With osteoarthritis of the ankle, the symptoms and treatment largely depend on the nature of the 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, which in itself is so dangerous and whether it is possible to get rid of this problem forever.
causes of the disease
In the development of arthrosis of the ankle, 2 groups are distinguished: primary (occur for no particular reason) and secondary (occur due to external unfavorable factors). Other names for this disease: cruarthrosis (the right or left ankle suffers) or osteoarthritis. With arthrosis of the lower leg, degenerative processes occur in the cartilage tissue, which subsequently cause a number of deviations.
In most cases, the disease occurs in older men and women. Over time, organs in the internal system stop working as actively and properly, and in some cases, failures lead to thinning of bone and cartilage tissue. In the normal state, the joints slide freely during movement without touching.
When they are negatively affected in osteoarthritis, the joint deforms and begins to rub against another joint. This creates an additional load, which is then transferred to the bones, resulting in their deformation. If a joint is injured again, the surrounding tissue is also affected. The legs lose their mobility and do not tolerate large loads (in the case of paresis).
Different reasons
A common cause of ankle hemarthrosis is active physical activity, which directly affects the musculoskeletal system. At risk are people whose work involves carrying heavy loads or other active work. A similar cause provokes a disease in professional athletes or in those who have been actively involved in sports for a long time. Improper strain exerts considerable pressure on the limbs, which subsequently leads to damage.
Acute osteoarthritis is a common problem in overweight people because movement puts pressure on the lower limbs that the legs cannot withstand. In obesity, the disease can also develop in young people (by around 20 years of age) if a person has been diagnosed with it since childhood. Other diseases that lead to deforming osteoarthritis of the ankle (the reasons were discussed above):
- Gout;
- Diabetes mellitus and arteriosclerosis (metabolic diseases);
- congenital malformations of the legs, ankles (clubfoot);
- any condition in which a nerve is pinched.
As a result, the function of the muscular apparatus is disturbed (e. g. osteochondrosis). Due to flat feet or clubfeet, in addition to the deforming condition, subtalar osteoarthritis occurs (it is so called due to changes in the talus).
Various types of injuries to the knees or legs (wrong squatting) and wearing uncomfortable, small or poorly made shoes are also causes of ankle osteoarthritis. Women are particularly at risk. They have negative symptoms that lead to wearing high-heeled shoes.
symptoms and stages
Years can pass from the first manifestation of the disease to the terminal stage of the disease. The timing of development depends on the initial condition of the human body, the treatment and the adequacy of the applicable therapy. Signs of osteoarthritis differ in a number of symptoms characteristic of them.
First of all, with any, even slightly increased load on the joints, a person feels a sharp tingling in the legs. The same happens when the patient moves slowly over long distances. Joints often crackle and squeak.
The patient begins to twist his legs, which sometimes leads to dislocations in the ankle. This happens due to violations of the functionality of muscles and tendons, up to and including atrophy of muscle tissue (a decrease or change in muscle tissue, followed by its replacement with connective tissue that is unable to perform basic motor functions). Stiffness and swelling are often felt in the legs for the same reason.
Doctors distinguish 3 stages of the development of the disease. The first two are perfectly treatable, after which the person fully returns to his former life. At grade 3, patients are often given disability for osteoarthritis.
During the development of the 1st degree disease, the symptoms of osteoarthritis appear very easily. A person can go to a medical institution with a complaint of rapid fatigue in the limbs and a slight pain in the legs, which disappears after rest. The diagnosis of osteoarthritis of the extremities is rarely made, since no pathologies are found in the patient during the studies.
In the second stage, the pain does not go away after rest. Swelling and redness appear on the legs, which leads to an increase in temperature. The pain intensifies during an active change in weather conditions, swelling appears.
At the last stage, the cartilage tissue ossifies, which causes significant discomfort to the patient, from which the person experiences severe pain. The legs lose their mobility and a crunch is heard with every step. If the disease has started, this can 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, in which the pain disappears completely, but the person loses the ability to walk, since at this stage the cartilage is completely destroyed and paralysis occurs. At the same time, the 4th degree is characterized by the frequent development of ankylosis (when the joints grow together) and neoarthrosis (when an unnecessary or incorrect joint is formed between the displaced bone ends).
Post traumatic osteoarthritis
Post-traumatic arthrosis of the ankle requires timely treatment, since it is characteristic of young people, unlike deformity and acute, since it occurs after an injury. For example in the case of dislocations, fractures and sprains.
Any tissue damage after an injury does not pass without a trace and directly affects the blood vessels and nerves.
At first, the patient does not feel any discomfort, only over time does he realize that the foot is twisted when walking, because the ligaments are weakened and can no longer support the entire leg.
Over time, with arthrosis of the ankle, physical activity (especially in athletes) becomes more difficult, legs quickly get tired during exercise. In such cases, girls often have complaints that they cannot sit on the yarn even with daily long and correctly performed stretches. Improvement is constantly followed by remission, in which the leg swells, hurts, and does not calm down even after rest.
Often it is post-traumatic osteoarthritis that causes nonunion, a bone defect that causes severe joint mobility. This makes it possible, for example, to bend the arm at the elbow not only backwards but also forwards. Pseudarthrosis occurs during bone healing when the tissues grow together improperly.
Often, post-traumatic arthrosis of the ankle is a consequence of surgical intervention during other operations. Scars form in the tissue area, which impairs blood circulation. The risk increases if surgery involves removing part of the affected joint. Treatment of post-traumatic arthrosis of the ankle is carried out using the same methodology as for other types.
