With osteoarthritis of the ankle joint, symptoms and treatment will largely depend on the type of damage and 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, which in itself is so dangerous and whether it is possible to get rid of this problem forever.
Causes of disease
During the development of arthrosis of the ankle, 2 groups are distinguished: primary (occurring for no specific reason) and secondary (appearing due to external adverse factors). Other names for this disease: crustarthrosis (the right or left ankle suffers) or osteoarthritis. With arthrosis of the lower leg, degenerative processes occur in the cartilaginous tissues, which subsequently cause a number of deviations.
In most cases, the disease is found in older men and women. Over time, the organs of the internal system no longer work so actively and properly, and in some cases failures lead to thinning of bone and cartilage tissue. In a normal state, the joints glide freely during movement without touching.
If they are negatively affected by osteoarthritis, the joint becomes deformed and begins to rub against another joint. This causes an additional load, which then goes to the bones, which leads to its deformation. When the joint is injured again, the surrounding tissues are also affected. Legs lose 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. At risk are people whose work is associated with carrying heavy loads or other active work. A similar cause causes illness in professional athletes or those who have been actively engaged in sports for a long time. Due to incorrect loads, great pressure is exerted on the limbs, which subsequently causes damage.
Acute osteoarthritis is a common problem in overweight people, because during movement a mass presses on the lower limbs, which the legs cannot withstand. Along with obesity, the disease can also develop in young people (about 20 years old), if a person has been diagnosed with it since childhood. Other diseases leading to deforming arthrosis of the ankle joint (the reasons were discussed above):
- drop;
- diabetes mellitus and atherosclerosis (metabolic diseases);
- congenital malformations 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 feet or clubfoot, in addition to the deforming condition, subtalar osteoarthritis occurs (it is so called due to changes in the talus).
Various types of knee or leg injuries (poor squatting position), as well as wearing uncomfortable, small or poorly made shoes, are also causes of osteoarthritis of the ankle joint. Women are particularly at risk. They have negative symptoms that cause them to wear high-heeled shoes.
Symptoms and Stages
Years may pass between the initial manifestation of the disease and the final stage of the disease. The development time will depend on the initial state of the human body, the treatment and the suitability of the applicable therapy. Signs of arthrosis differ in a number of symptoms that are characteristic of it.
First of all, with any, even slightly increased, load on the joints, a person begins to feel a sharp pain in the legs. The same happens if the patient moves long distances at a slow pace. Gaskets crack and creak often.
The patient begins to twist his legs, which sometimes ends in ankle dislocations. This occurs due to violations of the functionality of muscles and tendons, up to atrophy of muscle tissue (decrease or change in muscle tissue, followed by its replacement by connective tissue unable to perform basic motor functions). It is for the same reason that stiffness and swelling are often felt in the 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 old life. At grade 3, patients often receive disability for osteoarthritis.
During the development of the disease of the 1st degree, the symptoms of arthrosis appear very slightly. A person can go to a medical institution with a complaint of rapid fatigue of the limbs and mild pain in the legs, which disappears after rest. The diagnosis of osteoarthritis of the extremities is rarely established, since during the studies no pathology is 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 with an active change in weather conditions, swelling occurs.
At the last stage, the cartilage tissue ossifies, causing the patient considerable discomfort, from which the person suffers from severe pain. The legs lose their mobility, and with each step a crunch is heard. If the disease is triggered, this can lead to another diagnosis - a deformity of the foot. This pathology gives the right to receive a disability, so treatment should be started immediately.
At this stage, osteoarthritis is dangerous. Some distinguish another 4th degree, during which the pain completely disappears, but the person loses the ability to walk, since the cartilage at this stage is completely destroyed and paralysis occurs. At the same time, the 4th degree is characterized by the frequent development of ankylosis (when the joints are fused together) and neoarthrosis (when an unnecessary or false joint forms between the displaced ends of the bones).
Post-traumatic osteoarthritis
Post-traumatic arthrosis of the ankle joint requires timely treatment because, unlike deformity and acute, it is characteristic of young people, as it occurs after injury. For example, with dislocations, fractures and sprains.
Any tissue damage after injury does not pass without a trace, directly affecting blood vessels and nerves.
At first, the patient does not feel any discomfort, only over time he begins to notice that during walking the foot is twisted, because the ligaments have weakened and can no longer support the entire leg.
Over time, with arthrosis of the ankle joint, physical activity (especially in sportsmen) is more difficult, the legs quickly get tired during exertion. In such cases, girls often complain that they cannot sit on the twine, 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.
Often it is post-traumatic osteoarthritis that causes pseudarthrosis, a bone defect that causes severe joint mobility. For example, it becomes possible to bend the arm at the elbow not only backwards, but also forwards. Pseudarthrosis appears during bone healing, when the tissues do not come together properly.
Often, post-traumatic arthrosis of the ankle is a consequence of surgery during other operations. Scars form in the tissue area, impairing 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 takes place according to the same methodology as in the case of other types.
Dos and Don'ts for 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, having made the diagnosis, try not to lift weights, running is prohibited, you can not jump, squats, dopushes and presses with a heavy weight while standing, engaging in shock aerobics, performing asymmetrical exercises, and engaging in static loads (e. g. , seated squats). You can use a cane to help relieve arthritis pain while walking.
Nevertheless, it is not at all recommended to refuse physical activity. On the contrary, normal blood circulation in the ankle with osteoarthritis is achieved faster by playing sports. Recommended in case of illness (especially post-traumatic osteoarthritis of the ankle) brisk walking or swimming.
