With arthrosis of the ankle joint, the symptoms and treatment will largely depend on the type of damage and the degree of neglect of the patient's condition. Do not neglect the diagnosis, so you should consult a specialist. Only the attending physician will tell you in detail how to cure arthrosis of the ankle joint, what is so dangerous in itself, and whether it is possible to get rid of this problem forever.
Causes of the disease
During the development of ankle osteoarthritis, 2 groups are distinguished: primary (occurs without special reasons) and secondary (appears due to external adverse factors). Other names for this disease: cruciate arthritis (right or left ankle is affected) or osteoarthritis. With arthrosis of the lower leg, degenerative processes occur in the cartilaginous tissues, which subsequently lead to a number of deviations.
In most cases, the disease is found in older men and women. Over time, the organs of the internal system do not work as actively and correctly, and in some cases, failures lead to thinning of bone and cartilage tissues. In the normal state, the joints slide freely during movement without touching each other.
If negatively affected in osteoarthritis, the joint becomes deformed and starts rubbing against another joint. This causes an additional load, which then goes to the bones, leading to their deformation. When the joint is re-injured, the surrounding tissues are also affected. The legs lose their mobility and do not tolerate a large load (with paresis).
Other reasons
A common cause of ankle hemarthrosis is active physical activity, which has a direct effect on the musculoskeletal system. People whose work is associated with carrying heavy loads or any other active work are at risk. A similar cause provokes an ailment in professional athletes or those who have been actively involved in sports for a long time. Due to incorrect loads, significant pressure is exerted on the limbs, which subsequently leads to damage.
Acute arthrosis is a common problem for overweight people, because during movement, a mass presses on the lower extremities, which the legs cannot support. With obesity, the disease can also develop in young people (around 20 years old), if a person has been diagnosed with it since childhood. Other diseases that lead to deforming arthrosis of the ankle joint (the reasons were discussed above):
- drop;
- diabetes mellitus and atherosclerosis (metabolic diseases);
- congenital deformities of the legs, ankles (clubfoot);
- any condition in which a nerve is pinched.
This disrupts the functioning of the muscular apparatus (for example, osteochondrosis). Due to flat or club feet, in addition to the deforming condition, subtalar osteoarthritis occurs (it is named for the changes in the talus).
Different types of injuries to the knees or legs (improper squatting), as well as the use of uncomfortable, small or poorly made shoes, are also causes of osteoarthritis of the ankle joint. Women are especially at risk. They have negative symptoms that lead them to wear high-heeled shoes.
Symptoms and stages
Years can pass from the initial manifestation of the disease to the final stage of it. The development time will depend on the initial state of the human body, the treatment and the suitability of the applicable therapy. The signs of osteoarthritis will differ in a series of symptoms that characterize it.
First of all, with any, even slightly increased, load on the joints, a person begins to feel a sharp tingling in the legs. The same happens if the patient moves long distances at a slow pace. The joints often creak and creak.
The patient begins to twist his legs, which sometimes ends in ankle dislocations. This happens due to violations of the functionality of muscles and tendons, up to atrophy of muscle tissue (a decrease or change in muscle tissue, followed by its replacement by connective tissue that cannot perform basic motor functions). It is for the same reason that he often feels stiffness and swelling in his legs.
Doctors distinguish 3 stages of the development of the disease. The first two are perfectly treatable, after which the person completely returns to his previous life. In grade 3, patients are often disabled by osteoarthritis.
During the development of the disease of the first degree, the symptoms of arthrosis appear very slightly. A person may come to a medical institution with a complaint of rapid fatigue of the limbs and slight pain in the legs, which disappear after rest. The diagnosis of arthrosis of the extremities is rarely established, since during the studies no pathologies are found in the patient.
In the second stage, the pain does not go away after rest. Swelling and redness appear on the legs, which will lead to an increase in temperature. The pain intensifies during an active change in weather conditions, swelling occurs.
In the last stage, the cartilage tissue ossifies, causing the patient considerable discomfort, due to which the person suffers from severe pain. The legs lose their mobility and with each step a creaking sound is heard. If the disease is started, this can lead to another diagnosis - foot deformity. This pathology gives the right to receive a disability, so treatment must be started immediately.
At this stage, arthrosis is dangerous. Some distinguish another fourth degree, in which the pain completely disappears, but the person loses the ability to walk, because the cartilage at this stage is completely destroyed and paralysis occurs. At the same time, the fourth degree is characterized by the frequent development of ankylosis (when the joints fuse together) and neoarthrosis (when an unnecessary or false joint is formed between the displaced ends of the bones).
