Chen Laobo is a veteran, the body has been very good, but just a year ago, legs began to be not good. It's strange, Chen's legs are not red or swollen, sitting, squatting, riding a bicycle are no problem, but standing or walking can last up to 10 minutes, need to squat down to rest for a few moments in order to continue to walk, and can only sleep at night bending feet. The first thing you need to do is to get your hands on some of the most popular products and services in the world, and you'll be able to do it all at the same time.
Many older people have a similar experience with the old man Chen, usually stand for a period of time or walk a distance, the back of the waist and back "sinking feeling", bilateral calf swelling, can not continue to stand or walk. You need to squat down or lean forward to rest for a while before you can continue walking. The shortest continuous walking can only dozens of meters or stand a few minutes, seriously affecting the work and life.
This condition is called "intermittent claudication" in medicine. The cause of intermittent claudication can be due to lumbar lumbar spinal canal nerve compression, but also due to vascular disease of the lower limbs, clinically categorized into neurological intermittent claudication and vascular intermittent claudication.
Intermittent neurologic claudication
If the spinal canal is compared to a house, the cause of intermittent neurologic claudication is no more than two reasons, either the vertebral canal, the "room" becomes smaller, or "room" within the things more.
The "room" becomes smaller as we age, the discs in front of the spinal canal become bulging after dehydration and degeneration, and even protrude from the front into the spinal canal, and the ligamentum flavum and the small joint capsule proliferate and hypertrophy at the back, while the small joints also proliferate and hypertrophy like fists, and press into the spinal canal from the back and the side. There is also a type of spinal stenosis that arises from spinal deformities, commonly instability or even significant slippage between vertebrae, which distorts or turns the continuous smooth spinal canal.
Most rarely, "intracellular debris" is neoplastic, with primary or metastatic tumors of the vertebral bones growing into the spinal canal, or tumors growing in the spinal cord or cauda equina itself, or metastatic tumors in the spinal canal occupying the spinal canal.
Vascular intermittent claudication
Vascular intermittent claudication is somewhat similar to neurologic intermittent claudication, but they are two completely different diseases. The former belongs to the vascular surgery disease, and the latter belongs to the orthopedic category. As both develop in old age, spinal and vascular changes can exist at the same time, so the onset of similar performance, not easy to distinguish.
The pain in patients with intermittent vascular claudication is more related to movement than to changes in spinal posture. Symptoms Symptoms occur unilaterally, accompanied by a cold sensation, usually without sensory paralysis, walking stops the symptoms can be improved, disappeared, the most important because of the arterial occlusion, the dorsalis pedis arterial pulsation of this side of the foot must have been weakened or disappeared.
Prevention and treatment of intermittent claudication
So far, there is no way to prevent spinal stenosis. For mild lumbar spinal stenosis, it can be treated conservatively with short-term bed rest, physical therapy, acupuncture, injections, etc. At the same time, it can be treated by exercising the lumbar back muscles. At the same time, the spine can be stabilized by exercising the strength of the lumbar back muscles and abdominal muscles to reduce the pressure between the vertebrae and the articular processes. It is also possible to reduce the anterior protrusion and hyperextension of the lumbar spine and maintain the posture of lumbar spine forward flexion through the support devices such as lumbar circumference and exercise to reduce pain.
Moderate to severe spinal stenosis requires surgery to remove the lamina, ligamentum flavum, and hyperplastic articular eminences on the posterior side of the spinal canal to allow adequate space for the spinal cord and cauda equina.
Osteoarthritis: a recurring problem
Osteoarthritis is a joint disease characterized by degeneration, degeneration, and hyperplasia of the articular cartilage, most of which are insidious in onset and slow in progression, with the most prominent symptom being joint pain, which is characterized by recurring episodes of pain-relief-again pain. The pain is more intense when waking up in the morning, and then relieved after a little activity, and then reappears again after too much activity, and can be relieved again after resting. The pain comes back after too much activity and can be relieved again after rest. If the patient is in a certain position for a long time or when there is a lot of activity, the pain will come back and the sound of rough friction of the joint can be heard. With age, the symptoms will gradually increase, but also affect other joints.
The judgment of osteoarthritis mainly relies on X-ray examination. Unequal width or narrowing of the joint space, osteoporosis, osteomalacia or joint enlargement or even deformation of the joints, sclerosis of the subchondral bone plate and the formation of bony cumbersome bones, etc., are the basic features of osteoarthritis.
The leg pain caused by osteoarthritis of the knee is related to climate change. Leg pain is aggravated when it is cold (including chilled) and relieved when it is warm, while the patient has weakness in walking on the knee, and the pain is significantly aggravated when walking up and down stairs. For osteoarthritis, it is best to detect it early and treat it early.
Early physical therapy for early osteoarthritis, physical methods can be used, especially for patients who can not tolerate drugs. In the acute stage, the main focus is to relieve pain, reduce swelling and improve function; in the chronic stage, the main focus is to enhance local blood circulation and improve joint function. Hot compresses, ultra-short wave irradiation, Chinese herbal medicine Ion introduction, Chinese medicine fumigation, hydrotherapy, wax therapy, etc. can be used according to the needs, which can help to relieve the pain and accompanying muscle spasms, and to maintain and restore the function of the joints.
