Pain in the leg behind the knee, thighs, calves: pulling, strong

Pain is one of the most unpleasant symptoms of a variety of diseases. It is he who deprives us of rest, worsens working capacity, paints everything around in gloomy colors. And in order that even the most joyful and sunny day was finally spoiled, it does not necessarily have to hurt your teeth, head or heart. Even not very strong pain behind the leg can knock a person out of the rut, because not only is it terribly unpleasant, so also the thought does not leave, what caused such an unwanted sensation.

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Causes of the back pain

Pain in the legs is not so rare, because this part of the body has the biggest burden that bones, joints and muscles experience. Often it is so difficult to understand exactly what caused the failure.

Non-pathological causes of back pain

In many cases, the cause can not be looked for, it is enough to recall how many kilometers were passed per day. Perhaps the legs with unaccustomed habits are simply tired of a long walk. In principle, the appearance of pain behind the legs can be associated not only with walking, but also with the usual standing in place. Legs often hurt those who have to stand for a long time at work. In this case, it is worthwhile to sit down for a few minutes and lift your legs, as the pain gradually disappears.

Strangely enough, pain in the leg may appear and from sedentary work. In this case, prolonged compression of muscles and nerves is observed, as a result of which there is a muscle spasm, manifestations of which are painful sensations and convulsions. In principle, something like this is experienced by a person who fell under the rubble or someone who, due to severe poisoning or another situation, fell into a coma, and the soft tissues of his body and limbs were under the pressure of his own immobile body for a long time.

Pain in the leg can also appear from a soft tissue injury, which is also unlikely to surprise anyone. The same symptom is accompanied by other leg injuries: wounds, burns, fractures, dislocations, muscle tears, sprain. In this case, pain is a normal physiological response of the body to damage from outside.

Sometimes the cause of the pain are small bruises (bruises), which appeared not from where. Perhaps a person simply did not feel the damage, but it happens that spontaneous hematomas appear and as a result of past injuries.

Legs can ache even from the load exerted on them by their own body. At a normal weight, this phenomenon is not observed. But patients with a large body weight, especially with obesity, quite often complain about a symptom such as pain in the legs.

All of the above mentioned factors are considered risk factors for the appearance of pain at the back of the leg, not associated with a certain pathology of muscles, nerves, vessels, joints, bones, etc. However, the appearance of pain in the hip, knee or shin, having a chronic character, most likely indicates a pathological process in the body.

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Various diseases as a cause of pain in the legs

Vascular pathology. The pain in the back of the foot due to fatigue is hardly a cause for concern, unless it is repeated every day, which is very likely to indicate chronic venereal disease, which we know as varicose veins.

But varicose veins are not the only vascular pathology, in which there are pains in the legs. Chronic arterial insufficiency of the lower extremities is manifested by pains similar to those that a person feels after walking a few kilometers. Only in this case pains appear much earlier or even at night, when a person is in bed.

A possible cause of pain in the legs is thrombophlebitis. With this pathology, an inflammation of the venous wall occurs with the formation of a clot (thrombus) on it, which worsens the permeability of the vessel. This phenomenon can be observed in both superficial venous vessels (with varicose veins) and deep ones. In this case, severe pain in the gastrocnemius of the leg appears when the foot is bent or pressed down on the lower leg.

Painful sensations and edema on the legs may also appear as a result of a violation of lymphatic drainage (lymphostasis).

Inflammation of muscles and ligaments. In this group of pathologies, characterized by pain in the legs behind, include:

• inflammation of the muscle tissue (myositis) and other myopathies (polymyositis, dermatomyositis, etc.),
• inflammatory process in the area of "muscle-tendon" (myoenthesis),
• inflammation of the tissues around the tendon (parathenonitis),
• inflammation in the attachment of tendons to the bones (insertion).

A frequent reason for the development of many pathologies of this plan is a large load on the legs for a long time. However, to contribute to the development of the disease can also be hypothermia, infections, intoxications and other provoking factors. However, some myopathies themselves are a symptom of autoimmune pathologies.

Painful sensations with inflammation of muscles and joints are localized directly in the zone where the inflammatory process is taking place.

Infectious diseases. Pain in the leg muscles and their weakness are often observed in viral pathologies, such as influenza, SARS, etc. However, this symptom is not dangerous and disappears as recovery.

