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 with 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 osteoarthritis of the ankle, 2 groups are distinguished: primary (occur without special reasons) and secondary (appear due to external adverse factors). Other names for this disease: crusarthrosis (the right or left ankle suffers) or osteoarthritis. With osteoarthritis 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, organs in the internal system do not work so actively and correctly, and in some cases, failures entail thinning of bone and cartilage tissues. In a normal state, the joints slide freely during movement without touching each other.
If they are negatively affected in osteoarthritis, the joint becomes deformed and begins to rub against another joint. This causes an additional load, which then goes to the bones, which entails its deformation. When the joint is injured again, the surrounding tissues are additionally 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. At risk are people whose work is associated with carrying heavy loads or any other active work. A similar cause provokes an ailment in professional athletes or in those who have been actively involved in sports for a long time. Due to improper loading, significant pressure is exerted on the limbs, which subsequently causes damage.
Acute arthrosis is a common problem for overweight people, because during movement, a mass presses on the lower limbs, which the legs cannot withstand. With obesity, the disease can also develop in young people (by about 20 years), if a person has been diagnosed with this disease since childhood. Other diseases that entail deforming arthrosis of the ankle joint (the reasons were discussed above):
- gout;
- 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 feet or clubfoot, in addition to the deforming condition, subtalar arthrosis occurs (it is so called because of changes in the talus).
Various kinds of injuries to the knees or legs (improper squatting), as well as wearing uncomfortable, small or poorly made shoes, are also causes of arthrosis of the ankle joint. Women are especially at risk. They have negative symptoms leads to wearing high-heeled shoes.
Symptoms and stages
Years can pass from the initial manifestation of the disease to the final stage of the disease. The time of development will depend on the primary state of the human body, the treatment and the appropriateness of the applicable therapy. Signs of arthrosis will differ in a number of symptoms characteristic of it.
First of all, with any, even slightly increased, load on the joints, a person begins to feel a sharp tingling pain in the legs. The same thing happens if the patient moves long distances at a slow pace. Joints often crackle and creak.
The patient begins to twist his legs, which sometimes ends in dislocations in the ankle. 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 with a connective tissue that is 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 former life. At grade 3, patients are often given disability for arthrosis.
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 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, pain does not disappear after rest. Swelling and redness appear on the legs, which will lead to an increase in temperature. Pain intensifies during 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 every step a crunch is heard. If the disease is started, this may lead to another diagnosis - foot deformity. This pathology gives the right to receive a disability, so treatment should be started immediately.
At this stage, arthrosis is dangerous. Some distinguish another 4th degree, at 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 4th degree is characterized by the frequent development of ankylosis (when the joints are fused together) and neoarthrosis (when an unnecessary or false joint is formed between the displaced ends of the bones).
Post-traumatic arthrosis
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 an injury does not pass without a trace, directly touching the blood vessels and nerves.
At first, the patient does not feel any discomfort, only with 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 osteoarthritis of the ankle joint, physical activity (especially among athletes) is more difficult, the legs quickly get tired during exercise. Girls often in such cases have complaints that they cannot sit on the twine even with daily long and correctly performed 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 arthrosis that causes pseudoarthrosis, a bone defect that causes severe joint mobility. For example, it becomes possible to bend the arm at the elbow not only back, but also forward. Pseudarthrosis appears during bone healing, when the tissues grow together incorrectly.
Often, post-traumatic arthrosis of the ankle is a consequence of surgical intervention during other operations. Scars form in the tissue area, impairing blood circulation. The risk increases when part of the damaged joint is removed during surgery as needed. Treatment of post-traumatic arthrosis of the ankle joint occurs according to the same methodology as in the case of other types.
Do's and Don'ts for Arthrosis
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, do squats, do thrusts and presses with heavy weight while standing, engage in shock aerobics, perform asymmetric exercises and engage in static loads (for example, sittingsquatting). You can use a walking stick to help relieve arthritis pain while walking.
Nevertheless, it is not recommended to refuse physical activity at all. On the contrary, normal blood circulation of the ankle with arthrosis is achieved faster by playing sports. Recommended for disease (especially post-traumatic osteoarthritis of the ankle) brisk walking or swimming.
Each extra kilogram of weight will add stress to the legs and cause swelling of the ankle, so even a slight weight loss will significantly speed up the 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. Mono-diets will not help from arthrosis, 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 better to wait with this until a full recovery.
Choose shoes with low and wide soles. For the ankle joint, you can and should wear a small wide heel, but not ballet flats or sneakers. Such shoes are the most comfortable and safe to wear and significantly 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 of the boots will only increase the risk of injury. If you suffer from flat feet, this only increases the problem. When a person steps on the ground, the impact on it, along 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, since this will reduce the load on the knee joint when lifting. When working in the office, set up your desk chair so that your legs do not get numb. If the furniture is of poor quality, do not sit still and occasionally rise to your feet to do a warm-up.
If you are doing foot massage on your own or seeking help from a specialist, remember that massaging the knee itself is strictly prohibited. Gonarthrosis becomes inflamed in the articular 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 arthrosis in the form of corticosteroids are prescribed.
Medical treatment
How to treat osteoarthritis of the ankle joint? Therapy must 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. 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, drugs will not increase a person's motor activity, but they can ease movement and relieve pain. Good analgesics that relieve pain are nonsteroidal anti-inflammatory drugs (NSAIDs for short).
NSAIDs have a bad 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 remove swelling and inflammation. For the same reasons, corticosteroids, anti-inflammatory drugs, 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 one that is so popular for cosmetic purposes). Treating osteoarthritis of the ankle with this method is expensive, but effective. Injected hyaloron is similar in composition to the intra-articular fluid and, getting inside, regenerates the damaged joint, replacing the fluid that disappeared during the course of the disease.
Treatment of edema 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 restore and further protect the joint from negative influences. Treatment of ankle arthrosis involves the use of chondoprotectors. The result from 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 previous 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 often used method.
- Osteotomy of the tibia (also called coxarthrosis).
- Arthroplasty.
- Endoprosthetics.
During arthroscopy, the surgeon makes a small incision near the joint and inserts a small camera into it, 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 heals no longer than any ordinary cut.
In some cases, the deformation of this organ causes deforming osteoarthritis of the ankle joint (the treatment for it will be somewhat different from the treatment of other types of ailment), since the load on the entire ankle is distributed incorrectly. Osteotomy is aimed at correcting this curvature (coxarthrosis) and aligning the bone. It is usually contraindicated in the elderly and is used to treat young patients. During arthroplasty, a part of the material is taken from the femur, which is not subjected to heavy load, and transferred to the ankle joint. With the method of endoprosthetics, the affected area is completely or partially removed and replaced with an artificial, but similar in structure, apparatus.
Other treatment and prevention
The methods of treating arthrosis of the ankle joint by no means end with the use of various medications. 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 the 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 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, because comfortable lotions help with this. This principle is widely known among professional athletes.
Another method is kinesiology taping. Here, cotton adhesive 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 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 enhance the effect of drugs, so 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, since the muscles of the foot improve the work of the entire leg as a whole. The course usually lasts 2 weeks with breaks of 2 days, but the treatment can be adjusted on the recommendation of a specialist.
The diet for arthrosis of the ankle joint should be balanced and include the use of proteins, fats, carbohydrates, fiber, minerals. Nutrition for arthrosis in no case should be scarce. In any case, a variety of dishes is good and healthy. Vitamins for arthrosis will also be important. They can be obtained both with the help of tablets, and by using 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, control 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 do a warm-up. It is forbidden to squat with arthrosis, but if the patient got rid of the disease and returned to his old 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.