. Sometimes an ultrasound, computed tomography or magnetic resonance imaging is required to clarify the diagnosis. If an inflammatory-infectious lesion is suspected, the doctor prescribes blood and urine tests.

Sensory disturbances due to nerve damage

This is the most common disorder in diabetes mellitus - polyneuropathy, which almost inevitably occurs 15 or 20 years after the onset of the disease, but everything can happen much earlier. Numbness, heaviness, and decreased sensitivity appear.

The same disorders occur with funicular myelosis or degenerative disease of the spinal cord, when deep sensitivity is immediately impaired.

Neurologists identify many causes of polyneuropathy - from viruses to chronic alcoholism. Among them are tick bites, cytomegalovirus, tumors, diphtheria, chemical poisoning and much more.

When should you see a doctor?

Sometimes headaches and fatigue require immediate medical attention. Alarm signals, when they appear, you should call an ambulance12,13:

• sudden severe headache;
• headache, fatigue in combination with limited ability to tilt the head forward, bringing the chin closer to the chest (stiff neck);
• confusion;
• visual impairment;
• sensory disturbances, such as numbness of the limbs;
• speech disorder.

In the absence of alarms, consultation with a doctor may be necessary routinely in cases where the cause of headaches and fatigue is unknown.

References

1. Nikitin S.S. et al. Clinical recommendations for the provision of medical care to patients with Pompe disease // Neuromuscular diseases, 2016. Vol. 6. No. 1.
2. Clinical recommendations. Pompe disease, 2022
3. Morozova O. G. Migraine: modern ideas about classification, diagnosis, therapy and prevention (Part I) // Emergency Medicine, 2012. No. 4 (43).
4. Stuklov N.I., Mitchenkova A.A. Anemia and iron deficiency. Global problems and solution algorithms // Therapy, 2022. T. 24. No. 6. P.147-155.
5. Federal clinical guidelines for the treatment of iron deficiency anemia, 2015.
6. Fibromyalgia. MSD Handbook (accessed 09/18/2019).
7. Smirnov V.S. Modern means of prevention and treatment of influenza and ARVI // St. Petersburg: FARMIndex. – 2008.
8. Kovrov G.V., Lebedev M.A., Palatov S.Yu. Depression in general practice //Russian Medical Journal, 2010. T. 8. No. 18. P. 504-8.
9. Initial treatment of dehydration in acute malnutrition. World Health Organization. URL: https://www.who.int/elena/titles/bbc/dehydration_sam/ru/ (accessed September 19, 2019).
10. Clinical pharmacology and pharmacotherapy: textbook. – 3rd ed., add. and processed / ed. V.G. Kukesa, A.K. Starodubtseva. – M.: GEOTAR-Media, 2012. – 832 p.
11. Prilepskaya V.N., Mezhevitinova E.A. Premenstrual syndrome //Gynecology, 2005. T. 7. No. 4. P. 210-214.
12. Semenov V.M., Zenkova S.K., Dmitrachenko T.I. Purulent meningitis: features of the clinical course, variant of differential diagnosis //Medical alphabet, 2011. T. 2. No. 11. P. 24-30.
13. Parfenov V. A., Khasanova D. R. Ischemic stroke, 2012.

GZEA.PD.18.09.0435r

Psychological problems

Emotions influence our lives much more than we realize. The fact is that the body’s reactions are regulated by the autonomic nervous system, another name for which is the autonomic one. This system operates according to its own laws, regardless of our will and desires. Therefore, the body's reactions - heartbeat, breathing, blood circulation, digestion, spasms - practically cannot be regulated by willpower. Our every daily experience, and even more so mental illness, affects the functioning of all organs and systems.

Weakness in the legs occurs with the following disorders:

• panic attack;
• hysteria;
• prolonged stress;
• anxiety disorder;
• depression;
• schizophrenia;
• nervous exhaustion or neurasthenia;
• chronic psychotrauma;
• neurocirculatory dystonia.