But there are other infectious pathologies, in which the pain in the legs signals the onset of the disease. For example, the pathology caused by streptococcal infection, with an unattractive name "mug." Pain in the leg and headaches in this case appear earlier than the first external manifestations.

In osteomyelitis, which is considered a purulent infection that damages mainly the bone tissue, periosteum and bone marrow, pain in the legs is observed on the 2nd or 3rd day along with swelling of the tissues. The cause of pathology are myco-and pyobacteria.

Diseases of the joints. This is an inflammatory pathology that affects the joints of the upper and lower extremities (arthritis). Pain sensations in the knee and ankle joint can be observed with osteoarthritis, gouty and rheumatoid arthritis. Severe pain occurs during walking or running.

Neuropathies of the lower extremities. Severe pain in different parts of the lower extremity can be caused by neuralgia of the peripheral nerves (usually the lower part of the leg) or osteochondrosis that affects the lumbosacral section (upper part of the leg). Severe pain behind the foot in this case is observed with sudden movements or lifting of the heaviness, intensifying during movement.

Strongest pains in the upper part of the leg can be felt with a lesion of the sciatic nerve.

Other causes of pain in the legs. Pain in the lower extremities, differing in nature and localization, can be experienced in diseases of metabolism. On the pain in the leg muscles complain people who have a violation of water and electrolyte balance. Pain in the legs and feet is considered one of the symptoms of such complications of diabetes as diabetic polyneuropathy. The lack of vitamins and trace elements can cause seizures and traumatic pain in the legs.

Pain in the legs is also noted in tumor processes in the tissues (the pain is localized at the site of the neoplasm, has a constant character, is amplified at night), with flat feet (fatigue, pain and heaviness in the muscles of the legs), joint tuberculosis (pain in the region of large joints of the lower extremities).

In inflammatory processes in subcutaneous fat tissue, nodules are formed in it, which compress the nerve fibers and blood vessels. In the beginning of the disease, muscle pain and tension are observed, the acute course is also characterized by pain in the joints.

Pathogenesis

A wide variety of causes of pathological and non-pathological character that cause pain at the back of the foot does not allow us to determine the general mechanism of the onset of pain. Even the fact that such pains have different character (acute, stitching, pulling, intense, weak, etc.) suggests that the pathogenesis of this symptom should be considered in relation to a specific situation or pathology.

For example, with heavy loads, squeezing and overfatigue, the cause of pain is lactic acid, which ceases to be excreted from the muscles due to circulatory disturbances and tissue hypoxia. In this case, the pain can be as aching, or sharp, pricking.

In injuries of the lower extremities, nerves, vessels, and muscles can be damaged, whose spasm we feel in the form of pain.

In vascular pathologies, we have a place with the damage of blood vessels, which always causes circulatory disturbance and oxygen deficiency in the tissues. In this case, not only the vessels suffer, but also the nerves of the muscle, hence the cramps and pains in the legs.

Neurological diseases are characterized by damage to the nerves, which provide the body with sensitivity. It is clear that any negative impact on nerve fibers will be given pain, localized in the course of their passage.

Inflammatory processes in the muscles and joints are always accompanied by their enlargement and consolidation, because of what they begin to squeeze the nerves passing nearby.

As you can see, in the end everything comes down to nerves. Any irritation of the nerve endings, which are numerous in the limbs, responds with pain. And it does not matter what it is caused by: trauma, hypoxia, mechanical or thermal exposure.

Despite the fact that the pain is a nervous reaction, statistics insist that in most cases the pain behind the leg is associated with vascular pathologies, while both the pains are more painful, not both. On the second place there are lesions of nerves and muscles.

Pain in the legs is more likely to affect adults who have more weight than children, and additional baggage in the form of various health problems. The likelihood of encountering the problem of pain in the lower extremities is higher in people who, due to professional duties, are forced to stand or sit in a single position for a long time.

[3], [4], [5]

Symptoms

Depending on the location and nature of pain, this symptom may indicate a variety of pathologies. It is worth to listen carefully to your feelings, and they will tell you a lot about.

Here, for example,  pain in the leg behind the knee  is one of the most frequent complaints of athletes and people suffering from musculoskeletal pathologies. The reasons for such pain can be a great many, but most often it is associated with either trauma (meniscus damage, sprain, ligament rupture), or with an inflammatory process in the tendon of the knee joint. A separate line is  varicose veins, in which the pain has a pulling or pulsating nature and is not amplified during movement, but in a static position.