Osteoarthritis do's and don'ts
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 standing kicks and presses with heavy weight , do shock aerobics, perform asymmetric exercises, and do static exercisesloads (e. g. squatting). You can use a walking stick to relieve arthritis pain while walking.
Nevertheless, it is not recommended to refuse physical activity altogether. On the contrary, normal blood circulation in the ankle joint with arthrosis is achieved more quickly through sport. Recommended for diseases (especially post-traumatic arthrosis of the ankle) brisk walking or swimming.
Each extra pound of weight puts extra strain on the legs and causes ankle swelling, so even a modest weight loss will greatly speed up recovery time. Losing weight too quickly is not recommended, moderate exercise and a proper (but not debilitating) diet will gradually return the body to normal. Monodiets do not help with arthrosis, nor do those that dramatically and radically change the usual diet. When switching to a vegetarian diet, it is better to wait until you have fully recovered.
Choose shoes with low and wide soles. For the ankle, you can and should wear a small wide heel, but no ballet flats or sneakers. These shoes are the most comfortable and safe to wear and significantly increase the stability of the foot when walking. The soft sole further reduces the stress on the joint.
The upper should be soft, roomy and not compress the foot, but the wrong size of 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 ground, the impact must be canceled out by the joint along with the twisted foot. Special orthopedic insoles or bandages can help here.
While sitting, try to keep your knees slightly lower than your hips. Furniture with high legs helps, preferably with armrests. Such seats with handles are especially relevant for existing pain, as this reduces the load on the knee joint when lifting. When working in the office, adjust your desk chair so that your legs do not fall asleep. If the furniture is of poor quality, don't sit still and occasionally get up to warm up.
If you are doing a foot massage on your own or seek help from a specialist, remember that massaging the knee itself is strictly prohibited. Gonarthrosis also inflames itself in the joint bag, and active blood circulation inside only increases pain. Is it possible to warm the joints in the bath or use various warming compresses in therapy? Yes, but only if the person is sure of his diagnosis and the attending physician does not object to such interventions. Do not use heat if injections are prescribed for osteoarthritis in the form of corticosteroids.
Medical treatment
How is osteoarthritis of the ankle treated? The 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 pain aggravation. A bandage or walking with a cane with an emphasis on a healthy leg helps. Do not overload it, refrain from jogging and other physical activities for a while (running is dangerous).
Medications alone don't increase a person's motor activity, but they can make movement easier and reduce pain. Good analgesics that relieve pain are nonsteroidal anti-inflammatory drugs (NSAIDs).
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 remedies are aimed at relieving pain. Many of them allow you to remove swelling and inflammation. Corticosteroids, anti-inflammatory drugs, are also injected into the joints for the same reasons. Their use is advisable when the disease is in a critical stage and other drugs stop having an 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 hyaluronic acid is similar in composition to the intra-articular fluid and, upon penetration, regenerates the damaged joint and replaces the fluid that has disappeared as the disease progresses.
Treatment of edema can be carried out with the help of droppers, various ointments increase the tone of the veins. Chondoprotectors are drugs that are used last, since their main task is to restore the joint and further protect it from negative influences. Treatment of ankle osteoarthritis involves the use of chondroprotectors. The result from the use of funds occurs after at least 3 months, depending on the severity of the disease. Therefore, the remedy is usually prescribed for a year or even longer treatment, but only in the first two stages, otherwise they are useless.
operation and its variants
The operation is prescribed at 3-4 stages of the disease, as well as for those for whom the previous methods of treatment did not bring the right result. The treatment of osteoarthritis of the ankle with surgery has several subtypes:
- Arthroscopy is a well-known and frequently 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 to assess the general condition of the joints and bones. After that, the necessary surgical instruments are inserted and the actual operation is performed. Arthroscopy is considered the most gentle treatment method, since the person recovers quickly after the operation, and the incision made heals no longer than any ordinary incision.
In some cases, the deformation of this organ causes deforming arthrosis of the ankle (the treatment is somewhat different from the treatment of other types of ailments), since the load on the entire ankle is improperly distributed. The osteotomy aims to correct this curvature (coxarthrosis) and align the bone. It is usually contraindicated in elderly patients and is used to treat young patients. In endoprosthetics, part of the material is removed from the less stressed femur and transferred to the ankle. With the method of endoprosthetics, the affected area is completely or partially removed and replaced with an artificial, but similarly constructed device.
Other treatment and prevention
The methods of treating arthrosis of the ankle by no means end with the use of various drugs. The next step in treatment will be a variety of options. Therapeutic exercises (exercise therapy) restore muscle tone and return the ankle to its former mobility. The exercise scheme is determined by specialists. First, over time, physiotherapeutic exercises are performed in the prone position - sitting and standing.
Another option is to fix the legs. During such courses, 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). This reduces the risk of injury to a minimum, because soothing lotions help. This principle is well known among professional athletes.
Another method is kinesiology taping. Cotton adhesive tapes made of hypoallergenic material are attached to the leg. The latter dries quickly on the leg, is easily fixed and does not cause any discomfort.
Some doctors are skeptical about the next method of treating deforming ankle osteoarthritis. 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 about 15-20 minutes. At the same time, actions are performed not only on the ankle, but also shifted to adjacent areas, since the foot muscles improve the work of the 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.
Diet for osteoarthritis of the ankle should be balanced and include the use of proteins, fats, carbohydrates, fiber and minerals. Nutrition for osteoarthritis should by no means be scarce. In any case, varied food 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 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.
Avoid injury and heavy loads when working or playing sports. Before your favorite workout, be sure to warm up. It is forbidden to squat with osteoarthritis, but when 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 avoided.