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老年人腿疼的原因,老年人腿疼怎么办?

发布时间:2016-03-03   问大夫  责任编辑:红豆

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腿疼,腿部疾病已经成为了老年人的生活困扰,老年人群中经常会出现腿疼的现象,人步入了老年,身体各个部位就会出现衰老的症状,老年人腿疼怎么办?一起来看看以下的解析吧。

老年人腿疼的原因

您是否经常感到四肢无力、容易疲劳或出现四肢冰冷和麻木的感觉?您是否有小腿肚或足部乏力、酸胀、疼痛的感觉,休息后疼痛又会消失。是否在不运动的情况下,您的足趾、足部或小腿肚也出现持续性的疼痛,到了夜里更为剧烈,常常在床上抱足而坐,痛得彻夜不眠?如果您回答“是”,那有可能是“它们”在作怪——

【间歇性跛行】

很多老年人都有这样的的经历,平时站着一段时间或行走一段路程后,腰背部出现“下沉感”,双侧小腿发胀,无法继续站立或行走。需要蹲下来或身体前倾休息一会儿才能继续行走。最短只能连续行走几十米或站几分钟,严重影响工作和生活。

这种情况在医学上称之为“间歇性跛行”。造成间歇性跛行的原因可以是由于腰部腰椎管内神经受压迫,也可以是由于下肢的血管病变所引起,临床上分为神经间歇性跛行和血管间歇性跛行。

【神经间歇性跛行】

如果把椎管比作房子,造成神经间歇性跛行的原因不外乎两个,要么是椎管这个“房间”变小了,要不就是“房间”内的东西多了。

“房间”变小随着年龄的增长,椎管前方的椎间盘失水退变后膨隆,甚至突出,从前方向椎管内挤入,后方的黄韧带和小关节囊增生、肥厚,同时小关节也增生肥大得像拳头一样,从后方和侧面压向椎管。还有一种椎管狭窄来源于脊柱畸形,常见的是椎体之间的不稳定甚至出现明显的滑移,使得连续平顺的椎管出现扭曲或转折。

“房内杂物”多罕见的情况是肿瘤性的,椎骨的原发或转移性肿瘤向椎管内生长,或者椎管内脊髓或马尾神经本身长了肿瘤,或者椎管内的转移性肿瘤占据了椎管。

【血管间歇性跛行】

血管间歇性跛行与神经间歇性跛行的表现有点相似,但却是两种完全不同的疾病。前者属于血管外科疾病,后者属于骨科范畴。由于两者的发病都在老年期,脊柱和血管的改变可以同时存在,所以发病表现相似,不易区别。

血管间歇性跛行患者疼痛更大程度上与运动有关,而不是和脊柱姿势的变化有关。其症状好发单侧,伴有冷感,一般没有感觉麻痹,步行停止症状即可改善、消失,最重要的是因为动脉闭塞,这一侧的足背动脉搏动一定减弱或消失。

如何预防治疗间歇性跛行

目前为止,还没有预防椎管狭窄的方法。对轻度的腰椎管狭窄,可以采用短期卧床休息、理疗、针灸、注射等保守治疗。同时,可通过锻炼腰背肌和腹肌的力量使脊柱获得稳定,减轻椎体间和关节突之间的压力。还可以通过腰围等支具以及锻炼减少腰脊柱的前突和过伸状态,保持腰椎前屈的姿势,以减少疼痛。

中重度的椎管狭窄需要通过手术把椎管后侧的椎板、黄韧带以及增生的关节突切除,以使脊髓和马尾神经获得足够的空间。

怎么治疗骨性关节炎引起的腿疼

骨性关节炎是以关节软骨退化、变性、增生为病理特点的关节病变,大多起病隐匿、进展缓慢,最突出的症状是关节酸痛,其特点是:疼痛-缓解-再疼痛,反复发作。清晨起床时疼痛较剧,稍活动后疼痛即缓解,活动过频疼痛又再起,休息后可再度缓解。若处于某位置过久或活动多时,疼痛又起,可听到关节粗糙摩擦声。随年龄增长,症状会逐渐增重,还可影响其他关节部位。

判断骨性关节炎主要依靠X线检查,关节间隙不等宽或狭窄、关节处的骨质疏松、骨质增生或关节膨大乃至变形、软骨下骨板硬化和骨赘形成等,是骨性关节炎的基本特征。

膝关节骨性关节炎引起的腿痛与气候变化有关。寒冷(包括受凉)时腿痛加重,温暖时则缓解,同时患者膝部步行乏力,上下楼时疼痛明显加重。对骨性关节炎,最好早期发现,早期治疗。

早期物理治疗早期骨性关节炎,可以采用物理方法,尤其适用于对药物不能耐受的患者。急性期以止痛、消肿和改善功能为主;慢性期以增强局部血液循环,改善关节功能为主。根据需要可选用热敷、超短波照射、中药离子导入、中药熏蒸、水疗、蜡疗等,对缓解疼痛和伴发的肌肉痉挛,维持及恢复关节功能有一定帮助。

