About the disease
Stroke – translated means “strike, attack”, “paralysis” – an acute disturbance of blood circulation in the brain. The disease develops suddenly (from a few minutes to 1-2 days), manifests itself against the background of overexertion.
Reference. The first descriptions of the disease were made by Hippocrates back in 460 BC.
There are three types of disease:
- Ischemic stroke (up to 75–85% of cases), affects people over 60 years of age;
- Hemorrhagic stroke (up to 20%) occurs in people with hypertension aged 40–60 years;
- Subarachnoid hemorrhage (up to 5%) – rupture of an aneurysm, brain injury.
Important! Every 1-2 minutes, someone in Russia develops a stroke. Up to 80% of stroke survivors become disabled, 20–30% of them require constant care.
How to relieve swelling after a bruise
Treatment for a leg bruise usually comes down to eliminating pain and swelling. The swelling in this case is caused by damage to the blood vessels and the accumulation of fluid from them under the skin. The latter puts pressure on the nerve endings, hence the pain. So eliminating swelling also helps to get rid of unpleasant sensations.
You can help a bruised limb at home:
- stretch and provide peace;
- apply a wet towel, ice or a heating pad with cold water;
- apply a tight bandage.
You can also resort to drug treatment. External agents containing troxerutin or heparin will help. They strengthen capillaries, optimize blood viscosity and relieve inflammation.
Why do limbs swell?
A stroke is a powerful blow to the left and right hemispheres of the brain, disabling not only the central nervous system, but the functioning of the entire organism as a whole.
If the cerebellum and right hemisphere, which is responsible for the physical functions of the body, are damaged, the patient experiences convulsions, swelling, numbness, sensitivity is lost, and paralysis of the limbs is possible.
This is why patients often complain that their legs are swollen.
This disease is terrible precisely because of its consequences - the functioning of the kidneys, heart, and genitourinary system is disrupted. Swelling of the legs (failure of fluid exchange) is a consequence of these disorders.
Important! Swelling of the legs appears within 1-2 hours after a stroke; emergency medical assistance is necessary to prevent a recurrence of the crisis.
Next we will tell you the specific reasons for the violation.
Heart failure
As a result of unstable heart function, limited blood supply to the legs or arms occurs. After a stroke, the heart muscle cannot cope with the volume of blood, and stagnation occurs. Reason: when the right side is affected, the blood, overflowing the veins, penetrates the tissues of the arms, legs and liver.
Varicose veins
After a stroke, the functioning of the entire circulatory system is disrupted - the vessels dilate, the walls fill with blood, become thin, as a result, the legs swell and greatly increase in size.
It is important to prevent the formation of blood clots by increasing the tone of the vessel walls and improving blood flow.
Thrombosis
After a stroke, with temporary paralysis, the patient practically does not move, and is always in a supine position. The blood stagnates and becomes thick not only in small capillaries, but also in the deep veins of the legs and arms. The cells “starve”, the limbs go numb, severe swelling occurs, accompanied by pain and bluish skin. People with varicose veins and other vascular diseases are especially at risk for thrombosis.
It is impossible to cure thrombosis on your own with massage or special exercises; urgent surgery is required (removal of a blood clot or installation of special filter devices that “catch” clots).
Kidney complications
After a stroke, the water balance is disrupted, the body can accumulate water, and dehydration is also possible. A distinctive sign is that not only the legs and arms swell, but also the face. The swelling is pale, warm, soft to the touch.
Possible necrosis and kidney failure; Inpatient treatment, special medications, and massage are required. Kidney prevention is very important.
When paralyzed
After a stroke, temporary immobilization of the right or left side is possible (sensitivity and muscle tone are impaired).
In this case, swelling of the paralyzed leg is a common occurrence.
Reasons why a paralyzed leg swells:
- Clamping of large vessels. When paralyzed, a person does not feel discomfort, cannot roll over, or change body position. And if a bedridden patient lies in one position for a long time, the vascular system is pinched, blood circulation is disrupted, and swelling appears.
- Stagnation of venous blood and lymph. The hanging position of the foot or hand is unacceptable - blood stagnates in the paralyzed limbs. The situation is aggravated by muscle weakness. As you know, muscle work ensures normal blood flow.
- Thrombosis. A distinctive feature is that the leg becomes hot, and pain occurs when lightly pressed. In this case, immediate assistance from a specialist is required.
Stages of acute ischemia
1. Sudden pain in the leg, coldness, reduction in walking distance. If the collateral vessels are good, ischemia may stop at this stage with the development of intermittent claudication or critical ischemia. Most often, this stage is observed with thrombosis of altered arteries, if their lumen was previously narrowed and collateral circulation developed. At this stage, the operation is carried out after the necessary additional examination and preparation. The color of the leg may be pale or take on a bluish tint (cyanosis). The result of surgical treatment is excellent. Recovery of leg function is most often complete.
2. The symptoms described above are accompanied by weakness in the leg, which gradually worsens to the point of paralysis. However, passive movements in the fingers and other joints are possible. Such phenomena are associated with the death of nerve endings and blockade of nerve impulse transmission along the nerves. This stage of ischemia is an absolute indication for emergency surgery, since independent restoration of blood flow is impossible, and delay in intervention will lead to gangrene. Timely surgery restores blood flow with minimal loss of limb function. Numbness of the foot and fingers remains, and swelling of the leg persists for a long time.
3. Muscle death begins, first there are foci of muscle necrosis, muscle pain, and dense swelling of the lower leg. Then comes numbness of the fingers, ankle joint, and knee joint (muscle contracture). The muscles die completely. If the muscles are partially lost after restoration of blood flow and a long postoperative period, the leg may be preserved, but walking will be difficult. In the case of muscle contracture, amputation is necessary, since restoration of blood flow leads to the death of a person from poisoning with decay products.
Treatment
Treatment of leg swelling is carried out comprehensively; therapy includes taking medications, regular massage, and moderate exercises involving the limb. Only in combination these methods will help get rid of swelling and prevent complications.
Massage
Massage is an additional method of recovery after a stroke. Massage stimulates the functioning of blood vessels, accelerates blood flow, relaxes muscles, restores their strength, and relieves swelling.
Massage is prescribed in the first month of recovery. The course is long, at least 14-30 days, depending on existing complications, type of stroke, etc.
Important! In case of cerebral infarction without complications, massage is performed 2-3 days after the crisis; in case of hemorrhage - after 6-7 days.
Time of implementation : immediately after sleep, in the morning or before therapeutic exercises.
Duration – from 10 minutes, time gradually increases to 30 minutes.
Frequency day .
The entire course and number of sessions are prescribed by the doctor.
Carrying out conditions – air temperature not less than 20 ᵒС; Only the massaged part is exposed, the patient is covered with a blanket; massage is performed before meals or 2 hours after meals; after the massage – rest for 15 minutes.
Massage movements are directed from the foot to the knee, then to the inguinal lymph nodes. To quickly relieve swelling (to narrow blood vessels), massage is done with ice cubes, which include a decoction of oak bark and eucalyptus.
Additional remedies: cool gauze compresses (wrapped around the leg) are applied at night.
Gymnastics
Gymnastics is a prerequisite for relieving leg swelling.
To return the vessels to their previous state and normalize blood flow, feasible physical activity is necessary.
Time : in the morning after the massage.
Duration – at least 20 minutes.
Frequency – at least 2 times a day.
If possible, it is advisable to visit the pool and gym.
In the afternoon, exercise can be replaced by a walk. Fresh air, nature, positive emotions contribute to recovery.
For paralyzed limbs, passive gymnastics is performed.
Medicines
Attention! All medications are prescribed only by a doctor; self-medication is dangerous for the patient’s life.
In the initial stages, medications that thin the blood and prevent blood clotting (heparin, warfarin) are most often prescribed.
Diuretics - furosemide, torasemide, etc. can be used intravenously, intramuscularly and in tablets. Daily dose – from 10 mg. Negative consequences may occur - arrhythmia, exacerbation of heart disease.
For varicose veins, venotonics are added (detralex, phlebodia, etc.). For bedridden patients, an elastic bandage and special underwear are used.
Don’t forget about folk remedies - decoctions, baths, tinctures effectively relieve swelling:
- Carrot, cucumber, lemon juice are diuretics (drink 3 times a day before meals);
- To increase overall tone and quickly relieve swelling, it is recommended to mix the yolk with 3 grams of milkweed (use 2-3 times a day);
- Tincture of mint or flax relieves swelling after 3-4 days;
- Baths of mustard, sea salt and mint tone muscles and increase blood flow (every day before bed for 6 days).
What to do if your legs are swollen?
In order to reduce swelling, it is necessary to reduce physical activity on the lower extremities; ice can be applied to the swollen area. If the vein valves are insufficient, leg bandaging is performed. It is recommended to place a pillow under your feet while sleeping to enhance venous return to the heart. For heart failure, medications are prescribed.
If you find swelling in your legs, contact a cardiologist at the FIRST NEUROLOGY clinic. In our work we use modern diagnostic and treatment methods
Prevention
In order not to worsen the patient’s condition and prevent complications, immediately after a stroke you should take into account the necessary rules and recommendations:
- Fluid intake (in any form) is no more than 1 liter per day. The patient's urine should be excreted in the same volume;
- Diet (allowable amount of salt – 1.5 g per day);
- every 2 hours , at night - every 5 hours;
- It is unacceptable for limbs to hang from the bed (it is better to raise your legs and place them on a thick pillow);
- Massage and exercises should be performed regularly (even simple movements help restore blood circulation);
- In a sitting position, the back should rest on a backrest or support , pillows are placed under the arms, the position of the hands is palms down, fingers extended.
Useful video on the topic:
Angiography
To resolve the issue, surgical tactics require information about the patency of the arteries of the affected limb. The choice of technique for restoring blood circulation depends on the condition of the inflow pathways to the affected limb and the vascular bed below the site of blockage. In addition, angiography can distinguish embolism from thrombosis against the background of atherosclerotic narrowing. During an angiographic examination, endovascular treatment can be undertaken in the form of thrombectomy and angioplasty of the affected segments or local thrombolytic therapy can be performed.
Arterial embolism is an acute blockage of a vessel by a thrombus or other object brought from other parts of the vascular bed. Most often, vascular surgeons deal with thromboembolism from the heart cavity during a heart attack or atrial fibrillation, from the cavity of the aneurysm of the vessel overlying the blocked artery.
Consequences of acute cessation of blood flow
The sudden cessation of blood flow leads to the phenomenon of acute ischemia. The organs and tissues that are supplied by this artery lack nutrition and oxygen, so they begin to slowly die. The most specialized tissues are affected first—nervous, muscle, and finally skin. The body tries to restore blood circulation by opening additional bypass pathways for blood flow, so sometimes tissue death is stopped. But the likelihood of such an outcome is low. In any case, acute ischemia leads either to gangrene or to the development of chronic circulatory deficiency - critical ischemia.
Treatment of leg swelling due to heart or kidney failure
Patients with heart or kidney failure should be under the supervision of a physician. In acute attacks, resuscitation is required. If the disease takes a chronic form, swelling is removed as it appears with the help of diuretics and nutritional correction. Medicines should:
- stabilize blood pressure;
- remove excess sodium from the body;
- prevent protein loss;
- normalize blood flow speed.
When using diuretics (diuretics), it is important not to exceed the permissible dosage. Otherwise, there is a risk of getting the opposite effect in the form of drug-induced edema during withdrawal. They are caused by the kidneys’ reaction to a sudden change in the mode of fluid excretion.
Relieving swelling during pregnancy
In the body of a woman carrying a fetus, the concentration of the hormone progesterone increases. It is one of the causes of edema during pregnancy. In no case should it be reduced, because it is this that ensures the attachment of the embryo.
There is no need to fight physiological swelling. The main thing is to prevent it from getting worse. To alleviate the symptoms, you can carry out the mentioned water procedures and adhere to a healthy lifestyle (moderate activity, water consumption within the daily norm, adjusted for restrictions imposed by pregnancy, rest on your side).
The pathological nature of edema can only be determined by a doctor based on test results (in particular, protein in the urine). Having discovered the cause, he will prescribe treatment. It is prohibited to take any medications on your own.
Physiological reasons
In a healthy person, edema may appear in the evenings after heavy physical exertion or prolonged standing as a result of increased hydrostatic pressure in the blood vessels. The likelihood of swelling increases in the heat, when staying in a stuffy room or at high altitude, when drinking a large volume of liquid, excessively enjoying salty foods, and abusing alcoholic beverages (salt and alcohol retain water).
Swelling of the feet is especially common in women when wearing high-heeled or high-platform shoes. Due to the unnatural position of the foot, blood circulation in the lower extremities is significantly impaired, which leads to stagnation and accumulation of fluid. Similar processes are observed if you wear too narrow shoes and shoes with flat soles.
For physiological reasons, the swelling is mild and symmetrically covers the ankles and feet (occasionally the lower legs). When pressed with a finger, they leave an instantly disappearing mark. After rest they disappear completely.
If the legs swell for physiological reasons in women and men, then there is no need for special treatment. It is enough to adjust your lifestyle.
Hormonal fluctuations in women
In women, before the onset of menstruation, the concentration of progesterone in the blood decreases, which can cause fluid retention, causing pasty (swelling) ankles. Swelling is most pronounced during premenstrual syndrome.
During menopause, hormonal levels are constantly changing, so women may periodically swell their lower extremities. This problem can also be the result of hormone replacement therapy.
During reproductive age, swelling of the legs may occur when taking oral contraceptives.
