Deforming arthrosis most often affects the joints of the lower extremities, one of which is the ankle.These joints have great mobility in different planes and perform an important function when walking (rolling the foot and transferring body weight from the heel to the toe), and also bear the weight of the human body.Arthrosis of the ankle joint is a kind of retribution for upright posture.But many other factors also play a certain role in the development of the disease.First, unnoticed by the patient, the cartilage covering of the joint begins to soften and thin, then it cracks, which triggers the inflammatory process and the growth of bone tissue in the form of osteophytes.With advanced arthrosis, a person is unable to move without support and experiences severe pain, especially when leaning on the leg.Disability is possible within a few years after the onset of the disease if early and comprehensive treatment is not started.
Reasons for the development of the disease
Previous injuries to the ankle joint increase the likelihood of developing a degenerative process in it.
- Increased body weight;
- Flat feet, congenital foot deformities (cauda foot, clubfoot);
- Metabolic disorders in diseases such as diabetes, gout, atherosclerosis of the blood vessels of the legs;
- Previous joint injuries, for example, damage to the ligamentous apparatus, fractures of the ankles and foot bones;
- Constant overload of the joint, leading to microtrauma (in athletes and people carrying heavy loads);
- Hereditary predisposition to arthrosis of the joints;
- Previous inflammation of the joint (arthritis) of an infectious nature or in systemic diseases (rheumatoid, psoriatic, gouty arthritis).
Depending on the absence or presence of a specific factor that caused the disease, ankle arthrosis can be primary or secondary.There is also a division into stages.If stage 1 is present, a person is able to work; if arthrosis has progressed to stages 2 and 3, pain and limited mobility lead to disability (temporary or complete).
Symptoms of ankle arthrosis
- "Starting" pain.This is one of the early symptoms of ankle arthrosis.Pain appears after prolonged sitting when trying to lean on the leg, and may be accompanied by short-term stiffness of movement in the joint.After taking a few steps, the pain goes away;
- Pain during and after physical activity;
- Aching pain at night, it is associated with an inflammatory process that is triggered due to the destruction of cartilage tissue;
- Crunching, clicking in the joint when moving;
- Swelling, especially noticeable under the ankles;
- Limitation of movements;
- Hypotrophy of the periarticular muscles and weakness of the ligamentous apparatus due to the fact that a person begins to spare the sore leg;
- Joint deformation at the last stage of arthrosis.
Diagnostics
It is necessary to distinguish arthrosis and its exacerbation from various inflammatory processes in the joint, for example, as a result of rheumatoid gout or psoriatic arthritis.Therefore, the doctor prescribes a detailed blood test, rheumatoid tests, a test for CRP, and uric acid.With arthrosis, these indicators are normal, but if the disease is in the acute stage, ESR and leukocytes may be increased.To establish the stage of arthrosis and obtain more detailed information about the pathology, radiography in 2 projections, ultrasound, CT or MRI of the joint is used.An x-ray may show a slight narrowing of the joint space if arthrosis is at stage 1.Upon transition to the 2nd stage, the joint space is reduced by 40% or more from normal.And at the 3rd stage it is significantly narrowed, it may be practically absent, growths and deformations of the bones are visible.
Treatment methods
Arthrosis of the ankle joint, like other localizations, requires complex, long-term and course treatment.
- Unloading the ankle joint during a period of severe exacerbation (walking with a cane on the side of the healthy limb), using a bandage;
- Elimination of shock loads (jumping, running), vibration, heavy lifting, long periods of standing;
- Body weight control;
- Quitting smoking;
- Wearing a semi-rigid orthosis with concomitant joint instability;
- Physiotherapy (UHF, SMT, laser therapy, magnetic therapy);
- Drug therapy:
- NSAIDs externally, orally, by injection;
- glucocorticoids together with anesthetics intra-articularly and periarticularly to relieve inflammation;
- vascular agents;
- muscle relaxants to eliminate spasm of muscle tissue;
- chondroprotectors – drugs administered intra-articularly are more effective.If it is not possible to receive intra-articular injections, intramuscular administration or oral administration is indicated;
- hyaluronic acid preparations to restore the quality of synovial fluid.
- Orthopedic insoles, wearing comfortable shoes with small heels;
- Gymnastics to strengthen the muscular-ligamentous apparatus.The suggested exercises should be performed daily:
- lying or sitting, bend and straighten your toes 10 times;
- lying or sitting, pull your feet towards you and away from you 10 times;
- turn your feet out and in 10 times;
- make circular movements with your feet clockwise and counterclockwise 10 times;
- sitting on a chair, place your feet on the floor with your toes and heels together, alternately move your legs forward and backward, repeat 15–20 times.
- Swimming, water aerobics;
- In the 3rd stage of arthrosis and the ineffectiveness of conservative treatment, endoprosthetics of the ankle joint or removal of the destroyed cartilage covering and joint capsule with its closure using a rod structure or an Ilizarov apparatus (arthrodesis) is indicated.
Prevention
To reduce the risk of developing arthrosis, preference should be given to foods high in protein in the diet, and spicy, salty, fried foods and alcohol should be excluded from the diet.
- Avoid joint injuries.To do this, you must try not to wear shoes with unstable heels or too hard soles, and use special protective equipment when playing sports;
- Control body weight;
- You need to stick to a diet, that is, eat more foods rich in protein and refrain from salty, spicy, fried, and alcohol;
- Treat and correct metabolic disorders, endocrine, and vascular diseases in a timely manner;
- Perform the above exercises for the ankle joints.
The effectiveness of treatment for deforming arthrosis of the ankle joint depends on the stage of its development and the presence of concomitant diseases.In any case, if conservative therapy is indicated, it should include medications and physical methods, as well as correction with orthopedic products.
Which doctor should I contact?
If you have pain in the ankle joint, you should consult a rheumatologist.The doctor will prescribe exercises, medications, and identify the cause of the disease.If you have diabetes or gout, it will be useful to visit an endocrinologist; if you have atherosclerosis of the vessels of the lower extremities, it will be useful to visit a vascular surgeon and cardiologist.An orthopedist plays an important role in treatment - he will not only help you choose the right shoes and orthopedic insoles, but will also perform surgery if necessary.If you are overweight, you need to be examined by a nutritionist and select proper nutrition.Non-drug treatment is carried out with the participation of a physiotherapist.