In osteoarthritis of the ankle, the symptoms and treatment will largely depend on the type of injury and the degree of neglect of the patient's condition. Do not ignore the diagnosis, so you should consult a specialist. Only your doctor will tell you in detail how to cure osteoarthritis of the ankle, 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 (occurring without special reasons) and secondary (occurring due to external adverse factors). Other names for this disease: cruzarthrosis (affects the right or left ankle) or osteoarthritis. In osteoarthritis of the lower leg, degenerative processes occur in the cartilage tissues, which subsequently cause a number of abnormalities.
In most cases, the disease is found in older men and women. Over time, the organs in the internal system do not work so actively and properly, and in some cases failures lead to thinning of bone and cartilage tissue. Normally, the joints slide freely during movement without touching.
If they are adversely affected by osteoarthritis, the joint deforms and begins to rub into another joint. This causes an additional load, which then goes to the bones, leading to deformation. In case of repeated joint injury, the surrounding tissues are additionally affected. The legs lose their mobility and do not tolerate heavy loads (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 involves carrying heavy loads or other active work. Such a cause provokes disease in professional athletes or those who have been active in sports for a long time. Due to improper loads, significant pressure is applied to the limbs, which subsequently causes damage.
Acute osteoarthritis is a common problem for overweight people, because during movement, a mass compresses the lower extremities, which the legs can not withstand. With obesity, the disease can also develop in young people (about 20 years old), if a person is diagnosed with it from childhood. Other diseases that lead to deforming arthrosis of the ankle joint (the reasons were discussed above):
- gout;
- diabetes mellitus and atherosclerosis (metabolic diseases);
- congenital deformities of the legs, ankles (piston foot);
- any condition in which a nerve is pinched.
This disrupts the functioning of the muscular system (eg osteochondrosis). Due to the flatfoot or strabismus, in addition to the deforming condition, subtalar arthrosis occurs (so called due to changes in the talus).
Various types of knee or leg injuries (improper squats), as well as wearing uncomfortable, small or poorly made shoes, are also causes of osteoarthritis of the ankle. Women are especially at risk. They have negative symptoms leading to wearing high heels.
Symptoms and stages
It can take years from the initial onset of the disease to the final stage of the disease. The time of development will depend on the initial condition of the human body, treatment and the appropriateness of the applicable therapy. The signs of osteoarthritis will differ in a number of its characteristic symptoms.
In the first place, with each, even slightly increased, load on the joints, a person begins to feel a sharp tingling pain in the legs. The same happens if the patient moves long distances at a slow pace. Joints often crack and creak.
The patient begins to twist his legs, which sometimes ends in sprains in the ankle. This occurs due to dysfunction of muscles and tendons, to atrophy of muscle tissue (reduction or change in muscle tissue, followed by its replacement with connective tissue, which is unable to perform basic motor functions). For the same reason, stiffness and swelling of the legs are often felt.
Doctors distinguish 3 stages of disease development. The first two are completely curable, after which the person returns completely to his previous life. In grade 3, patients often develop a disability for osteoarthritis.
During the development of the disease of the 1st degree the symptoms of arthrosis are very weak. One can go to a hospital with a complaint of rapid limb fatigue and mild leg pain that disappears after a break. The diagnosis of osteoarthritis of the extremities is rarely established, as no pathologies are found in the patient during the examination.
In the second stage, the pain does not disappear after a break. Swelling and redness appear on the legs, which will lead to a rise 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 significant discomfort, from which the person suffers from severe pain. The legs lose their mobility and a crunch is heard at every step. If the disease starts, it can lead to another diagnosis - deformity of the foot. This pathology entitles to disability, so treatment should begin immediately.
At this stage, osteoarthritis is dangerous. Some distinguish the 4th degree, in which the pain completely disappears, but the person loses his ability to walk, because the cartilage at this stage is completely destroyed and paralysis occurs. At the same time, grade 4 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 osteoarthritis
Post-traumatic osteoarthritis of the ankle joint requires timely treatment, because, unlike deforming and acute, it is characteristic of young people, as it occurs after injury. For example, with sprains, fractures and sprains.
Any tissue damage after injury does not go unnoticed by directly touching 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 distorted because the ligaments have weakened and can no longer support the whole leg.
Over time, in 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 can not sit on a rope, even with daily long and properly performed stretches. Improvement is constantly followed by remission, during which the leg swells, hurts and does not calm down even after rest.
Often, post-traumatic osteoarthritis causes pseudoarthrosis, 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. Psevartrosis occurs during bone healing, when tissues grow improperly.
Often, post-traumatic ankle osteoarthritis is the result of surgery during other surgeries. Scars form in the area of the tissue that disrupt blood circulation. The risk increases when part of the affected joint is removed, if necessary during surgery. The treatment of post-traumatic arthrosis of the ankle joint is performed by the same method as for other types.
What should and should not be done in osteoarthritis
Is it possible to exercise with this disease? It is important to minimize the load on the diseased joint, so once the diagnosis is made, try not to lift weights, running is prohibited, you can not jump, squats, push-ups and heavy presses while standing, exercisedo shock aerobics, perform asymmetric exercises and engage in static loads (eg sitting squats). You can use a cane to relieve arthritis pain while walking.