Aching in the back of the knee with a high probability indicates an inflammatory process in the joint ( rheumatoid arthritis, arthrosis) or a benign tumor process (Becker cyst). Although sometimes aching pain can cause an ordinary bruise.

Unintentional pulling pain under the knee is also observed in vascular pathologies and  osteochondrosis of the lumbosacral section. But in general, if there is a  pulling pain in the leg from behind, the patient is firstly sent to the neurologist, since this symptom is more typical for neurological pathologies. The pain thus spreads in the direction of movement of the affected nerve.

Sharp pain is characteristic of most serious traumatic pathologies. By the way, when the Becker cyst ruptures, a slight aching pain can also turn into a strong and sharp pain. Acute pain can be a symptom of  meniscus rupture  or radicular syndrome.

In vascular pathologies, pain under the knee is more pronounced when sitting or standing, other pathologies are characterized by the fact that the  pain behind the leg under the knee becomes stronger when walking.

The severe pain at the back of the knee when bending the leg with a high probability indicates that there are some damages to the structure of the joint, stretching of the tendons, microdamaging of the tissues. If the flexion and extension of the leg is accompanied by a crunch, everything indicates a joint dystrophy (arthritis, arthrosis).

The pain in the leg in the thigh at the back is  most often associated with lumbosacral osteochondrosis. Pain spreads along the sciatic nerve (on the back of the thigh), often occurring suddenly. However, one should not forget about the accompanying symptoms.

The pain in the leg in the calf from behind  can be caused by most of the above pathologies. Acute pain in the calf can be observed with ruptures of muscles and ligaments, with fractures. Throbbing pain in the legs is characteristic of varicose veins. When the muscles and ligaments are inflamed, aching pain is noted.

Pain in the leg may not be felt in the calf itself, but above the heel from behind. In this case, we are most likely talking about the result of a negative effect on the Achilles tendon. Such pains are often complained by professional athletes, patients with  flat feet, as well as women who prefer shoes with high heels. However, sometimes pain in the Achilles tendon area can be triggered by wearing tight shoes.

Pain in the left leg behind can be the first sign of a variety of diseases: varicose veins and thrombophlebitis, erysipelas,  inflammation in the sciatic nerve, muscles and tendons of this leg, other peripheral nerve damage (for example, due to problems with the spine). The pain in the left leg may occur due to injuries, wearing uncomfortable shoes, heavy stress on the leg when playing sports or as a result of performing professional duties.

The pain in the right leg behind most often has the same reasons. At the same time, vascular diseases (atherosclerosis of vessels, varicose veins, thrombosis, etc.) stand in the first place. The second position in prevalence is occupied by pathologies of the spine (osteochondrosis in the lumbar region, spondylolysis, spondylitis,  herniated disc, tumor processes of the spinal column). In this case, the pain may be localized either behind or at the side of the leg.

Then there are inflammatory pathologies of muscles and tendons, neuralgia, joint diseases, diabetes mellitus, etc. Strong and prolonged back pain may be a symptom of osteomyelitis or other bone disease.

[6], [7], [8]

Diagnostics of the back pain

If a symptom such as pain behind the foot does not rest for a few days, it is unlikely to be the result of overwork (except when the strong load on the legs is regular), so you need to look for the cause of pain in the body. Most likely the pain is caused by a certain pathology, which a person may not even know about. To clarify the situation in this case, the doctor will help. Another question is which doctor should I seek counseling and help?

To begin with, of course, it is worth to visit a therapist or traumatologist, depending on the alleged cause of the pain. If the pain was preceded by a trauma, the trauma specialist must be visited necessarily. The therapist, in turn, after consulting the patient, studying his complaints and some special studies, will send a consultation to one of the specialists: a neurologist, a rheumatologist, an infectious disease specialist, a surgeon, an oncologist, a vascular surgeon, etc.

In most cases, the first doctor to whom patients apply for help is still a therapist who carefully listens to the patient's complaints, clarifies certain points, conducts a physical examination and assigns diagnostic studies.

Questions that the doctor specifies during the initial admission:

• on what part of the leg behind the pain is felt,
• which preceded the appearance of pain behind the legs,
• what is the nature of pain,
• a symptom is present constantly or only in certain situations,
• whether pain intensifies with bad weather, at night, when walking or bending the leg,
• painful sensations are localized only in the region of one leg or both limbs hurt,
• whether there are any other unusual symptoms (fever, swelling and hyperemia of the tissues, swelling of the veins, pain in other parts of the body).