Types of muscle weakness

Doctors distinguish the following forms of myasthenia gravis:

• sensory: the sensitivity of muscle tissue on the extremities increases (numbness, tingling, burning is observed);
• motor: severe muscle weakness, due to which a person practically cannot lift an arm or leg - this ailment can lead to muscle atrophy;
• sensorimotor: there is a combination of symptoms of the first two types of myopathy - this is the most common form of the disease;
• vegetative: in parallel with muscle weakness, increased sweating is observed, the skin becomes pale, the head is constantly dizzy, digestion is disturbed, the heart beats faster, breathing becomes difficult;
• mixed: combines the symptoms of all the above-described ailments.

Bone lesions

Weakness and decreased muscle strength in the legs may be the first sign of osteoporosis, or decreased bone mineral density.
Muscle tendons lose support. It is not uncommon for people who constantly use their limbs to suffer from a “stress fracture” of the foot. This happens when a critical mass of microtraumas accumulates from the same type of loads - from running, walking, jumping, jerking. Such injuries occur not only in athletes, but also in people constantly engaged in monotonous physical work.

Some bone tumors develop gradually and imperceptibly, so at first nothing but weakness bothers the person.

Primary

Muscle weakness (myasthenia gravis) is manifested by a significant decrease in muscle strength, due to the fact that the muscles cannot contract quickly and forcefully. A person does not get full movements provided by this muscle in case of myopathy, muscular dystrophy and myasthenia gravis. In myasthenia gravis, muscle strength is normal when a person is sedentary. But as soon as physical activity is required (washing dishes, going to the store, etc.) true weakness occurs.

Neurologists believe that muscle weakness has different etiologies.

Violation in:

• The upper and lower motor neuron system.
• The system of neuromuscular connections.
• The muscle itself.

Neurologists believe that the main causes of the disease in question are:

• Damage to the cervical spinal cord, cells of the anterior horns of the spinal cord, and neuromuscular junctions.
• Muscle diseases.

Doctor Nikonov

My opinion: the changes in muscle cells are the same for all these diagnoses - this is swelling in them. Edema in muscle cells pushes the cell nuclei to the periphery. Mitochondria (the energy of muscle fibers) follow the nucleus, like a dog on a leash following its owner. Depending on where the muscles swell, neurological damage occurs.

In the upper motor neuron system, damage to the cervical spinal cord is associated with pressure on it between the vertebral disc. The swollen neck muscles put pressure on the disc. In the lower motor neuron system, the cells of the anterior horns of the spinal cord are affected, for example, in the diagnosis of multiple radiculopathy, due to pressure from the side between the vertebral discs. Swollen back muscles move the intervertebral discs out of place.

In the neuromuscular junction system, when diagnosed with myasthenia gravis, edema in muscle cells squeezes the nucleus with mitochondria to the periphery of the cell. The muscle cell is left without energy. In the skeletal muscle system itself, muscle swelling puts pressure on the core. The nucleus is forced to “move away” to the periphery of the cell, taking mitochondria with it.

Main symptoms of primary muscle weakness

• Decreased muscle strength.
• Difficulties arise when performing daily tasks: walking, climbing stairs, holding a mug, writing with a pen, carrying medium-heavy packages.
• Drooping eyelid.
• Swallowing disorders.
• Speech or chewing problems.

Clinical symptoms of primary weakness in the arms

Neurologists: the main known causes of constant muscle weakness in the arms include various types of degenerative-dystrophic injuries of the spinal cord, which are associated with its compression, i.e. compression.

Doctor Nikonov

My opinion: the cause of degenerative-dystrophic damage to the spinal cord is associated with its compression, that is, with compression - these are swollen muscles of the neck, collar area and back, which put pressure on between the vertebral discs and the roots of the spinal cord.

Clinical symptoms of arm muscle weakness

• Long-term decrease in muscle tone.
• Fatigue quickly with light loads.
• Feeling of stiffness in the limbs in the morning (with arthritis).

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• Paresthesia (feeling of “pins and needles”, tingling of the fingertips).
• Episodic or regular pain in the joints or muscles of the hands.
• Reduced range of motion in the hands.

Daily overload

A load that exceeds the physiological load for a long time inevitably leads to weakness in the legs.
This is primarily excess weight, when the joints and muscles of the lower extremities bear excessive load for a number of years. Obesity destroys bones, muscles and ligaments very slowly, and it seems to go unnoticed. But if you compare the physical capabilities of people with normal weight and obesity, the comparison will not be in favor of the latter. The third trimester of pregnancy is a test for a woman’s musculoskeletal system, when she is forced to adapt to her growing body weight. Lymphostasis or elephantiasis is another reason for the increased load on the legs.

