Leg numbness is observed with neuropathies, dorsopathy, traumatic and non-traumatic lesions of the spinal cord and brain, diseases of the arteries and veins, hypovitaminosis, vegetative-vascular dystonia, and mental disorders. It can be temporary or permanent, spread throughout the limb or cover a specific area. Often combined with a feeling of "crawling", muscle weakness. To determine the cause of numbness, a survey, general and neurological examination, ultrasound, electrophysiological, laboratory studies are carried out. In the course of treatment, NSAIDs, vitamins, vasodilators and painkillers, physiotherapy are used.
Short-term numbness of the leg occurs when the vessels are compressed against the background of an uncomfortable position of the limb. In professions associated with prolonged standing and walking, a slight numbness of the feet and legs appears by the end of the day, due to overwork. The symptom is combined with pain, heaviness, bursting. It comes to light at hairdressers, sellers, waiters.
In patients with mononeuropathies, one limb is involved in the pathological process. The localization and prevalence of the zone of numbness in neuropathy are determined by the affected nerve trunk:
Extensive sensory disturbances are detected in patients with lumbar and sacral plexitis. The area of numbness may vary depending on the primary lesion of certain nerves. With the predominance of disorders at the level of the lower back, hypesthesia is detected mainly along the front surface of the leg, at the level of the sacrum - along the back.
In polyneuropathy, a decrease in sensitivity is often preceded by paresthesia and hyperesthesia. Numbness covers both legs like "socks", gradually spreading in the proximal direction. It is associated with muscle atrophy, changes in gait. Common variants of the disease are alcoholic and inflammatory polyneuropathy (including CIDP), neuropathy of pregnant women.
People with insufficiency of the functions of internal organs develop metabolic neuropathies. Pathology is detected in lesions of the liver, kidneys, severe diabetes mellitus. In addition, multiple nerve damage occurs in systemic vasculitis, neuroAIDS, neuroacanthocytosis, and other diseases.
Lumbar dorsopathy is a heterogeneous group of diseases of the spine and surrounding tissues, accompanied by numbness, weakness in the legs, cramps, constant or periodic pain in the lower back, radiating to the lower limb. Hypesthesia is due to radicular syndrome, myelopathy. It is observed in the following cases:
Pathology is accompanied by numbness, itching, paresthesia, bouts of involuntary motor activity. Symptoms decrease or disappear with movement, worse at rest, especially at night. Both legs are involved, and an asymmetric lesion is less common. Numbness first occurs in the lower legs. Subsequently, hypoesthesia, other uncomfortable sensations spread to the feet and hips.
Damage to the pathways or the corresponding centers in the brain leads to numbness in one or both legs. The symptom is detected in diseases such as:
The most serious cause of leg numbness is spinal cord injury. Hypesthesia or complete loss of sensitivity is combined with paresis, paralysis. The reason for the violation of the integrity of the peripheral nerve is the wound of the buttocks, thighs, and lower legs. Damage to bone fragments in fractures is rare. The zone of numbness coincides with that of the mononeuropathy of the corresponding nerve.
With positional compression syndrome, a rapid increase in edema, and some other conditions, myofascial compartment syndrome may develop, accompanied by intense pain and subsequent numbness of the leg distal to the injury site. The cause of numbness after the application of gypsum is the increase in swelling. To prevent complications, a dissection of the bandage is required.
With obliterating diseases of peripheral arteries (endarteritis, thromboangiitis, peripheral atherosclerosis), Menckeberg's arteriosclerosis, numbness is localized mainly in the feet. Atherosclerosis of the abdominal aortic bifurcation is characterized by widespread hypoesthesia of the legs, swelling of the feet, and trophic disorders.
Acute arterial occlusion due to obliterating pathologies, some other diseases of the cardiovascular system is manifested by sudden numbness, pain, paresis, in the absence of treatment - necrosis of the distal limbs. Pain, cramps, numbness in the legs at night are detected with subcompensated and decompensated varicose veins, occur against the background of chronic venous insufficiency.
Temporary or permanent numbness of the legs can be observed with the following pathologies:
Ultrasound of the vessels of the lower extremities
The nature of the pathology that causes leg numbness is established by neurologists. Patients with vascular lesions require consultation with a phlebologist or vascular surgeon. The specialist finds out the history of the disease, evaluates the appearance of the lower limb, determines the pulsation in the arteries, reveals edema, signs of inflammation, and trophic disorders.
Neurological examination involves the determination of reflexes, sensitivity, muscle strength. The program of additional examination may include the following procedures:
With numbness of the legs against the background of overload, vascular diseases, it is recommended to limit the length of stay on the legs, take regular breaks, wear comfortable shoes, and avoid hypothermia. Patients with radicular syndrome are advised to reduce the load on the back, use painkillers and local warming agents.
In case of traumatic injuries, immobilization is required, sometimes bandaging, anesthesia. Signs of circulatory disorders in the spinal cord or brain are an indication for the immediate call of an ambulance.
With polyneuropathies, treatment of the underlying pathology is required. Patients with neuropathies, plexitis, radicular syndrome are prescribed anti-inflammatory, vasodilator, painkillers, vitamins. Persistent pain syndrome, not relieved by analgesics, is an indication for therapeutic blockade. Patients are referred for physiotherapy, massage, exercise therapy, manual therapy, acupuncture.
The program for the treatment of vascular pathologies includes antispasmodics, antithrombotic therapy, vitamin therapy. Acute occlusion is eliminated with the use of anticoagulants and thrombolytics. With severe pain, blockades are performed. As part of physiotherapy treatment, ozone therapy is performed. ILBI, hyperbaric oxygenation. A good effect provides hydrotherapy.
In pathologies accompanied by leg numbness, interventions such as: