Symptoms

Calf pain: Pain in the calf

Calf pain: Pain in the calf


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Whether walking, running, climbing stairs or at rest - calf pain can occur in very different situations and be very uncomfortable for those affected. In most cases, an overload or incorrect posture is the trigger for the pain, which can sometimes become so severe that physical activity or even normal walking are no longer possible without restrictions.

In addition, calf pain can also be triggered by a serious illness such as thrombosis or circulatory disorders such as peripheral arterial disease ("window disease"). Accordingly, in the event of sudden, severe pain, as well as persistent or frequently recurring complaints, a doctor should be consulted to determine the exact cause.

Definition

Pain in the calves occurs frequently and is mostly described as boring and / or pulling, and the complaints are usually increased in the event of stress such as sports or climbing stairs. Calf pain can also show up at rest, the best example being calf cramps that suddenly appear at night or after a long immobilization. The symptoms can generally persist, but can also occur repeatedly in short attacks; they often show up after a heavy load on the muscles, for example after a long jogging round or mountain hike.

The pain is usually felt to be very severe, often even so severe that movements, or even simple walking, are hardly or not possible for a few days. Often calf pain does not remain "alone", but there are also other complaints such as thigh pain, foot pain, knee pain, Achilles tendon pain or ankle pain. In addition, there is often a feeling of numbness or tingling in the calves; in some cases, those affected also feel that they can no longer keep their legs still.

Cause calf cramps

A common cause of calf pain is muscle spasms, which can either be acute or permanent. Calf cramps occur suddenly and in most cases completely unexpectedly, for example during the yoga class, while jogging or at night while sleeping and can cause extremely severe pain.

The so-called gastrocnemius muscle, which is also called "two-headed calf muscle" and which gives the calf its typical shape, is usually affected in a calf cramp. In the event of a spasm, the muscle contracts abruptly and hardens. From the outside, you can feel a conspicuously hard strand in the muscles during the spasm. As long as the cramp persists, normal walking is not possible. If the calf muscles are stretched - i.e. the foot is pulled or pressed up by the person affected or a helper - the cramp usually also loosens and the pain disappears again, but in some cases a muscle-sore, pulling feeling remains.

In most cases, leg cramps are harmless and disappear again relatively quickly due to the stretching - however, caution is required in some cases, since dangerous movements can occur due to the severely impaired movement, for example in traffic or swimming, as the person affected could drown in the worst case .

The cause of calf cramps is often an under or overuse of the muscles. Accordingly, especially athletes are often affected by painful cramps in the calves when they strain their muscles too much or too much. If you then sweat profusely, the body loses a lot of fluid and important minerals such as magnesium or potassium, which are necessary for the proper functioning of the muscles. Underloading the muscles often leads to calf cramps, especially those who spend a lot of time at their desk or on the sofa during the day and do not provide enough movement to compensate are often woken up by severe pain in their calves at night. Nocturnal calf cramps also occur quickly if you have been walking in unsuitable shoes for too long during the day or if there are misaligned feet such as flat or spreading feet.

Calf cramps occur increasingly with age, which is partly due to the fact that muscles contract with age and muscle mass is lost - unless targeted sport is used to combat it. As the feeling of thirst subsides in old age, older people also tend to drink too little and tend to eat only one side - which favors a lack of fluids and electrolytes and thus quickly leads to leg cramps. The lack of minerals also affects pregnant women due to changes in metabolism and hormone balance, especially in the second half of pregnancy, due to insufficient magnesium, night cramps often occur.

Taking dehydrating medications (diuretics) often leads to leg cramps, as do high blood pressure medications, chemotherapy agents or contraceptives. If the calf cramps occur again and again in a very painful form and last for a relatively long time, nerve damage can also be the trigger, which can be caused, for example, by diabetes, alcoholism or disorders in the brain and spinal cord. Here, the cramps occur not only in the calf, but also in the feet or other areas of the body, other symptoms such as numbness or swelling can also indicate a serious illness.

Other possible causes of calf cramps are chronic kidney weakness, varicose veins, thrombosis or poor circulation in the leg (peripheral arterial disease). Muscle diseases, which are hereditary in many cases and are often recognized in childhood and adolescence, are less likely to be considered for leg cramps. It is typical here, among other things, that those affected often can only relax their tense muscles (e.g. the clenched fist) with great effort, in addition to this there are sometimes paralysis and an overall increased stiff muscles.

Cause tension

If calf pain occurs chronically or recurrently, this is in many cases caused by tension in the muscles or the connective tissue layer (fascia) surrounding the muscles. The pain often causes a drilling or pulling feeling and in most cases worsens after a heavy load such as jogging or hiking. In some cases, the complaints become so severe that movements are hardly tolerable or possible. There are very different triggers and areas for tension in the calf:

Pain in the superficial calf muscles

If, for example, the two superficial, posterior, large calf muscles "Musculus gastrocnemius" and "Musculus soleus" are affected, sufferers usually experience extensive pain, which - depending on the cause - can radiate either on one side or on both sides of the entire calf. In addition, there are achilles tendon pain in many cases; if the pain originates from the gastrocnemius muscle, it often extends to the back of the knee and the uppermost part of the calf, which can also lead to knee pain in parallel. If the pain occurs on both sides, a so-called hollow back is the trigger in most cases, since the shifting of the weight backwards while standing as well as in motion leads to permanent muscle tension. As a result, pain occurs in the calf with prolonged exercise, which is often accompanied by low back pain, thigh pain or knee pain.

Even those who often walk with their knees bent, stand or sit by constantly folding their feet and lower legs backwards, encourages permanent tension and thus pain on both sides. In some cases, calf pain also arises when the flexor muscles of the leg are kept in constant tension, for example while accelerating in the car, or when the office chair is set too high, causing the toes to be pressed onto the floor Toe pain is coming.

In addition, calf pain can occur on both sides if sporting activity is not carried out correctly, for example when the bicycle is not moving the feet sufficiently or the muscles are not relaxed enough during strength training, but only tensioned. Wearing the wrong shoes can also have serious consequences and lead to severe bilateral pain in the calf - caused both by too hard, stiff soles, in which natural foot movement is not possible, as well as by high heels, which cause the calf muscles to develop permanently tensed and even shortened.

In addition to the bilateral pain, the superficial calf muscles can also cause unilateral pain. In many cases, these arise from incorrect posture, for example when the weight is shifted to the other leg over a longer period as a result of an injury to one leg. This form of crookedness can also often be observed in everyday life, because many find it easy or particularly “casual” to shift the weight onto one leg - but also risk tension in the muscles and connective tissue of the supporting leg.

Tension in the toe flexors

Pain in the calves can also result from the long flexor digitorum longus muscle, which lies on the tibia side of the lower leg and on the one hand bends the outer four toes down through branching tendons and on the other hand also ensures that the Foot is turned outwards. If the toes are bent again and again or over a longer period of time, this muscle also creates a permanent tension, which eventually leads to calf pain, but sometimes also toe pain or pain in the soles of the feet.

The curved toes usually result from the permanent wearing of unsuitable shoes - here shoes with high heels are particularly suitable, in which the toes must be constantly curved and tightened in order to get hold. At the same time, the unnaturally held feet are also loaded with the entire body weight - which quickly leads to tension and the resulting pain in the calves.

In addition to wearing the wrong shoes, “toe curling” is not a rare phenomenon as such, because especially in the event of fear, excitement or in stressful situations, but also during concentrated work on the PC, for example, some people reflexively claw their toes - in most cases without it themselves to notice.

Calf pain in the posterior tibia muscle

Pain in the calves can also result from the so-called tibialis posterior muscle (“posterior tibia muscle”), which is one of the deep calf muscles and on the one hand lifts the inner edge of the foot and on the other hand lowers the sole of the foot towards the floor (plantar flexion). In this form of calf pain, the symptoms usually occur lengthways in the middle of the calf, often accompanied by foot pain in the longitudinal arch of the foot.

If they show up on both sides, they are often related to “hollow feet” and “bow legs” (medical: genu varum), which can either be inherited or acquired through accidents, for example, and the cause of these deformities can also be in the hip - or foot area or in rare cases in inflammation, bone metabolism disorders and systemic diseases. If, on the other hand, the pain in the posterior tibia muscle is noticeable on one side, there is in most cases an often unnoticed, regularly taken oblique posture, in which you push the pelvis to one side and thereby automatically raise the foot on the other side.

Pain caused by tension in the connective tissue

Pain in the calves, however, can result not only from the muscles, but also from the connective tissue in the calves. In this case, the complaints are usually not clearly localized and explainable, but they can be very uncomfortable and annoying and are often accompanied by an itch, tingling or burning in the calves. Often, those affected also have the feeling that the calf is extremely tight or that it is less strong than usual. The cause of tension in the connective tissue of the calves is mostly past injuries, some of which are no longer present, such as bruises, strains or Fractures, but also scars from previous operations.

Muscle fiber tear in the calf

A muscle fiber tear can also cause pain in the calf. This occurs when one or more bundles of muscle fibers in the calf tear as a result of permanent heavy strain on the muscles (e.g. in competitive sports) or sudden overexertion (e.g. when starting the sprint or jumping off). A torn muscle fiber is therefore one of the most common sports injuries, whereby sports are particularly often affected, in which the athlete often runs alternately and then stops abruptly (e.g. football, tennis, badminton) or the rapid strength of the muscle is used, such as in running .