The doctor examines the diseased limb, conducts her palpation, checks the reflexes and motor activity using tapping and special tests. Also, the patient is prescribed standard blood and urine tests that show the presence of inflammation in the body, give information on blood coagulability and predisposition to thrombosis, and the state of the kidneys (information is important for the safe administration of medications).

Instrumental diagnostics is appointed either by the therapist or by a specialist, to which the therapist sent by a pre-diagnosed diagnosis.

Since the pains at the back of the foot can be caused by a large number of pathologies of a diverse nature, different methods of diagnosis can be used to find the truth using the appropriate equipment:

• Ultrasound of the lower extremities (prescribe with suspicion of vascular pathology, tumor processes), and if necessary, and pelvic organs.
• Radiography of the lower limbs (usually prescribed for injuries and pathologies of the joints) and the spine, depending on the preliminary diagnosis.
• Venous and arteriography, duplex angioscanning are indicated in pathologies of the vascular system.
• MRI will tell you about the condition of not only the vessels, but also cartilage and bones.
• Scintigraphy is prescribed for suspected bone disease.

[9], [10], [11], [12]

Differential diagnosis

Differential diagnostics should be carried out on the basis of examination of the patient by the therapist, the results of laboratory and instrumental studies, the conclusion of doctors of a narrow profile. Alas, often everything is limited to an examination of a therapist and a neurologist, who prescribe many necessary and unnecessary studies, and then put one of the popular preliminary diagnoses: varicosity, arthrosis, osteochondrosis, obliterating atherosclerosis, etc., allowing the patient to be redirected to surgeons.

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Treatment of the back pain

As in diagnosis, and in the treatment of pain behind the foot, there is no general scheme effective for various diseases and conditions. If the pain is caused by tired feet, then the best way to get rid of unpleasant sensations is rest. In this case, the legs are best raised.

You can remove unpleasant symptoms and with the help of various ointments from leg fatigue, which are sold both in pharmacies, and in the departments of cosmetics manufactured goods stores. There are such means among the products of many popular cosmetic brands.

Such treatment will help with non-pathological pain. If this symptom is a sign of a disease, then you need to treat not so much the pain as the disease itself. And here there are no general recommendations.

If we are talking about such a popular leg pathology as varicose veins, then at the initial stage of the disease, the therapy is performed using external means: creams and ointments that have a resolving action (heparin-based drugs), relieve pain and strengthen the vessels ("Venital" , "Troxevasin"), relieve inflammation and swelling ("Voltaren", "Fastum-gel", "Celestoderm, etc.).

For internal administration and injection, drugs that stimulate blood flow and increase vascular walls (Angistax, Detralex), anticoagulants that reduce blood viscosity and prevent the formation of thrombi ("Aspirin", "Venolife"), anti-inflammatory painkillers (Diclofenac, "Indomethacin").

Among the methods of physiotherapy, hydrotherapy, the treatment with leeches, and laser therapy are indicated. It is useful to wear compression linen.

Surgical treatment: phlebectomy and thrombus removal.

Treatment for vein thrombosis is identical to the treatment of varicose veins, but here the focus is more on the use of thrombolytic drugs and drugs that dissolve blood clots, as well as drugs that prevent the emergence of new clots. The addition of infection requires the addition of antibiotics. In addition, bed rest is shown, which reduces the burden on the diseased legs.

At an atherosclerosis of vessels of the bottom extremities the list of medicines, procedures and requirements even more. The main drugs are sequestrants of bile acids ("Kolestipol", "Kvantalan"), statins ("Simvastatin", "Pravastatin"), fibrates ("Clofibrate", "Bezafibrate"), nicotinic acid preparations (vitamin PP). All these drugs reduce blood cholesterol, however, in various ways.

In addition, thrombolytic agents are prescribed, the heart improves peripheral circulation (usually "Pentoxifylline"), anticoagulants, blood thinners, antispasmodics that relieve spasms and pain, vasodilators, drugs that improve trophic tissue. When ulceration occurs, ointments with antibiotics are prescribed.

Surgical treatment: prosthetics, bypass, endarterectomy, stenting.

Patients with atrozes are treated with nonsteroidal (locally and in the form of tablets inside, for example, "Nimesulide", "Ibuprofen") and hormonal (in the form of injections: "Hydrocortisone", "Diprospan", etc.), anti-inflammatory drugs that reduce inflammation and pain. In addition, chondroprotectors ("Alflutop", "Ostenil", "Mukosat", complex drug "Teraflex", etc.), hyaluronic acid preparations are prescribed.