Every extra pound of weight will add stress to the legs and cause ankle swelling, so even a slight weight loss will dramatically speed up recovery time. Losing weight too quickly is not recommended, moderate exercise and proper (but not debilitating) diet will gradually bring the body back to normal. From arthrosis, mono-diets will not help, as well as those who radically and radically change the usual diet. If you are considering switching to a vegetarian diet, it is best to wait until you are fully recovered.
Choose shoes with low and wide soles. For the ankle joint, you can and should wear a small wide heel, but no ballet flats or sneakers. These shoes are the most comfortable and safest to wear and greatly increase the stability of the foot when walking. The soft sole will further reduce some of the load on the joint.
The top should be soft and spacious, not compress the foot, but the wrong size boots will only increase the risk of injury. If you suffer from flat feet, it only makes the problem worse. When a person steps on the floor, the impact on it, as well as the twisting of the foot, should be extinguished by the joint. In this case, special orthopedic insoles or instep supports will help.
While seated, try to keep your knees slightly lower than your hips. Furniture with high legs will help with 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 working at the office, set up your office chair so that your legs do not become numb. If the furniture is of poor quality, do not sit still and get up from time to time to warm up.
If you do a foot massage yourself or seek help from a specialist, remember that the massage of the knee itself is strictly prohibited. Gonarthrosis also becomes inflamed in the joint bag itself, and active blood circulation inside will only increase 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 his diagnosis and the attending physician 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? The therapy should be comprehensive and work with several 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. Bandaging or walking with a cane with emphasis on a healthy leg will help. Do not overload it, give up jogging and other physical activities for a while (running is dangerous).
By themselves, the drugs will not increase a person's motor activity, but they can make movement easier and relieve pain. Good analgesics that relieve pain are nonsteroidal anti-inflammatory drugs (NSAIDs for short).
NSAIDs have a detrimental effect on the gastric mucosa, causing a number of problems and pain, so it is best to use them in the form of various ointments or injections. These funds are aimed at reducing pain, many of them allow you to eliminate swelling and inflammation. For the same reasons, corticosteroids, anti-inflammatories, are also injected into the joints. Their use is advisable when the disease is at a critical stage and other drugs no longer give any effect, since corticosteroids are strong and powerful drugs.
In the modern method of treatment, the drug is injected directly into the joint itself with the help of steroid hormones or with the help of hyaluronic acid (the same that is so popular for cosmetic purposes). Treating ankle osteoarthritis with this method is expensive, but effective. The injected hyaloron has a composition similar to intra-articular fluid and, penetrating inside, regenerates the damaged joint, replacing the fluid that has disappeared during the course of the disease.
Treatment of edema can be carried out using droppers, various ointments will increase the tone of the veins. Chondoprotectors are drugs that are last used, since their main task is to restore and further protect the joint from negative influences. Treatment of ankle osteoarthritis involves the use of chondroprotectors. 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 longer, 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 previous methods of treatment did not give the right result. Surgical treatment of arthrosis of the ankle has several subspecies:
- Arthroscopy is a well-known and often used method.
- Osteotomy of the tibia (also called coxarthrosis).
- Arthroplasty.
- Stents.
During arthroscopy, the surgeon makes a small incision near the joint and inserts a small camera there, assessing 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 sparing method of treatment, since the person recovers quickly after the operation, and the incision made does not heal longer than any ordinary cut.
In some cases, the deformation of this organ causes deforming arthrosis 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 poorly distributed. The osteotomy aims to correct this curvature (coxarthrosis) and to align the bone. It is generally contraindicated in the elderly and is used to treat young patients. During arthroplasty, part of the material is taken from the femur, which is not under heavy load, and transferred to the ankle joint. With the stent 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 stop with the use of various drugs. The next stage of treatment will be a wide variety of options. Therapeutic exercise (exercise therapy) restores muscle tone and restores the ankle to its former mobility. The exercise scheme is drawn up by specialists. First of all, physiotherapy exercises are performed while lying down, 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 principle of taping. This is done with the help of special tapes and plasters (teips). Thus, the risk of injury is reduced to a minimum, as comfortable lotions contribute to this. This principle is well known to professional athletes.
Another method is kinesiological taping. Here, cotton tapes made of hypoallergenic material are applied to the leg. The latter dries quickly on the leg, attaches easily and does not cause any feeling of discomfort.
Some doctors are skeptical about the next method of treating deforming osteoarthritis of the ankle joint. However, it has been scientifically proven that magnetotherapy, electrophoresis and Vitafon treatment significantly improve the effect of drugs, so that they perfectly relieve pain.
Each massage session should 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, as the muscles of the foot improve 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 proteins, fats, carbohydrates, fiber and minerals. Nutrition for arthrosis should by no means 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 with the use of fruit and vegetable vitamins.
To prevent the development of the disease, follow a number of simple rules and this disease will not manifest itself.
For example, control your diet. Do not give up your favorite harmful products at all - try to reduce their consumption to a minimum.
When working or playing sports, try to avoid injuries and heavy loads. Before your favorite workout, be sure to do a warm-up. It is forbidden to squat with arthrosis, but if the patient gets rid of the disease and returns to his former activities, this should be done as carefully as possible. Patients should wear comfortable shoes. Give preference to high-quality shoes, which is why heels should be abandoned.