Chilliness of the legs occurs with hypothermia, arterial hypotension and vegetative-vascular dystonia, protein-energy deficiency. The symptom is observed in polyneuropathies, vascular pathologies: obliterating endarteritis and atherosclerosis, chronic venous insufficiency. Diagnosis of the causes of chilliness includes ultrasound of the veins of the legs, radiological methods (arteriography, phlebography, CT), electrophysiological studies (ECG, ENMG). To relieve discomfort, warming is carried out, etiopathogenetic drugs are prescribed, and physiotherapeutic methods are selected.
A decrease in body temperature to 35 ° C and below causes chilliness of the distal parts of the legs and arms. The symptom is due to increased heat loss, when the own mechanisms of heat production cannot cope with maintaining equilibrium. With hypothermia, a person feels severe cold, tingling or numbness of the lower extremities. The situation is aggravated if tight, uncomfortable shoes are worn, which impairs blood circulation in the tissues of the feet.
Feet begin to freeze more than usual if a person follows a low-calorie diet for a long time, lacks vitamins and minerals. Alimentary deficiency is supplemented by metabolic and heat transfer disorders, which leads to chilliness of the lower extremities. Most often, symptoms are detected in those suffering from deficiency anemia - a decrease in hemoglobin levels impairs the flow of oxygen to the legs, which causes discomfort.
A typical pathological cause of chilliness is atherosclerosis obliterans. Lipid plaques spread from large vessels to peripheral arteries and impair blood flow in them, which is accompanied by trophic disorders. Feet constantly cold to the touch, hardly warmed up in a hot bath or with a heating pad. The skin on the legs and feet becomes pale, dry, thinned. The clinical picture mainly develops in the elderly.
The above symptoms, found in people of young and middle age, are more characteristic of obliterating endarteritis. A distinctive feature of the disease is the spread of changes from the distal parts of the limb to the hips. Patients also feel constantly chilly, their feet are very cold outside in cold weather, even if warm socks and suitable shoes are worn. The sensitivity of the feet decreases, periodically there are tingling and paresthesia.
Chilliness of the legs
Chilliness of the legs, combined with increased fatigue and heaviness in the limbs, are typical signs of venous outflow disorders. Patients notice that the feet feel cold to the touch, even when the room is hot. There is a periodic tingling, crawling, numbness. The skin of the legs becomes pale or cyanotic, swelling is noted. In the later stages of CVI, trophic ulcers are formed.
With reduced blood pressure, blood circulates worse throughout the body, so moderate ischemia of the distal parts of the lower extremities is possible. Patients with hypotension do not tolerate cold well, freeze faster and feel chilly, so they do not like long walks in winter. Despite wearing insulated shoes, the feet remain cold, and after entering a warm room, they do not warm up for a long time.
The defeat of the peripheral nerves is accompanied by impaired perception of heat and cold, so chilliness worries patients constantly. A variety of uncomfortable sensations are possible: tingling in the legs, heaviness, increased fatigue. Chilliness first occurs in the feet in the form of "socks", spreading proximally. If the motor nerve fibers are affected, changes in gait, paresis and paralysis of the legs are noticeable.
Examination of a patient with complaints of chilliness of the legs is started by a family doctor (therapist), who, if necessary, connects highly specialized specialists to the diagnostic search - vascular surgeons, neurologists, endocrinologists. Physical examination assesses the color and temperature of the extremities, reveals signs of venous congestion or ischemia. For diagnostic purposes, the following instrumental and laboratory research methods are used:
Vascular surgeon consultation
If chilliness occurs against the background of banal hypothermia, the person needs to be warmed as soon as possible. With a mild degree of hypothermia, warm drinks, baths, heating pads are used. Raise the temperature gradually. With superficial frostbite, warming bandages are applied to the legs. With moderate and severe hypothermia, the patient requires comprehensive medical care.
To correct vegetative-vascular dysfunction or physiological hypotension, non-drug measures are sufficient. Patients experiencing chilliness are advised to normalize the mode of work and rest, walk more in the fresh air, and start dosed workouts in the gym. It is recommended to limit TV viewing and surfing social networks. A balanced diet with a high content of vitamins helps to improve well-being.
Medicines are selected taking into account the etiological factors of chilly legs. In case of arterial circulation disorders, infusions of saline solutions and antiplatelet agents, which prevent erythrocytes from sticking together and increase blood fluidity, show a good effect. For the prevention of thrombosis, anticoagulants are included in the therapy. Expansion of peripheral vessels and improvement of blood flow is achieved by taking antispasmodics.
With obliterating atherosclerosis, which causes chilliness of the legs, lipid-lowering drugs are effective, which reduce cholesterol and LDL levels, and prevent the appearance of new lipid plaques. With endarteritis, pathogenetic treatment includes anti-inflammatory drugs and corticosteroids, which neutralize pathological changes in the vascular wall.
With insufficient venous outflow, phlebotropic agents are used in combination with elastic compression. To act on trophic ulcers, local effects are shown in the form of creams or ointments. Patients with polyneuropathy are recommended B vitamins, which improve neuromuscular transmission. The therapeutic regimen is supplemented with neurotrophic drugs.
To eliminate chilliness associated with obliteration of the vessels of the legs, physiotherapy is used: electrophoresis with medicinal solutions, ozocerite applications, diadynamic currents. Hyperbaric oxygen therapy helps to improve the supply of oxygen to tissues. General strengthening balneological procedures are actively prescribed: coniferous, pearl or radon baths.
Patients with obliterating atherosclerosis perform surgical techniques for revascularization of the lower extremities. In vascular surgery, the following are used: dilatation and stenting of affected arteries, endarterectomy and thromboembolectomy, replacement of vessels with synthetic prostheses. In the treatment of CVI, phlebectomy is used. To relieve the pathological spasm characteristic of endarteritis, a lumbar sympathectomy is performed.