Physiotherapy treatment:

• pain relief - SUF-irradiation, magnetotherapy,
• relief of inflammation - laser therapy, UHF procedures, CMV-therapy.
• Improvement of blood circulation and metabolic processes in the joint - ultrasound, diadynamic therapy, interference therapy, darsonvalization, therapeutic baths (with broths of herbs or bischofite, radon, hydrogen sulphide, gas-mud).

Surgical treatment: arthroscopy, osteotomy, endoprosthetics.

Treatment of myositis, in which one of the main symptoms is leg pain, is an even more complicated process, because this pathology often develops against the background of other diseases. Here they also need to be treated first.

Basic principles and preparations: Pain relief with injections, tablets or ointments (Ketonal, Milgin, Analgin, Voltaren, Diclofenac, Fastum-gel, etc.), relief of pain and inflammation by warming ointments from the NVPS group (Dolobieni, Diprilif, Espol, Diklak-gel) and preparations for oral administration (Nimesulid, Indomethacin, Movalis). In addition, pain in the gastrocnemius muscle can be prescribed for taking anticonvulsants (for example, "Phenazepam"). In purulent processes, antibiotic therapy is indicated.

In parallel with drug therapy, physiotherapeutic treatment (paraffin, amplipulse, electrophoresis), reflexotherapy, and massage is performed.

Osteochondrosis of the lumbosacral spine is treated with NSAIDs for topical application and oral administration (Voltaren, Diclofenac, Indomethacin) and steroid preparations (Prednisolone, Hydrocortisone), venotonicks (Troxevasin, Escuzan ) and muscle relaxants ("Baclofen", "Tizanidine"), chondroprotectors, injections of hyaluronic acid, agents for improving blood circulation and venous outflow ("Pentoxifylline", "Spironolactone").

In addition, reflexotherapy, shock wave therapy, magneto- and laser therapy, masses are carried out. The methods of manual therapy, spinal traction, medicinal electro- and phonophoresis, LFK (at the final stage) are applied.

Surgical treatment: discectomy, supporting spondylodesis, dynamic stabilization of the spinal column, laser nucleotomy, release of spinal roots, subjected to compression by modified or displaced discs.

Pathologies that cause pain at the back of the legs are of different localization and intensity, a great many. Describe the treatment of all in one article does not make sense, especially since, after studying the information about the therapy of some of them, you can notice a certain similarity in the approach to choosing anesthetic drugs that can stop pain in the legs. We will talk about them further.

Medications for pain relief in the legs

Whatever pathology you have, causing pain at the back of your leg, one of the areas of therapy is the removal of pain. And since the pain in the vast majority of cases occurs against the backdrop of the inflammatory process in the muscles, charters, bones, the doctors give preference to drugs with anti-inflammatory and analgesic effects.

"Nimesulide"  is a drug from the category of non-steroidal anti-inflammatory drugs, which also relieve fever and pain. It is shown both with joint pains, and in case of acute pain in muscles. The medicine does not affect the development of the disease, but only helps to remove symptoms such as inflammation and pain.

Take the drug 2 times a day for ½-1 tablet weighing 100 mg. Doing this is desirable after a meal, to reduce the irritant effect of the medicine on the gastrointestinal mucosa. Doctors recommend to do with minimal effective doses.

The drug is not assigned to patients with erosions and ulcerative processes in the GI tract, especially if they are accompanied by bleeding, bronchial asthma, inflammatory bowel pathology, hemophilia and bleeding disorders. Contraindicated drug use in Crohn's disease, polyposis of the nose with frequent relapses, with any bleeding and hypersensitivity to the components of the drug and other NSAIDs.

Doctors are careful not to prescribe the drug for severe liver and kidney disease, especially if their function is impaired, with heart failure in decompensation stage, increased potassium level in the body (hyperkalemia), during pregnancy and after coronary artery bypass grafting. In childhood, you can apply, starting at age 12.

The drug has quite a few side effects. This is increased anxiety and headaches, hyperhidrosis and skin rashes, problems with the urinary system and the risk of bleeding, bronchospasm and visual impairment. Quite often, the digestive tract suffers: dyspepsia, stools, malfunctioning of the liver, jaundice of the skin, pain and bleeding in the stomach and intestines. Sometimes patients complain of lowering pressure and temperature, hot flashes, severe palpitations and weakness.