A muscle fiber tear usually manifests itself by a quick shooting in calf pain or the feeling that something is tearing, in rare cases the symptoms only appear hours after the tear. Walking, running and especially standing on tiptoe cause severe, stinging pain, often these movements are no longer possible. On the outside, a muscle fiber tear is difficult to recognize at the beginning, in some cases a dent appears in the corresponding place, in the further course the calf swells strongly in many cases.

In addition to permanent muscle strain and sudden muscle strain, direct violence (e.g. by kicking) can also result in a muscle fiber tear. The risk of injury is higher the lower the stretching ability of the muscles, which is why insufficient or unsuitable stretching exercises or a short warm-up phase before exercise are often the cause of a muscle fiber tear. There are also other possible triggers such as incorrect running shoes, misaligned feet, a regeneration phase that is too short, a return to sport too quickly after a previous injury, muscle hardness or muscle shortening.

Calf pain due to herniated disc

Calf pain can also result from a herniated disc, which occurs very frequently in this country and in most cases is easy to treat without surgery. The intervertebral discs are cartilage-like, flexible tissue with a gelatinous core that lies between the vertebral bodies of the spine and ensures the mobility of the back and the cushioning of impacts. In the event of a herniated disc, this soft core escapes from the cartilaginous connective tissue ring of the intervertebral disc and thereby presses on the neighboring nerves, causing the characteristic strong pain.

The symptoms of a herniated disc vary depending on the area and the type of hernia. In many cases, sufferers experience a sharp, deep back pain or pain in the thigh, which can radiate to the calves or even feet. This form of pain is often also described as "lumbago" or "sciatica pain", which lasts for a long time and often intensifies even when moving. In addition, there is sometimes tingling or a feeling of numbness in the corresponding regions, and paralysis is also possible. A herniated disc rarely arises spontaneously, but usually has a history in which those affected have had painful tension or degenerative changes in their joints (arthrosis) for a long time.

The aging process plays a central role in the development of a herniated disc, because the intervertebral discs lose elasticity with increasing age, causing the outer connective tissue ring of the intervertebral disc to lose its strength and to give in more quickly. In addition, there are other risk factors such as being overweight, lack of movement, constant sitting and heavy lifting, which put additional strain on the intervertebral discs and thus promote herniated discs. Weak back and abdominal muscles can also cause a herniated disc. In addition, a herniated disc often occurs in the course of pregnancy, since more and more water is stored in the intervertebral discs due to hormonal changes, which in turn leads to greater instability.

Calf pain - thrombosis

If the pain in the calf suddenly occurs, deep leg vein thrombosis can also be the cause, whereby a distinction is made here between thrombosis in the superficial veins and thrombosis in the deep veins. In the case of superficial vein thrombosis or phlebitis, a varicose vein is inflamed in most cases, which can lead to a thrombus (blood clot), which can be very dangerous because the blood flow is restricted.

But an actually healthy vein can also become inflamed, which in this case indicates a possibly more serious illness - and should therefore be taken seriously. Superficial phlebitis occurs relatively frequently and can develop into a deep leg vein thrombosis if left untreated or, in serious cases, can also lead to life-threatening pulmonary embolism if parts of the blood clot detach and get into a lung vessel with the blood.

In deep vein thrombosis, the blood clot is in the veins that run inside the leg. Typical signs are a sudden, severe swelling of the ankle, lower leg and / or the whole leg as well as severe, excruciating pain. In addition, the affected leg feels warm and unusually heavy or tense, and on the outside there is often a bluish or reddish discoloration of the skin. The symptoms in deep leg vein thrombosis in most cases occur below the point at which the thrombus is located and usually become even stronger when standing and sitting - lying and elevating the affected person, on the other hand, in most cases helps to alleviate the symptoms.

Deep vein thrombosis can lead to serious complications: On the one hand, there is a risk of pulmonary embolism, in which small pieces of the blood clot get into the lungs, block the vein there and thereby block the blood flow. In untreated leg vein thrombosis, lung embolism occurs relatively frequently and then manifests itself, among other things, through shortness of breath, chest pain, cough (also with a bloody sputum), rapid heartbeat, palpitations, sweating or sudden fainting. Since the heart suddenly has to "fight" against the "interferer" in the pulmonary cycle in the event of a severe embolism, there is a risk of heart failure and thus an acute risk to life. If a thrombosis is not detected or the therapy does not work, this can also lead to permanent venous weakness, which in severe cases causes poorly healing, deep wounds in the skin ("open leg"), which causes it to close severe pain and infection quickly.