早期锻炼疗法早期锻炼也能达到治疗的目的,首先应通过锻炼减轻体重,多做增强肌肉力量的锻炼,同时避免爬山等运动。但要注意的是,在急性炎症期,应禁止锻炼,少走多坐。待炎症消退后,可选择对关节冲击小的柔和运动,如散步、慢跑、游泳、太极拳等,以改善关节功能、促进康复。

可以使用一些辅助措施,如助行器及拐杖等,还可以穿吸收冲击力的鞋子,使用内低外高的鞋垫和使用膝关节内侧支具,配合适宜的锻炼,可有效控制病情的发展。

晚期防止致残骨关节炎发展到后期可致残,防止骨关节炎致残的主要方法有:

预防扭伤与过劳,调控饮食避免体重过胖,防寒保暖,避免某个关节负担过重的姿势;

在适当休息、合理运动(保持肌力及关节稳定性)基础上进行理疗、按摩(关节肿痛时不宜按摩)、封闭、药物(含中医中药)等治疗;

关节变形时,在身体条件允许的情况下,建议接受人工关节置换手术,提高生活质量。

骨质疏松:仅靠补钙是不够的

有人说,“骨质疏松,补钙就行。”这其实是不对的。患了骨质疏松症,并不是平时多补补钙就行,须根据不同的病因和证型选择合适的治疗药物。

原发性I型骨质疏松症是由于绝经后雌激素减少,使骨吸收增强引起骨量丢失所致,因此应选用骨吸收抑制剂如雌激素、降钙素、钙制剂等药物治疗。原发性II型骨质疏松症其病因是由于年龄老化,导致激素自身调节失衡,使骨形成低下,应选用骨形成促进剂,如活性维生素D、蛋白同化激素(苯丙酸诺龙)、氟化剂和维生素K2等药物治疗。

当然,日常食物补钙可作为骨质疏松症的辅助治疗方法之一。首先以提高膳食中的钙含量为主,若食物中所进钙量不够,则需用含钙制剂补充。但若已形成骨质疏松症,单纯靠多吃含钙食物并不能代替药物治疗。服药期间适当进行户外活动,可增强疗效。

女性绝经后,雌激素水平下降,造成骨质丢失,使骨骼开始变脆,此时采用雌激素替代疗法能防治骨质疏松,降低骨折发生率。因此,雌激素为防止妇女绝经后骨质丢失的首选药物,但单独使用雌激素有可能增加患乳腺癌和子宫内膜癌的机会,故应使用最低有效剂量,并辅以适当的孕激素。使用雌激素治疗的妇女在用药前和用药期间,应定期进行妇科和乳腺检查。

中药治疗,补肾为本

中医把骨质疏松症归属“骨痿、骨枯”范畴,认为其发病是由于肾虚所致。使用补肾法治疗肾虚症可使骨质疏松症状明显改善,骨密度平均值回升,骨钙含量、骨密度等均可得到提高。

中医运用补肾法治疗时分成肾阴虚和肾阳虚两型,并分别用左归丸补肾阴及右归丸加减补肾阳治疗(参见本刊第1025页“经典名方”栏目——编者注),加减补肾药物,如淫羊藿、杜仲、巴戟、续断、紫河车女贞子、旱莲草、泽泻龙骨熟地等(具体药方根据病情在医师指导下服用)。从而调节骨代谢平衡,促进骨生成,提高骨密度,从源头上施治。

合理饮食、适当运动

预防骨质疏松,平时多注意合理饮食、定期运动。

保持均衡饮食确保摄取足够的钙质及维生素D,如高钙低脂的鲜奶及芝士、鱼类及深绿色的菜都是好的选择。根据体质的阴阳偏颇,定期选服补肾之品,在一定程度上能稳定和提高人的性激素水平,间接抑制破骨细胞的骨吸收活动。应戒烟及避免过量饮酒,及时防治全身性代谢性疾病,如高血压、糖尿病、痛风等。

坚持适当运动长期坚持循序渐进的运动,如游泳、保健操、太极拳、散步等,不仅可减缓骨量的丢失,还可明显提高骨盐含量,促进骨细胞的活性。但不宜参加剧烈运动,尤其是引起肌肉过度酸痛的运动。打拳、跳舞时转身、转颈及弯腰动作不宜太猛,避免上下跳。可根据个人的身体状况做一些负重的运动,如爬坡、上楼梯等,帮助建立骨骼的钙质储备。工作、活动或休息时,均不要长时间处于同一体位或姿态,要经常进行动作位置的变换调整。

下肢动脉硬化:老寒腿的病因

冬季将至,很多老年人就开始腰酸、腿疼,“老寒腿”发作。这“老寒腿” 到底是怎么一回事呢?它就是每年随着气温的下降发作的下肢动脉硬化闭塞症。

下肢动脉硬化闭塞症是指动脉硬化斑块在动脉内壁上形成,向血管内增生、突起,随着斑块不断扩大和继发血栓的形成,使血管变得狭窄,血液流速减慢,血流量减少,当狭窄达到一定程度,甚至形成管腔闭塞时,供给下肢的血流量不能满足人体的需要,下肢就会出现慢性或急性缺血症状。