Early exercise therapy early exercise can also achieve the purpose of treatment, first of all, should be through exercise to reduce weight, do more to enhance muscle strength exercise, while avoiding mountain climbing and other sports. However, it should be noted that in the acute inflammation period, exercise should be prohibited, less walking and sitting. After the inflammation subsides, you can choose gentle exercise with little impact on the joints, such as walking, jogging, swimming, tai chi, etc., to improve joint function and promote recovery.
Some assistive measures can be used, such as walking aids and crutches, etc. You can also wear shoes that absorb impact, use insoles that are low on the inside and high on the outside, and use medial knee braces, along with appropriate exercise, which can effectively control the progression of the disease.
Prevention of disability in the late stage Osteoarthritis can cause disability in the late stage of development. The main ways to prevent disability from osteoarthritis are:
Prevention of sprains and overwork, diet control, avoiding overweight, preventing cold and keeping warm, avoiding postures that overburden certain joints;
Physiotherapy, massage (massage is not recommended when the joints are swollen), sealing, medication, and other treatment based on proper rest and reasonable exercise (to maintain muscle strength and joint stability).
On the basis of appropriate rest and reasonable exercise (to maintain muscle and joint stability), physiotherapy, massage (massage is not suitable for swollen and painful joints), sealing, drugs (including Chinese medicine) and other treatments;
In the case of deformation of the joints, it is recommended to undergo artificial joint replacement surgery to improve the quality of life when the physical conditions allow.
Osteoporosis: Calcium supplementation is not enough
Some people say, "Osteoporosis, calcium supplementation can be." This is actually not true. This is actually not true. The first thing you need to do is to make sure that you have a good understanding of what is going on in your life, and that you have a good understanding of what is going on in your life, and that you have a good understanding of what is going on in your life.
Primary type I osteoporosis is due to postmenopausal estrogen reduction, bone resorption enhancement caused by bone loss, therefore, should be selected with bone resorption inhibitors, such as estrogen, calcitonin, calcium and other drug therapy.
The cause of primary type II osteoporosis is due to ageing, resulting in an imbalance of hormone self-regulation, so that bone formation is low, and should be treated with bone formation enhancers, such as active vitamin D, anabolic hormone (nandrolone phenylpropionate), fluoride, and vitamin K2 and other drugs.
Of course, daily food calcium supplementation can be used as an adjunctive treatment for osteoporosis. First of all, to increase the dietary calcium content, if the amount of calcium in the food is not enough, it is necessary to supplement with calcium-containing preparations. However, if osteoporosis has already developed, eating calcium-containing foods alone cannot replace medication. The most important thing to remember is that you should be able to go outdoors when you are taking the medication, and you should be able to do that when you are on the road.
After menopause, the level of estrogen decreases, resulting in bone loss, so that the bones begin to become brittle, and at this time the use of estrogen replacement therapy can prevent osteoporosis and reduce the incidence of fracture. Therefore, estrogen is the drug of choice for preventing bone loss in postmenopausal women, but the use of estrogen alone may increase the chances of breast cancer and endometrial cancer, so it should be used at the lowest effective dose and supplemented with appropriate progesterone. Women treated with estrogen should have regular gynecological and breast examinations before and during treatment.
Chinese medicine treatment, tonifying the kidney as the basis
Chinese medicine puts osteoporosis in the category of "bone impotence, bone wither", and believes that its onset is due to kidney deficiency. The use of tonic kidney method of treatment of kidney deficiency can make the symptoms of osteoporosis significantly improved, the average value of bone density rebound, bone calcium content, bone density can be improved.
The Chinese medicine treatment of kidney tonic method is divided into two types: kidney yin deficiency and kidney yang deficiency, and respectively use Zuo Gui Pill to tonify kidney yin and Right Gui Pill to tonify kidney yang with addition or subtraction (see the "classic prescription" column on page 25 of issue 10 of the journal - editor's note), and addition or subtraction of drugs to tonify the kidneys. Drugs, such as Epimedium, Cortex Eucommiae, Morinda Citrifoliae, Zihechuan, Chasteberry, Araliaceae, Zedoariae, Longzhi, Radix Rehmanniae, and so on (specific prescriptions according to the condition of the physician's guidance to take). This will regulate the balance of bone metabolism, promote bone production, improve bone density, and provide treatment from the source.
Reasonable diet and proper exercise
To prevent osteoporosis, pay more attention to reasonable diet and regular exercise.
Maintaining a balanced diet ensures adequate intake of calcium and vitamin D, such as high-calcium, low-fat milk and cheese, fish and dark green vegetables are good choices. Regularly take kidney tonic according to the Yin and Yang bias of the body, which to a certain extent can stabilize and increase the level of sex hormones and indirectly inhibit the bone resorption activities of osteoclasts. You should quit smoking and avoid excessive alcohol consumption, and timely prevention and treatment of systemic metabolic diseases, such as hypertension, diabetes, gout and so on.
Adhering to appropriate exercise and long-term adherence to progressive exercise, such as swimming, health exercises, tai chi, walking, etc., not only can slow down the loss of bone mass, but also significantly increase the content of bone salts, and promote osteoclasts activity. However, it is not advisable to participate in strenuous exercise, especially exercise that causes excessive muscle pain. Turning, turning the neck and bending should not be too violent when playing boxing or dancing, and avoid jumping up and down. Weight-bearing exercises, such as climbing slopes and stairs, can be done according to your physical condition to help build up calcium reserves in your bones. When working, moving or resting, don't stay in the same position or posture for a long time, and often change the position of the movement to adjust.