The drug has a toxic effect on the liver, so it is not desirable to use it simultaneously with other hepatotoxic drugs. As an external agent, the "Nyz" and "Nimulide" ointments with the same active substance are used.

"Diclofenac"  is a popular NSAID, which is prescribed for many pathologies, including those that accompany pain behind the foot. In pharmacies, the medicine can be found in the form of tablets, rectal suppositories, injectable solution, ointment and gel, which can be used to relieve inflammation and pain in the legs.

The method of administration and dose depend on the form of the preparation.

• Pills. They should be taken half an hour before meals, but this is not considered an obligatory requirement. The daily dose for patients over 15 years is 75-150 mg. It is recommended to divide it into 2 or 3 admission. The maintenance dose is 50 mg.
• Solution. Intended for intramuscular injection. A single dose contains 75 mg of active ingredient. The drug should be administered every 12 hours for no more than 2 days, the field of which the patient is transferred to tablets.
• Suppositories. Rectal administration is provided. The daily dose of 100 to 150 mg. It is recommended to administer suppositories 2 or 3 times a day.
• Ointment and gel. The drug is applied to intact skin with light rubbing movements in the amount of 2-4 g. Do this 3 or 4 times a day.

Contraindications to the use of various dosage forms are quite extensive.

Tablets are not prescribed for the same pathologies that are listed in the description of "Nimesulide." When pregnancy is forbidden to take the drug in the third trimester, before the 6-month period, the drug is prescribed in small doses and only as a last resort. Children can take pills from 6 years.

Additional contraindications: impaired digestibility of lactose, excess potassium in the body.

Suppositories have the same contraindications plus proctitis. In childhood they are prescribed from the age of 14 (dosage of 50 mg).

Injection administration is not practiced in patients with exacerbations of erosive and ulcerative gastrointestinal pathologies, hematopoietic disorders, and the development of aspirin asthma. Do not prescribe the drug in solution during pregnancy and breastfeeding. Injection treatment for children has been shown since 15 years.

The use of a gel or ointment is not permitted with aspirin asthma, and in the last 3 months of pregnancy. Children ointments and gels can be prescribed from 6 years. External application of the drug provides for its application on undamaged skin.

Any form of the drug is not used for intolerance of the components of the drug and other NSAIDs.

Among the side effects it is worth mentioning those that are observed most often. These are dizziness and headaches, various complications from the gastrointestinal tract, development of bronchospasm, swelling, skin rash, tinnitus.

The analogue of "Diclofenac" with the same active substance is "Voltaren-gel", which is prescribed to patients from 12 years of age.

"Indomethacin"  is another drug from the NSAID group with an analgesic property, which is prescribed for statutory pains, myalgia and neuralgia, pains in the spine and on the periphery, traumatic lesions with the development of inflammation. The medicine is given in the form of tablets, suppositories, ointment and gel.

Method of administration and dose depending on the form of release:

• Tablets: the initial single dose of 25 mg with a multiplicity of intake of 2 or 3 times a day. In the future, it is possible to increase the dosage to the maximum possible (200 mg per day). You can take the medicine during or after a meal.
• Suppositories: within a day, you can use the suppository 3 times 50 mg or 1 time 100 mg. Maximum of a day - 200 mg for severe pain. Apply the suppository rectally (enter the rectum).
• External means: depending on the content of the main substance, 2-3 (10 percent drugs) or 3-4 times a day (for 5 percent funds) are used. Dosage depends on the affected area (usually the band of the ointment ranges from 4 to 20 cm).

Contraindications to the use of tablets are identical to other NSAIDs. The medicine is not used for congenital heart defects. When pregnancy and breast-feeding, it is also not prescribed. And in pediatrics apply from 14 years.

Suppositories are not used for the same pathologies and conditions. Additional contraindications are hemorrhoids, proctitis, bleeding from the rectum.

External means are not used for wounds, scratches and other damage to the skin. Children can be applied to the skin from 1 year.

Since the 7th month of pregnancy, the use of the drug in any form is prohibited. A single important contraindication for any dosage forms is the intolerance of the constituents of medicines and preparations from the NSAID group.

Like other drugs from this group, Indomethacin is famous for its multiple side effects, which are characteristic of NSAIDs.

All non-steroidal anti-inflammatory drugs have a large number of contraindications and side effects, so it is not recommended to use them without preliminary diagnosis and prescription. If the cause of pain behind the legs is unknown, it is better to use ointments based on natural ingredients, which are now quite a few.

One of these effective means of fatigue and pain in the legs, which are successfully used even with various pathologies of muscles and joints, is the cream of the company Veda Vedika from India with a warming and relaxing effect.

The cream is created on the basis of many useful oils, extracts of medicinal plants and vitamin E. It should be applied to the skin of the legs with light massage movements. A good way to prepare for a therapeutic massage.

Alternative treatment

We mentioned the cream of Indian production, but there are no less useful tools for domestic manufacturers, and even more so for fans of alternative medicine.

Muscular pain behind the foot can be removed with the help of honey compress. He needs only natural honey, which is smeared with sick meta and wrapped up for the night. In the afternoon, they again lubricate their feet with honey and wrap up with a bandage.

Articular pain can be treated with a composition based on apple cider vinegar (1 tablespoon), turpentine (1 tsp) and eggs (1 yolk).

With joint and muscle pain, a medicine based on aloe juice and essential oils is helpful. For its preparation, the oils of menthol and eucalyptus, cloves and camphor are taken. They can be used one at a time, but it is better to mix them. Aloe juice and a mixture of oils are taken in equal proportions, and this composition is applied by massage movements to the feet 2-3 times a day. After the procedure, the feet should be warmly wrapped.

Some experts in alternative medicine advise as a medicine for pain in the legs to use a black radish, which must be rubbed and applied to the skin in the form of compresses.

It is popular with leg pain and herbal treatment. With pain in the joints, drinking of tea from the sea buckthorn leaves is shown (1 tablespoon per 1 tbsp water, boil 10 minutes, drink for 2 meals). Also, with the pain caused by arthritis, it is useful to take infusion of tansy (raw materials and water are taken in the same proportions, insist 2 hours, take 2 or 3 times a day for 1 tablespoon).

In vascular pathologies, grasses will also be useful. For example, to a sore spot you can tidy up fresh leaves of a plant of mother and stepmother or ordinary cabbage for the night. And with varicose can be taken inside dried and crushed dandelion root.

It is said that the alcoholic tincture of horse chestnut fruit (50 g of raw materials per ½ liter of alcohol, insist for 14 days) also has a good effect in vascular pathologies. Take the medicine inside with water or use as rubbing. The daily dose is from 30 to 40 drops.

With pains in the muscles, the herb of the jellyfish (2 tablespoons of raw material per 1 tbsp boiling water, insist 4 hours, drink for 2 times during the day) has proved well.

Useful for pain behind the legs and baths, which are prepared using sea salt, pine needles, mint, plantain, mother and stepmother. The procedure is carried out for 15 minutes, after which the legs should be wrapped.

[16],

Homeopathy

There is a certain part of people who trust not traditional or alternative treatment, but homeopathy, which is considered therapy, the most safe for the body. They can be understood, because homeopathic drugs have virtually no contraindications and side effects. In addition, homeopathy is able to help in virtually all diseases in which medical treatment is indicated.

It also helps if a person is suffering from pain at the back of the leg, provoked by exhaustion of the limb or exposure to unfavorable weather factors that cause exacerbations of chronic pathologies of the musculoskeletal system. Here are some indicative drugs in this regard.

Aconite  is a homeopathic drug that is prescribed if pains in the legs occur during hypothermia, and also if they develop against a background of nervous tension or colds. An important point is the increased pain at night and in a supine position, and its decline in rest. Helps with muscular and joint pain.

Arnica  is a homeopathic remedy used for pain in muscles and stretchings caused by a heavy load. Such a moment is indicative: pains become stronger from touching, any limb movement, cold effects, and decrease in lying position. In this case, the pain is felt mainly in the evenings and at night, accompanied by a violation of the mobility of the foot, a decrease in its sensitivity and the appearance of "goose bumps" in the body.

Rus toxicodendron  is a medicine used in homeopathy for pain in muscles and joints. Especially revealing is its use in the defeat of tendons and ligaments. Assign with severe pain in the Achilles tendon, along the sciatic nerve in the thigh, etc. An important point: pain intensification at the beginning of movement and at rest, with flexion or strain of the leg during ascent or descent, the pain goes away when walking and changing the position, lying down and under the influence of massage and heat. Pain is felt stronger at night and in the evening, and also in bad weather.