Post-traumatic osteoarthritis
Post-traumatic arthrosis of the ankle joint requires timely treatment, because, unlike deforming and acute, it is characteristic of young people, since it occurs after an injury. For example, with dislocations, fractures and sprains.
Any tissue damage after injury does not pass without a trace, directly touching the blood vessels and nerves.
At first, the patient does not feel any discomfort, only over time he begins to notice that when walking the foot twists, because the ligaments have weakened and can no longer support the entire leg.
Over time, with osteoarthritis of the ankle joint, physical activity (especially among athletes) is more difficult, the legs quickly tire during exercise. Girls often in such cases complain that they cannot sit on the thread, even with long and correctly performed daily stretches. Improvement is constantly followed by remission, during which the leg swells, hurts and does not calm down even after rest.
It is often post-traumatic osteoarthritis that causes pseudarthrosis, a bone defect that causes severe joint mobility. For example, it is possible to bend the arm at the elbow not only backwards, but also forwards. Pseudarthrosis appears during bone healing, when the tissues come together incorrectly.
Post-traumatic ankle osteoarthritis is often a consequence of surgical intervention during other operations. Scars form in the tissue area, which affects blood circulation. The risk increases when part of the affected joint is removed as needed during surgery. Treatment of post-traumatic arthrosis of the ankle joint is carried out according to the same methodology as in the case of other types.
What to do and what not to do with osteoarthritis
Is it possible to do physical exercises with this disease? It is important to reduce the load on the diseased joint as much as possible, therefore, after establishing the diagnosis, try not to lift weights, running is prohibited, you can not jump, squat, push and press with heavy weight while on foot. , engage in shock aerobics, perform asymmetric exercises and engage in static loads (for example, squatting). You can use a cane to help relieve arthritis pain while walking.
However, it is not recommended to refuse physical activity at all. On the contrary, the normal blood circulation of the ankle with osteoarthritis is achieved faster by practicing sports. Recommended for disease (especially post-traumatic ankle osteoarthritis) brisk walking or swimming.
Every extra kilogram of weight will add stress to the legs and cause ankle swelling, so even a slight weight loss will significantly speed up recovery time. Losing weight too quickly is not recommended, moderate exercise and a proper (but not debilitating) diet will gradually bring the body back to normal. From arthrosis, monodiets will not help, as well as those that will dramatically and radically change the usual diet. If you are going to switch to a vegetarian diet, it is best to wait until you are fully recovered.
Choose shoes with low, wide soles. For the ankle joint, you can and should wear a small wide heel, but not ballerinas or sneakers. These shoes are the most comfortable and safe to wear and significantly increase foot stability when walking. The soft sole will further reduce some of the load on the joint.
The upper should be soft and roomy, not compressing the foot, but the wrong size of boots will only increase the risk of injury. If you suffer from flat feet, this only adds to the problem. When a person steps on the ground, the impact on the ground, together with the twisted foot, has to be extinguished by the joint. In this case, special orthopedic insoles or instep supports will help.
While sitting, try to keep your knees slightly lower than your hips. Furniture with high legs will help in this, preferably with armrests. Such seats with handles will be especially relevant for existing pains, as this will reduce the load on the knee joint when lifting. When you work in the office, position your desk chair so your legs don't go numb. If the furniture is of poor quality, don't sit still and stand up from time to time to warm up.
If you are doing a foot massage on your own or seek the help of a specialist, then remember that massaging the knee is strictly prohibited. Gonarthrosis is also inflamed in the articular bag, and the active blood circulation inside will only increase the pain. Is it possible to warm the joints in the bath or use a variety of warming compresses in therapy? Yes, but only if the person is sure of their diagnosis and the treating doctor does not object to such procedures. Do not use heat if injections for osteoarthritis in the form of corticosteroids are prescribed.
Medical treatment
How to treat osteoarthritis of the ankle joint? Therapy must be comprehensive and work with various techniques. First of all, it is necessary to reduce the load on the ankle as much as possible, especially during the period of exacerbation of pain. A bandage or walking with a cane with an emphasis on a healthy leg will help in this. Do not overload it, give up jogging and other physical activities for a while (running is dangerous).
By themselves, the medications will not increase a person's motor activity, but they can make movement easier and relieve pain. Good pain relievers that relieve pain are nonsteroidal anti-inflammatory drugs (NSAIDs).