There are a number of risk factors for deep vein thrombosis, in addition to suffering from varicose veins, for example, obesity, blood clotting disorders, cardiac arrhythmias such as atrial fibrillation, pregnancy or the "pill" - whereby a particularly high risk is assumed here if women are parallel to Smoking. Even if you sit with your legs bent for a longer period of time (e.g. at a desk or on a plane), you run the risk of developing deep leg vein thrombosis. The tricky thing is that a thrombosis in some cases remains asymptomatic or does not cause symptoms until after some time - therefore, if you suspect a thrombosis or if your calf pain is severe or persistent, you should definitely consult a doctor because it is actually present or whether it is it is a superficial or deep form, can only be clarified by a medical examination.

Peripheral arterial disease

Certain types of pain require special care and attention, as these may indicate an increased risk of a stroke or heart attack, and in the worst case there is a risk of amputation of the affected leg. This is especially true for calf pain that occurs when walking, but quickly subsides when you stop, because in many cases this form of pain indicates arteriosclerosis in the blood vessels of the legs. This is the disease that is colloquially referred to as "arterial calcification" and which can lead to dangerous circulatory disorders due to deposits in the arteries.

Arteriosclerosis can be favored by various factors such as diabetes mellitus, high blood pressure, overweight or lack of exercise, but smoking is the main cause. The calcification can affect all arteries in the body. If the blood vessels to the legs are affected, the clinical picture is medically referred to as "peripheral arterial occlusive disease" (PAD). This occurs as a chronic circulatory disorder, in the course of which the arteries of the legs narrow more and more and as a result are poorly supplied with blood. As a result, oxygen and nutrients can no longer be adequately transported into the surrounding skin, muscle and nerve tissue, which means that as the disease progresses, those affected often experience such severe pain that they can only walk very short distances on foot.

Instead, they stop more and more frequently, because then the muscles need less oxygen compared to movement, which means that the pain subsides after a few minutes of rest. Often, people affected by peripheral arterial occlusive disease try to hide it from their fellow human beings out of shame and insecurity by stopping in front of shop windows, sights or the like until the pain subsides - that's why the complaint is popularly also called "shop window disease" called.

In the initial stages, peripheral arterial occlusive disease usually shows no symptoms, so it is rarely diagnosed in the early phase. In the further course, those affected experience ever greater pain when walking, which indicates that the corresponding leg no longer receives sufficient oxygen due to the disruption of the blood circulation. Exactly where the pain occurs depends on where the vasoconstriction exists - in addition to the very common pain in the calf, peripheral arterial occlusive disease can also cause foot pain, buttock pain or thigh pain.

As a result, the pain forces you to stop more and more frequently, the pain-free stretches become shorter and shorter until the complaints not only occur when you are moving, but also when you are at rest - especially at night, in a lying position. If the "window disease" reaches the last stage, the "calcification" of the affected arteries may have progressed to such an extent that the surrounding tissue dies due to insufficient blood circulation (necrosis), which in advanced cases can even lead to amputation. In addition, wound healing is limited, so there is an increased risk of infection - in this case, those affected must be taken to the hospital immediately.

Compartment syndrome / chronic lodge syndrome

Calf pain can also be caused by the so-called compartment syndrome (or "chronic log syndrome"). In this case, there is increased tissue pressure in a defined area, a "compartment" (or "muscle log") of the lower leg due to a stronger swelling of the muscle or a bruise. As a result, nerves and blood vessels in the affected compartment are pinched off and the affected leg may no longer be adequately supplied with oxygen.

Muscles and nerves are damaged in the course of this, this condition lasts longer, the undersupplied tissue dies, scars on the muscles develop as a result and limited muscle mobility, in an emergency it can even lead to an amputation of the affected limb. There are also other dangers for the whole organism, because if a large amount of muscle tissue dies, this can lead to disturbances in the fluid and salt balance and also lead to cardiac arrhythmias or kidney failure. Accordingly, a compartment syndrome is a medical emergency that must be treated immediately.

Medically, a distinction is made between acute and chronic compartment syndrome. The chronic form primarily affects athletes (for example, in bodybuilding or running), as the volume of the muscles increases through intensive training, but the muscle fascia surrounding the compartment cannot react to them quickly enough. As a result, a slightly increased pressure arises in the compartment concerned, but the complaints usually only occur during exercise, while the pain normally disappears when the patient is at rest. Often there is also a clearly recognizable swelling of the affected compartment, which usually also quickly subsides when at rest.

With acute compartment syndrome, on the other hand, there is suddenly an increased pressure in the compartment. This is usually caused by accidents in which bruises, bruises or bruises result in bruising and water retention in the tissue (edema), which require more space within the compartment. In addition to this, thrombosis or too tight bandages can also trigger a compartment syndrome. In acute cases there is usually very severe pain, typically there are severe swellings and a numb or tingling sensation in the leg, the foot often looks pale and is cold due to the interrupted blood supply.

Treatment options

The treatment of the calf pain depends on the corresponding cause. If the pain is triggered, for example, by incorrect or excessive strain, this should be treated by changing behavior and changing the movement pattern. It is also often helpful to stretch the aching muscles through certain exercises so that relaxation can occur. If there is an acute muscle injury, such as sore muscles, the affected muscles should primarily be spared and an exercise break should be made until the affected person is free of pain again. In addition, ointment bandages, bandages or a tape bandage can help to relieve the muscles and thereby relieve the pain more quickly.

In order to avoid calf pain in the first place, you should also pay attention to a healthy lifestyle with lots of exercise and a balanced diet. There are also a number of risk factors that should be minimized or avoided in order to prevent chronic calf pain - these include, above all, smoking, alcohol and obesity.

Treatment for a calf cramp

In most cases, a calf cramp is harmless and resolves quickly, especially when the muscle is stretched by the patient or a helper pulling or pushing the foot upwards. It is also just as helpful to step on the foot and shift the strength to the front area of ​​the foot, alternatively walking on the front foot is also suitable, which also causes the calf muscles to be stretched. A calf massage and a warm shower can also help to relieve the cramp in some cases.

However, if the calf cramps occur repeatedly, those affected should definitely undergo a thorough medical examination to find out the cause. If there is an underlying disease, it is treated specifically, which in most cases also alleviates or completely eliminates the cramps. In general, to prevent calf cramps, it is advisable to drink enough - which particularly affects people who work hard physically or do a lot of sport.

You should also pay attention to a balanced, healthy diet with sufficient minerals (especially magnesium) and regular exercise. If calf cramps occur frequently, magnesium supplements, but also other mineral or vitamin supplements (such as quinine) may be useful - however, intake should be discussed with a doctor in advance to avoid side effects.

Treatment for a torn muscle

Liegt ein Muskelfaserriss vor, empfiehlt sich – wie auch bei anderen Sportverletzungen – zur Sofortbehandlung die Umsetzung der bewährten „PECH-Regel“, bei der durch sofortiges Pausieren, Eiskühlungen, Compressen und Hochlagern der Beine eine weitere Schädigung des Körpers vermieden und der Heilungsprozess so schnell wie möglich in Gang gesetzt werden soll. Im weiteren Verlauf stehen im Bereich der konservativen Behandlungsmethoden schmerzstillende und entzündungshemmende Medikamente, Salben und Injektionen zur Verfügung, zur Entlastung der verletzten Muskeln nutzen viele Patienten für einen gewissen Zeitraum Unterarmgehstützen („Krücken“).

Um den Muskelfaserriss optimal abheilen zu lassen, sollte der betroffene Muskel unbedingt möglichst bald wieder belastet werden – natürlich nur in dem Maße, wie keine Schmerzen auftreten. Daher eignet sich hier insbesondere individuell abgestimmte Krankengymnastik – Massagen oder Dehnübungen stellen hingegen bei frischen Verletzungen ein zu großes Risiko für Verknöcherungen dar. Betrifft der Riss mehr als zwei Drittel des Muskeldurchmessers oder hat sich ein Hämatom gebildet, wird aus medizinischer Sicht häufig eine Operation in Betracht gezogen – bei dieser besteht jedoch ein erhöhtes Risiko für einen massiven Funktionsverlust des verletzten Muskels.

Behandlung bei einem Bandscheibenvorfall

Liegt ein Bandscheibenvorfall vor, gehen die Beschwerden in den meisten Fällen von alleine deutlich zurück bzw. lassen sich durch konservative Behandlungsmethoden in den Griff bekommen. Hierzu zählen unter anderem schmerzlindernde Medikamente, Wärmetherapien und Physiotherapie, bei stärkeren Schmerzen kann der Arzt zudem im Einzelfall lokal wirkende Arzneimittel spritzen.

Parallel empfiehlt sich eine so genannte „Rückenschule“, in der Betroffene Möglichkeiten erlernen können, ihren Rücken zu stärken und dadurch zu entlasten. In schwereren Fällen, beispielsweise wenn Lähmungserscheinungen auftreten, aber auch wenn die Schmerzen dauerhaft anhalten, ist meist eine Operation notwendig, da in diesem Fall eine Schädigung von Nervenzellen oder sogar dem Rückenmark droht.

Auch wenn selbst gut therapierte Bandscheibenvorfälle normalerweise nicht vollständig verschwinden, kann jedoch eine über Jahre anhaltende Beschwerdefreiheit erzielt werden. Dementsprechend ist es gerade für ältere Menschen besonders wichtig, auf eine gesunde Lebensweise zu achten, die Risiko-Faktoren weitestgehend zu minimieren und Rücken sowie Bauch zu stärken.

Behandlung bei Thrombose

Bei einer Thrombose geht es zunächst darum, diese möglichst schnell zu behandeln, um das Risiko für eine Lungenembolie und eine spätere Venenschwäche zu minimieren. Die Therapie erfolgt dabei je nach Lage, Größe und Bestehen des Blutgerinnsels. Normalerweise wird empfohlen, zu aller erst das betroffene Bein ruhig zu stellen und hoch zu lagern. Bei einer tiefen Venen-Thrombose werden normalerweise sofort Medikamente zur Hemmung der Blutgerinnung – so genannte Blutverdünner – eingesetzt, um das Wachsen des Gerinnsels zu stoppen und eine Embolie zu verhindern.

Zudem erhalten Betroffene meist speziell angepasste Kompressionsstrümpfe. Diese üben Druck auf das betroffene Bein aus, was sich positiv auf den Blutfluss auswirkt und die Beschwerden verringert. In einigen Fällen wird der Thrombus auch operativ oder mittels eines Katheters entfernt, zudem ist es prinzipiell möglich, im Anfangsstadium einer tiefen Beinvenenthrombose das Gerinnsel durch die Wirkstoffe Streptokinase und Urokinase abzubauen, die per Infusion zugeführt werden.

Wird eine Thrombose in den oberflächlichen Venen diagnostiziert, so reicht in vielen Fällen Kompression durch Strümpfe oder Verbände und Kühlung (zum Beispiel durch Umschläge oder Salben-Verbände) aus, teilweise werden zusätzlich entzündungshemmende Medikamente verschrieben. Bei größeren Blutgerinnseln in oberflächlichen Venen bzw. Krampfadern wird dieses normalerweise durch einen kleinen Schnitt in die Haut entfernt und im Anschluss ebenfalls mit „Blutverdünnern“ weiter behandelt. Da sich eine oberflächliche Beinvenen-Thrombose schnell und oft unbemerkt zu einer unter Umständen sehr gefährlichen tiefen Beinvenen-Thrombose entwickeln kann, sollte bei einer Venen-Entzündung zur Abklärung immer ein Arzt aufgesucht werden.

Behandlung bei einer Verschlusskrankheit

Liegt den Wadenschmerzen eine periphere arterielle Verschlusskrankheit (PAVK) bzw. „Schaufensterkrankheit“ zu Grunde, setzt die Therapie im ersten Schritt bei den Risikofaktoren an. Diese müssen für einen dauerhaften Erfolg konsequent bekämpft werden, um einer weiteren Arterien-Verengung und damit Amputationen bzw. lebensbedrohlichen Ereignissen wie einem Herzinfarkt und Schlaganfall vorzubeugen. In diesem Zusammenhang ist es vor allem wichtig, mit dem Rauchen aufzuhören sowie Übergewicht zu reduzieren.

Hinzu kommen weitere entscheidende Faktoren wie ausreichend körperliche Bewegung, eine gesunde Ernährung und eine angemessene, individuell abgestimmte Therapie bei bestehenden Krankheiten bzw. Stoffwechselstörungen wie Bluthochdruck oder Diabetes mellitus. Im frühen Stadium bilden zudem Gehtraining und spezielle Gymnastik die therapeutische Basis, um die Schmerzen zu mildern und zu erreichen, dass der Patient wieder längere Strecken laufen lernt. Wichtig ist hier jedoch, das Training unbedingt mit dem Arzt abzustimmen, um die Strecke, Geschwindigkeit und Dauer des Gehens entsprechend der Leistungsfähigkeit des Einzelnen anzupassen.

Zusätzlich werden im Regelfall so genannte Thrombozytenaggregationshemmer (vor allem Acetylsalicylsäure) verschrieben, welche die Verklumpung von Blutplättchen und damit die Entstehung von Blutgerinnseln hemmen. Bringen andere Verfahren keinen Erfolg, so kommen weiterhin Medikamente zum Einsatz, welche die Durchblutung verbessern (zum Beispiel „Prostanoide“ und „Cilostazol“).

In schwereren Fällen ist ein chirurgischer Eingriff notwendig, um den Blutfluss wieder zu entstören – besonders dann, wenn das Risiko einer Amputation besteht. Hier bestehen je nach Fall verschiedene Möglichkeiten, bei denen die Verengung entweder geweitet (Gefäßaufdehnung / Kathetertherapie) oder sozusagen eine „Umleitung“ für das Blut geschaffen wird (Gefäßoperation / Bypass).

Vor allem in den fortgeschrittenen Stadien ist neben den medizinischen Maßnahmen zusätzlich eine regelmäßige und sorgfältige medizinische Pflege von Beinen und Füßen enorm wichtig, um kleine Verletzungen zu vermeiden, die bei einer PAVK schnell zu Geschwüren und dem Absterben von Gewebe führen können.

Daher sollte unbedingt darauf geachtet werden, passende, nicht zu enge und atmungsaktive Schuhe zu tragen, die Füße regelmäßig gut einzucremen und nach dem Baden bzw. Duschen sorgfältig abzutrocknen. Zudem sollte möglichst darauf verzichtetet werden, barfuß zu gehen und beim Schneiden der Nägel sehr vorsichtig vorgegangen werden, da es hier besonders schnell zu kleinen Verletzungen kommt. Um sicher zu gehen, sollten die Füße regelmäßig gründlich angeschaut sowie von einem Arzt fachmännisch untersucht werden.

Behandlung bei einem Kompartmentsyndrom

Bei einem Kompartmentsyndrom erfolgt die Behandlung je nach dem, ob es chronisch oder akut auftritt. Bei der chronischen Form ist es normalerweise das Wichtigste, das Bein sofort zu kühlen sowie ruhig und hoch zu lagern. Sportler sollten ihr Programm möglichst ganz einstellen und nach Abklingen der Beschwerden unter ärztlicher Aufsicht wieder starten. Läufern, die in Folge einer falschen Lauf-Technik besonders häufig von einem chronischen Kompartmentsyndrom betroffen sind, wird außerdem ein professionelles Lauf-Training bei einem Laufspezialisten empfohlen.

Bei einem akuten Kompartmentsyndrom handelt es sich hingegen um einen Notfall, der sofort medizinisch behandelt werden muss, um unter Umständen gravierende Folgeschäden zu vermeiden. Ist ein zu enger Verband der Auslöser, muss dieser umgehend entfernt werden. Ansonsten erfolgt in den meisten Fällen eine Operation, bei der die entsprechende Faszie aufgeschnitten und so der Druck innerhalb des Kompartments gesenkt wird, zudem wird – wenn nötig – abgestorbenes Muskel- und Nervengewebe entfernt. Erfolgt die Operation rechtzeitig, heilt in den meisten Fällen auch ein schweres Kompartmentsyndrom ohne Folgen aus, ansonsten ist Krankengymnastik hier das Mittel der Wahl.

Naturopathy

Neben den konventionellen Therapiemaßnahmen bietet auch die Naturheilkunde viele Möglichkeiten bei Wadenschmerzen – insbesondere, wer häufig an Verspannungen leidet, kann hier schnell und zuverlässig Hilfe erhalten. Generell empfiehlt sich bei Verspannungen alles, was gut tut – so wird von den meisten Betroffenen Wärme als sehr wohltuend und entspannend empfunden, ob in Form von Entspannungsbad, Wärmepflastern oder warmen Umschlägen ist dabei Geschmackssache.

Gerade bei dauerhaften oder immer wiederkehrenden Verspannungen in den Muskeln und dem Bindegewebe der Wade reichen jedoch Wärme, einfache Massagen oder das spontane „Abstellen-Wollen“ von Fehhlhaltungen oder anderen ungünstigen Gewohnheiten oft nicht aus, um die Kontraktionen vollständig aufzulösen. Hier setzt beispielsweise das so genannte Körper-Bewusstseins-Training an, welches dem Patienten im Anschluss an manuelle Verfahren durch das Erkennen und Beobachten der eigenen Handlungen und Fähigkeiten hilft, Fehlhaltungen nachhaltig zu ändern und dadurch Verspannungen vorzubeugen.

Auch andere „schlechte Angewohnheiten“ können hier durch das Bewusstmachen und anschließende Erlernen bestimmter Techniken verändert werden – auf diesem Wege lässt sich beispielsweise eine ungünstige Gangweise in einen gesunden, dynamischen Gang wandeln, der sich wiederum auf die gesamte Körperhaltung positiv auswirkt.

Wenn die Wadenmuskeln infolge ungewohnter bzw. übermäßiger körperlicher Belastung schmerzen, helfen unter anderem auch Schüßler Salze und homöopathische Mittel wie beispielsweise die Salze Nr. 3 (Ferrum Phosphoricum), Nr. 6 (Kalium Sulfuricum), Nr. 7 (Magnesium Phoshoricum) sowie das Komplexmittel „Calendula Oligoplex“ (unter anderem mit Calendula, Bellis perennis, Euphorbia cyparissias) dabei, die Beschwerden zu lindern, indem die Inhaltsstoffe die Durchblutung und Wundheilung fördern.

Im Falle eines Muskelfaserrisses hat sich zudem Arnica montana als klassisches Mittel bewährt, welches sowohl im akuten Fall als auch in den Tagen nach der Verletzung angewendet werden kann. Bei Wadenschmerzen in Folge von schweren Prellungen durch einen Tritt oder Stoß wird häufig das Schüssler Salz Nr. 3 (Ferrum Phosphoricum) als Tablette und Salbe verwendet.

Arnica ist hier als homöopathisches Mittel ebenso zu empfehlen wie Bellis perennis (Gänseblümchen) bei tiefen, berührungsempfindlichen Blutergüssen sowie Verhärtungen. Die Dosierung und Dauer der Anwendung sollte hier in jedem Fall mit einem Arzt bzw. Alternativmediziner oder Heilpraktiker abgesprochen werden.

Wer häufig speziell unter Wadenkrämpfen in Folge von Mineralstoffmangel leidet, dem kann die Naturheilkunde ebenfalls wertvolle Unterstützung bieten: Hier kommt insbesondere das Schüßler Salz Nr.7 (Magnesium phosphoricum) in Form der „heißen Sieben“ zum Einsatz. Dafür geben Erwachsene und Kinder ab 12 Jahren 10 Tabletten Magnesium phosphoricum in eine Tasse und gießen diese mit 200ml heißem Wasser auf.

Nachdem sich die Tabletten aufgelöst haben, wird die heiße Sieben – so heiß wie möglich – in kleinen Schlucken getrunken, dabei sollte das Getränk vor dem Herunterschlucken möglichst lange im Mund behalten werden, da die heilsamen Schüßler Salze über die Mundschleimhaut aufgenommen und an die entsprechenden Stellen transportiert werden. Vorsicht gilt allerdings beim Umrühren, denn dafür sollte niemals ein Löffel aus Metall verwendet werden, da dieses die Wirkung der Salze beeinflusst.

Auch innerhalb der Homöopathie gibt es einige hilfreiche Mittel speziell bei Wadenkrämpfen, so zum Beispiel Arnika, Mutterkorn, Tabak und metallisches Zink in den Potenzen D12-D3. Auch wechselwarme Knie- und Armgüsse sowie ein wechselwarmes Fußbad eignen sich gut zur Linderung der Beschwerden.

Liegt den Wadenschmerzen ein Muskelfaserriss zugrunde, so haben sich hier neben Akupunktur und homöopathischen Maßnahmen zur Beschleunigung des Heilungsprozesses neben konventionellen Methoden auch die Elektro- und Magnetfeldtherapie bewährt. Ebenso kommen in diesem Fall häufig Lymphdrainagen, Kälteanwendungen und Entspannungsübungen wie Yoga, autogenes Training oder progressive Muskelrelaxation zum Einsatz – Massagen und Dehnübungen sollten bei frischen Muskelfaserrissen hingegen vermieden werden, da dadurch das Risiko für Verknöcherungen steigt. (nr)

Author and source information

This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.

Dipl. Sozialwiss. Nina Reese

Swell:

  • Heike Höfler: Gesunde Venen, schöne Beine, Schlütersche Verlag, 2. Auflage, 2015
  • Hans-W. Müller-Wohlfahrt, Peter Ueblacker, Lutz Hänsel: Muskelverletzungen im Sport, Thieme Verlag, 3. Auflage, 2018
  • Michael C. Levin: Muskelkrämpfe, MSD Manual, (Abruf 06.10.2019), MSD
  • Doris Brötz, Michael Weller: Diagnostik und Therapie bei Bandscheibenschäden: Neurologie und Physiotherapie, Thieme Verlag, 4. Auflage, 2017
  • D. Heuß et al.: Diagnostik und Differenzialdiagnose bei Myalgien, Deutsche Gesellschaft für Neurologie (DGN), (Abruf 06.10.2019), DGN
  • Holger Lawall et al.: S3-Leitlinie zur Diagnostik, Therapie und Nachsorge der peripheren arteriellen Verschlusskrankheit, Deutsche Gesellschaft für Angiologie - Gesellschaft für Gefäßmedizin, (Abruf 06.10.2019), AWMF
  • Gerhard Reichel: "Wadenkrämpfe (Krampi) - Differenzialdiagnose und Therapie", Psychoneuro, Volume 33 Issue 11, 2007, (Abruf 06.10.2019), thieme
  • Bernd L. P. Luther: Intestinale Durchblutungsstörungen, Steinkopff Verlag, 2001
  • P. Gerhardt Scheurlen: Differentialdiagnose in der Inneren Medizin, Springer-Verlag, 2013


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