Ruta  is another preparation of homeopathy, which has a positive effect on tendons and relieves neurologic pain. Shown and with bruises. An important point: the pain is aggravated from the strain of the foot, as well as when in dampness and cold, they decrease during movement and change of position. An additional symptom is the numbness of the foot.

All drugs are recommended for use in 6 dilutions, after consulting with a homeopath physician about the dosage and reception characteristics.

Complications and consequences

Considering this question, it is necessary to understand that in itself the pain behind the leg, no matter how strong it is, carries no danger in itself. Pain is only a symptom, a signal of distress, a consequence of the impact of negative factors on the muscles, tendons of the joints, bones, skin of the legs. But do not listen to it, because this feeling can hide dangerous pathologies.

So vascular pathologies are dangerous circulatory disorders, leading to tissue hypoxia, resulting in various organs can malfunction. In addition, frequent complications of pathologies of the arteries and veins are ulcers on the skin and gangrene, entailing an amputation of the lower limb.

Vein thrombosis is dangerous because of the risk of a thrombus rupture and its progression with the blood to the lungs, resulting in such a life-threatening condition as pulmonary thromboembolism.

Inflammatory processes in the muscle and ligamentous area in the absence of treatment will continue to spread, and the tissues undergo negative changes leading to atrophy.

Pathologies of the spine accompanied by pain in the legs, in the absence of appropriate treatment, lead to equally sad consequences: a deterioration in the quality of life, a decrease in working capacity, a violation of the internal organs (stool and urinary disorders, erectile dysfunction and prostatitis in men, inflammation of the uterus and ovaries in women) due to a decrease in the sensitivity of the pelvic department, disability.

Even wearing uncomfortable shoes can have its unpleasant consequences in the form of a heavy load on the spine, pouring out into various pathologies of the spine, accompanied by pain in the legs, back and waist.

Without consequences, except passing pains caused by fatigue of the feet, and if the situation will not have regular repetitions.

[17], [18], [19], [20], [21], [22],

Prevention

Prevention of pain at the back of the foot is, first of all, a careful attitude towards one's body. Realizing that the main load always falls on the lower limbs, you need as soon as possible to facilitate their work. To do this, you must follow certain rules:

• Be sure to monitor your weight, because every extra kilogram increases the risk of pathology, accompanied by pain in the legs. People with more weight complain of such pain more often than those whose weight is approaching the norm.
• Try not to overstraight your legs during a long walk, periodically taking breaks for rest.
• If the work is associated with a long stay on your feet, you need to find the opportunity to give your feet rest during the day.
• If your legs are tired, you need to sit down or lie down so that they are on a hill.
• If possible, try not to raise more serious weight. It is better to go 2 times than to transfer weight of 50 kg or more. People engaged in heavy physical labor suffer from pain in the legs much more often.
• Sitting work can also provoke pain in the thigh due to its contraction and blood circulation disorders for a long time, so you need to periodically get up, stretch your legs, massage the back of your thigh, which takes up all the load.
• If, in spite of everything, the legs are still tired for the day, in the evening they need to be pampered: make a bath with salt or mint, rub your feet with a cream that helps with fatigue and pain, massage and rest.
• Nutrition is worth paying attention not only to excess weight, but also in the sense that the use of certain foods, increases the level of cholesterol in the blood, which subsequently results in arteriosclerosis of the vessels.
• With increased blood viscosity and a tendency to thrombosis, it is necessary to take blood-thinning medications to prevent the formation of thrombi.
• The best way to prevent the appearance of pain in the legs with various pathologies, is to treat the beginning of the disease in time, not allowing them to move into a chronic form.
• The least pain in the legs and other parts of the body threatens those who lead a healthy and active lifestyle, abandoning hypodynamia and bad habits.
• To improve the functioning of the bone, muscle, cartilaginous, nervous and other tissues of the body, it is recommended to drink vitamins or vitamin-mineral complexes that will support the normal functioning of all parts of the body during a vitamin deficiency period, as well as in the absence of a rational diet.

[23], [24], [25], [26], [27],

Forecast

Pain in the legs, caused by individual cases of fatigue, do not cause anxiety and usually go away without a trace after the feet have rested. The prognosis of pathologies, in which one of the symptoms is pain at the back of the foot, depends entirely on the severity of the disease and the accuracy of the procedures prescribed by the doctor. In most cases, these are chronic pathologies, and their treatment is aimed at preventing relapses about their characteristic symptoms, including pain in the legs.

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