NSAIDs have a negative effect on the gastric mucosa, causing a number of problems and pain, so it is better to use them in the form of ointments or injections. These funds are intended to reduce pain, many of them allow you to eliminate swelling and inflammation. For the same reasons, corticosteroids, anti-inflammatory drugs, are also injected into the joints. Its use is advisable when the disease is in a critical state, and other drugs no longer have any effect, since corticosteroids are strong and powerful drugs.
In the modern method of treatment, the drug is injected directly into the joint with the help of steroid hormones or with the help of hyaluronic acid (the same one that is so popular for cosmetic purposes). Treatment of ankle osteoarthritis with this method is expensive, but effective. Injected Hyaloron has a composition similar to intra-articular fluid and, entering it, regenerates the damaged joint, replacing the fluid that disappeared during the course of the disease.
Edema treatment can be carried out with the help of droppers, various ointments will increase the tone of the veins. Chondoprotectors are drugs that are used last, since their main task is to further restore and protect the joint from negative influences. The treatment of ankle osteoarthritis involves the use of condoprotectors. The result of the use of funds occurs after at least 3 months, depending on the severity of the disease. That is why the remedy is usually prescribed for treatment for a year or even more, but only in the first two stages, because otherwise they are useless.
Operation and its varieties.
The operation is prescribed at 3-4 stages of the disease, as well as for those to whom the above methods of treatment did not give the proper result. Treatment of arthrosis of the ankle joint with surgery has several subspecies:
- Arthroscopy is a well-known and frequently used method.
- Tibial osteotomy (also called coxarthrosis).
- Arthroplasty.
- endoprosthesis
During arthroscopy, the surgeon makes a small incision near the joint and inserts a small camera into it, evaluating the general condition of the joints and bones. After that, the necessary surgical instruments are inserted inside and the operation itself is performed. Arthroscopy is considered the most moderate method of treatment, since the person recovers quickly after the operation, and the incision made does not heal more than any ordinary cut.
In some cases, deformation of this organ leads to deforming osteoarthritis of the ankle joint (the treatment will be somewhat different from the treatment of other types of ailments), since the load on the entire ankle is incorrectly distributed. The osteotomy aims to correct this curvature (coxarthrosis) and align the bone. It is usually contraindicated in the elderly and is used to treat young patients. During arthroplasty, a part of the material of the femur, which is not subject to heavy load, is taken and transferred to the ankle joint. With the endoprosthesis method, the affected area is completely or partially removed and replaced with an artificial device, but similar in structure.
Other treatment and prevention
Methods of treating arthrosis of the ankle joint by no means end with the use of various drugs. The next step in treatment will be a wide variety of options. Therapeutic exercise (exercise therapy) restores muscle tone and returns the ankle to its former mobility. The scheme of exercises is established by specialists. First, physiotherapy exercises are performed in a prone position, over time - sitting and standing.
Another option is to fix the legs. During such classes, it would be advisable to fix the leg with a bandage or refer to the bandage principle. This is done with the help of special tapes and plasters (teips). Thus, the risk of injury is reduced to a minimum, because comfortable lotions help with this. This principle is widely known among professional athletes.
Another method is kinesiology taping. Here, cotton tapes made of hypoallergenic material are applied to the leg. The latter dries quickly on the leg, is easily fixed and does not cause any sensation of discomfort.
Some doctors are skeptical about the following method of treating osteoarthritis deformans of the ankle joint. However, it has been scientifically proven that magnetotherapy, electrophoresis and Vitafon treatment significantly enhance the effect of drugs, due to which they perfectly relieve pain.
Each massage session must be performed by a specialist and last approximately 15-20 minutes. At the same time, actions are performed not only on the ankle joint, but also move to adjacent areas, since the foot muscles enhance the work of the entire leg as a whole. The course usually lasts 2 weeks with 2-day breaks, but the treatment can be adjusted on the recommendation of a specialist.
The diet for osteoarthritis of the ankle joint should be balanced and include the use of protein, fat, carbohydrates, fiber and minerals. Nutrition for osteoarthritis should in no case be scarce. In any case, a variety of dishes is good and healthy. Vitamins for osteoarthritis will also be important. They can be obtained both with the help of tablets, and through the use of vitamins from fruits and vegetables.
To prevent the development of the disease, follow a number of simple rules, and this disease will not manifest itself.
For example, watch your diet. Do not give up your favorite harmful products at all: try to reduce their consumption to a minimum.
While working or playing sports, try to avoid injuries and heavy loads. Before your favorite workout, be sure to warm up. Squatting with arthrosis is forbidden, but if the patient got rid of the disease and returned to his former activities, then this should be done as carefully as possible. Patients should wear comfortable shoes. Give preference to high-quality shoes, for which heels should be abandoned.