提高警惕,自我检查

一般来说,早期患者可自觉足部、腿部发凉、怕冷,或有轻度的麻木感,走路等活动后容易感到腿部疲劳、沉重无力。

如果病变继续发展,患者通常会出现如下情况:行走时,由于足、腿部缺血缺氧,较易发生小腿肌肉痉挛、疼痛及疲乏无力。必须停止行走,休息片刻后症状有所缓解,才能继续活动。如再行走一段距离,上述症状又重复出现。患者自己可以试着触摸位于足背弓的中点偏内的足背动脉,如果搏动较自己手腕处的正常搏动弱,同时脚出现发凉、苍白等情况时,可初步判断患有下肢动脉硬化。此时应立即到医院做进一步检查,否则会延误治疗时机。

注意饮食,预防病发

日常生活中,通过摄入以下一些食品,可以有效降低血清中胆固醇的浓度,降低动脉硬化斑块发生的可能。

牛奶含有一种因子,可降低血清中胆固醇的浓度,牛奶中还含有大量的钙质,也能减少胆固醇的吸收。

大豆含有一种皂甙物质,可以降低血液中胆固醇的含量。

生姜含有一种含油树脂,具有明显的调节血脂和降胆固醇的作用。

大蒜含挥发性蒜素,可消除积存在血管中的脂肪,具有明显的降低有害血脂的作用。

洋葱在调节血脂,防止动脉粥样硬化和预防心肌梗塞方面有良好的作用。

茄子含有较多的维生素P,能增加毛细血管的弹性,对防治高血压、动脉硬化及脑溢血有一定的作用。

木耳能降低血液中的胆固醇,可减肥和抗癌。

燕麦具有调节血液中胆固醇和甘油三酯的作用,常食可防动脉粥样硬化。

山楂具有加强和调节心肌,增大心脏收缩幅度及冠状动脉血流量的作用,还能调节血清中的胆固醇。

蜜橘多吃可以提高肝脏的解毒能力,加速胆固醇的转化,调节血清胆固醇和降低有害血脂的含量。

注意小细节,避免大麻烦

老年腿痛非常麻烦,但也不是不能预防的。生活中注重一些小的细节,可有效防止腿痛的发生。

情绪平和老年人生活并非都是安逸清闲,那些受情绪影响和过分操劳者,会发生心身疲劳,出现头痛腰酸、四肢痛软、精力不佳、失眠等症状,其中,腰酸腿痛较为明显,这是由于老年人肌肉过久处于紧张状态,新陈代谢加快,代谢物乳酸在血液中浓度升高所致,这就需要老年人调节情绪,减少劳作。

慎穿平底鞋人上了年纪后,足底肌肉和韧带会发生退行性衰老变化,足弓弹性也逐渐丧失,负重能力大大降低。正因为如此,许多老年人在长时间站立或行走后,容易发生足、踝、膝、髋及腰部疼痛。若经常穿平底鞋,就会加速足弓弹性的丧失,更易引起脚和腿部疼痛。

选择合适的座椅老年人由于关节、韧带老化,柔韧性大大下降,长时间地坐低矮凳和沙发,一方面由于极度的屈髋和屈膝,关节面之间的压力增加,使本已退变的关节受损伤而出现疼痛;另一方面起立时由于有明显的姿势和位置的改变,使腰椎之间的关节产生异常活动或使腰部过伸,从而出现腰腿痛。所以老年人适合坐高一点的带靠背的板凳,使髋、膝自然屈曲90度,并上身坐直,同时坐的时间也不宜过长,要适当起来活动一下腿脚和腰部。

注意保暖大多数疼痛喜热不喜冷。绝大多数老年人存在或轻或重的骨性关节炎。热可以增加血液循环,消除炎症,而冷刺激正好相反。所以老年人为减少疼痛的发生,肢体保暖十分重要。在高温天气里,使用空调很容易受到冷的刺激,应特别注意采取防范措施。

预防腿部衰老5

1、以手扶墙或桌子,分别用单足站立10秒钟,左右交替20次。

2、以手扶墙或桌子,抬起脚后跟,然后下蹲5秒钟,使胸部尽量贴近大腿,反复做1520次,注意蹲下起立时动作要慢。

3、扶墙或桌子,用脚跟踢自己的臀部,左右交替2030次。

4、坐在沙发或椅子上,压膝压髋,用双手把持住小腿中上段,使大腿分开、合拢,使髋部尽量外展,做1020次。

5、平卧床上,左腿尽力屈髋屈膝,双手抱住下肢使膝关节尽量贴近同侧肩部,停留35秒钟复原,左右交替,2030次。

老年人体质较弱,抵抗力较差,所以要多补充营养,加强锻炼哦。

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