Removing swelling from arm muscles

• Decreased sensitivity in the fingers, hand, or on the front or back of it.
• Impaired skin sensitivity of the hands and a decrease in the temperature of their skin.
• Tremor.
• Involuntary movements (with central paralysis and brain injuries).
• Partial muscle atrophy.

Neurologists like to give this example: due to compression of the lower cervical spinal nerves, weakness in the arms is felt with osteochondrosis, cervical spondylosis, cervical radiculopathy.

Doctor Nikonov

My opinion : osteochondrosis is caused by swollen neck and back muscles that compress the bone cells of the vertebrae. As a result of this compression, the bone cells are unable to free themselves from their waste products. The bone cell waste remains inside the cell. The bone cell and intervertebral discs become dry. The neck muscles do not allow lymph to pass through, which moves from the fingers. The muscle cells of the arms begin to swell a second time. Result : primary muscle weakness of the arms occurs.

Due to swelling in the cells, primary muscle weakness develops:

1. For Arana-Duchenne muscular atrophy.
2. In the late stages of progressive myopathic Kurshman-Steinert syndrome.
3. Landouzy-Dejerine myopathies (scapulohumeral-facial dystrophy), Emery-Dreyfus dystrophy.
4. Multiple sclerosis.
5. Guillain-Barré syndrome (or Landry-Guillain-Barré polyneuropathy), amyotrophic lateral sclerosis (Charcot's disease).
6. Rheumatoid arthritis (connective tissue disease affecting small joints).
7. Scleroderma (connective tissue disease affecting the skin, joints, etc.).
8. Systemic erythematosus (lupus or Libman's disease).
9. Periarteritis nodosa - vasculitis of medium and small vessels.
10. Inflammation of the blood vessels of the hands (Buerger's disease).

Weakness and cold hands are characteristic of Raynaud's syndrome, when patients have greatly increased sensitivity of the fingers to cold. Pain and weakness in the hand appear when the joints of the hands are affected - arthritis and arthrosis (with arthritis, the joints hurt at rest, with arthrosis - during movement).

Doctor Nikonov

My opinion: Anterior scalene syndrome occurs due to swelling of this muscle. Neuritis causes swelling of the muscles of the collar area. Swollen forearm muscles cause the disease carpal tunnel syndrome. Swollen forearm muscles compress the medial nerve of the forearm in the carpal tunnel.

Intoxication

Any poisoning or infection causes general poisoning of the body and failures in many systems. Even a common ARVI, not to mention a bacterial infection, is accompanied by general weakness. Sunstroke, harmful working conditions, stale food - everything can lead to weakness, and each reason needs to be dealt with. In many cases, long-term alcoholism is destructive to nerves and muscles.

CELT doctors, who have unique practical experience, will help to accurately determine the cause of the disease.

Make an appointment through the application or by calling +7 +7 We work every day:

• Monday—Friday: 8.00—20.00
• Saturday: 8.00–18.00
• Sunday is a day off

The nearest metro and MCC stations to the clinic:

• Highway of Enthusiasts or Perovo
• Partisan
• Enthusiast Highway

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Why does constant fatigue occur?

If there is a suspicion that weakness is caused by neurological or other pathological problems, then you need to contact a neurologist and have an MRI done.

But constant fatigue is often caused by an unhealthy lifestyle.

Chronic fatigue often manifests itself with the following symptoms:

• weakness in arms and legs;
• muscle pain;
• headache;
• deterioration of concentration and memory;
• immunity decreases, a person gets sick more often;
• intestinal upset, diarrhea;
• loss of appetite;
• chills;
• sweating;
• insomnia;
• there may be increased anxiety.

The body suffers greatly from stress. Therefore, first of all, you need to improve your lifestyle:

1. Minimize stress and nervous tension.
2. Get good sleep (at least 8 hours).
3. Eat a nutritious, healthy diet.
4. Drink plenty of fluids.
5. Exercise.
6. Go for walks and breathe fresh air.
7. Take multivitamin and mineral complexes, as well as Omega-3 and Omega-6 preparations, to restore the lack of nutrients in the body.