However, it is not recommended to refuse physical activity at all. On the contrary, normal blood circulation in the ankle with osteoarthritis is achieved faster through exercise. Fast walking or swimming is recommended for diseases (especially post-traumatic osteoarthritis of the ankle).
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 recovery time. Too fast weight loss is not recommended, moderate exercise and proper (but not exhausting) diet will gradually return the body to normal. From osteoarthritis monodiet will not help, as well as those who will drastically and radically change the usual diet. If you are going to go on a vegetarian diet, you'd better wait until you're fully recovered.
Choose shoes with low and wide soles. For the ankle joint, you can and should wear a small wide heel, but not ballet shoes or sneakers. These shoes are the most comfortable and safe to wear and significantly increase the stability of the foot when walking. A soft sole will further reduce some of the strain on the joint.
The upper part should be soft and spacious, not to press on the foot, but the wrong size of the boots will only increase the risk of injury. If you suffer from flat feet, this only exacerbates the problem. When a person steps on the ground, the impact on him, together with the twisted leg, must be suppressed by the joint. In this case, special orthopedic insoles or footrests will help.
While sitting, 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 suitable for existing pain, as this will reduce the load on the knee joint when lifting. When working in the office, adjust your desk chair so that your feet do not tingle. If the furniture is of poor quality, do not sit still and occasionally stand up to warm up.
If you are doing a foot massage yourself or seek help from a specialist, remember that the knee massage itself is strictly prohibited. Gonarthrosis is also inflamed in the joint sac itself and the active blood circulation inside will only increase the pain. Is it possible to warm the joints in the bath or to use different warming compresses in the therapy? Yes, but only if the person is sure of his diagnosis and the doctor does not object to such procedures. Do not use heat if arthrosis injections are prescribed in the form of corticosteroids.
Medical treatment
How to treat osteoarthritis of the ankle joint? The therapy should be complex and work with several techniques. First of all, it is necessary to minimize the load on the ankle, especially during the period of exacerbation of pain. A bandage or walking with a cane with an emphasis on a healthy leg will help with this. Do not overload it, give up jogging and other physical activities for a while (running is dangerous).
Medications alone will not increase a person's physical activity, but they can relieve 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 remedies are aimed at reducing pain, many of which allow you to eliminate swelling and inflammation. For the same reasons, corticosteroids, anti-inflammatory drugs, are also injected into the joints. Their use is recommended when the disease is in a critical stage, and other drugs no longer give any effect, as 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). Treatment of ankle osteoarthritis with this method is expensive but effective. The injected hyaluronic acid is similar in composition to the intra-articular fluid and, once inside, regenerates the damaged joint, replacing the fluid that has disappeared during the course of the disease.
The treatment of edema can be done with the help of droppers, various ointments will increase the tone of the veins. Chondoprotectors are drugs that are used last, as their main task is to restore and further protect the joint from adverse effects. Treatment of ankle osteoarthritis involves the use of chondroprotectors. The result of the use of funds appears after at least 3 months, depending on the severity of the disease. That is why the drug 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 variants
The operation is prescribed at 3-4 stages of the disease, as well as for those to whom previous methods of treatment have not given the appropriate result. The treatment of osteoarthritis of the ankle with surgery has several subtypes:
- Arthroscopy is a well-known and widely used method.
- Tibial osteotomy (also called coxarthrosis).
- Arthroplasty.
- Endoprosthesis.
During arthroscopy, the surgeon makes a small incision near the joint and inserts a small chamber into it, assessing the general condition of the joints and bones. Then the necessary surgical instruments are inserted inside and the operation itself is performed. Arthroscopy is considered to be the most gentle method of treatment, as 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 osteoarthritis of the ankle joint (treatment will be slightly different from the treatment of other diseases), because 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, some of the material is taken from the femur, which is not subjected to much stress, and transferred to the ankle joint. With the endoprosthesis method, the affected area is completely or partially removed and replaced with an artificial but structurally similar device.
Other treatment and prevention
Methods of treating osteoarthritis of the ankle joint do not end with the use of various drugs. The next step in treatment will be a wide variety of options. Therapeutic gymnastics (exercise therapy) restores muscle tone and restores the ankle's previous mobility. The scheme of exercises is determined by specialists. First, physiotherapy exercises are performed in a supine position, over time - sitting and standing.
Another option is to fix the legs. During such classes it would be advisable to fix the legs with a bandage or refer to the principle of gluing. This is done with the help of special tapes and plasters (tapes). This minimizes the risk of injury because comfortable lotions help. This principle is widely known among professional athletes.
Another method is kinesiological taping. Here, cotton strips made of hypoallergenic material are glued to the feet. The latter dries quickly on the feet, is easy to fix and does not cause any discomfort.
Some doctors are skeptical about the next method of treating deforming osteoarthritis of the ankle joint. However, it has been scientifically proven that magnetic therapy, 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, the 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 whole leg as a whole. The course usually lasts 2 weeks with breaks of 2 days, but 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, minerals. Nutrition for osteoarthritis should never be scarce. In any case, the 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 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 exercising, try to avoid injuries and heavy loads. Be sure to warm up before your favorite workout. Squatting with osteoarthritis is forbidden, but if the patient has recovered from 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.