Joint deformities often affect the joints of the lower limbs, one of which is the ankle.These joints have high mobility in different planes and perform an important function when walking (rolling the foot and transferring body weight from heel to toe), while also bearing the weight of the human body.Ankle arthritis is a kind of retribution for an upright posture.But many other factors also play a role in the development of the disease.At first, without the patient paying attention, the cartilage covering the joint begins to soften and thin, then cracks, causing an inflammatory process and the growth of bone tissue in the form of bone spurs.With advanced arthritis, a person cannot move without support and feels severe pain, especially when leaning on the leg.Disability can occur within several years after the onset of the disease if treatment is not initiated early and comprehensively.
Cause of development of the disease
Previous injuries to the ankle joint increase the likelihood of developing a degenerative process there.
- Increased body weight;
- Flat feet, congenital foot deformities (caudal feet, club feet);
- Metabolic disorders in diseases such as diabetes, gout, atherosclerosis in the legs;
- Previous joint injuries, for example, damage to the ligamentous apparatus, fractures of the ankle and foot bones;
- Constant overload of the joints, leading to micro-trauma (in athletes and people carrying heavy loads);
- Genetic predisposition to osteoarthritis;
- Previous arthritis (arthritis) of an infectious nature or in systemic diseases (rheumatoid arthritis, psoriasis, gout).
Depending on the absence or presence of a specific trigger, ankle arthritis can be primary or secondary.There is also a division into stages.If in stage 1, a person can work;If joint disease has progressed to stages 2 and 3, pain and limited mobility will lead to disability (temporary or complete).
Symptoms of ankle arthritis
- The pain "starts".This is one of the early symptoms of ankle arthritis.The pain appears after sitting for a long time when trying to lean on the leg and may be accompanied by short-term stiffness during movement.After walking a few steps, the pain disappeared;
- Pain during and after physical activity;
- Nocturnal pain, which is associated with the inflammatory process triggered by the destruction of cartilage tissue;
- Crackling or crunching sound in joints when moving;
- Swelling, especially noticeable below the ankles;
- Restriction of movement;
- Periarticular muscle atrophy and weakness of the ligamentous apparatus due to which a person begins to no longer feel pain in the legs;
- Joint deformity in the late stages of arthritis.
Diagnose
It is necessary to distinguish arthritis and its exacerbation from various inflammatory processes in the joints, for example, due to rheumatoid gout or psoriatic arthritis.Therefore, the doctor prescribed a detailed blood test, rheumatism test, CRP and uric acid tests.With joint disease, these indicators are normal, but if the disease is in the acute stage, ESR and white blood cells may increase.To determine the stage of joint disease and obtain more detailed information about the pathology, 2-projection radiographs, ultrasound, CT or MRI of the joints are used.X-rays may show a slight narrowing of the joint space if the arthritis is in stage 1. When it moves to stage 2, the joint space is reduced by 40% or more compared to normal.And in the 3rd stage, it is significantly narrowed, it may practically be absent, bone growth and deformation can be seen.
Treatment methods
Ankle arthritis, like other local sites, requires complex, long-term, and regimented treatment.
- Disarticulate the ankle in severe stages of the disease (walk with a cane on the healthy limb), use a bandage;
- Eliminate shock loads (jumping, running), vibration, lifting heavy objects, long standing;
- Control body weight;
- Quit smoking;
- Wearing semi-rigid orthotics also causes joint instability;
- Physical therapy (UHF, SMT, laser therapy, magnetic therapy);
- Drug treatment:
- NSAIDs for external, oral, and injectable use;
- glucocorticoids with intra-articular and peri-articular anesthetics to reduce inflammation;
- vascular agent;
- muscle relaxants to eliminate muscle tissue spasms;
- chondroprotectors – drugs injected into the joint are more effective.If intra-articular injection is not possible, intramuscular or oral injection is indicated;
- hyaluronic acid preparations to restore the quality of synovial fluid.
- Orthopedic insoles, wear comfortable shoes with small heels;
- Exercise to strengthen the musculo-ligamentary apparatus.Suggested exercises that should be done daily:
- lying or sitting, bend and straighten your toes 10 times;
- lying or sitting, pull your legs toward you and away from you 10 times;
- rotate your legs out and in 10 times;
- make circular movements with your legs clockwise and counterclockwise 10 times;
- Sit on a chair, put your feet on the floor, toes and heels touching each other, alternately move your feet forward and backward, repeat 15–20 times.
- Swimming, water aerobics;
- In the third stage of arthritis and conservative treatment is ineffective, ankle arthroscopy or removal of the destroyed cartilage and joint capsule by closure with a rod structure or an Ilizarov device (arthrodesis) is indicated.
prevent
To reduce the risk of developing joint disease, priority should be given to protein-rich foods 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 follow a diet, that is, eat lots of protein-rich foods and limit salty, spicy, fried, fried foods and alcohol;
- Timely treatment and adjustment of metabolic, endocrine, and vascular disorders;
- Do the above exercises for the ankle joint.
The effectiveness of treatment of ankle joint deformity depends on its stage of development and the presence of accompanying diseases.In any case, if conservative treatment is indicated, it must include medications and physical methods, as well as correction with orthopedic products.
Which doctor should I contact?
If you have pain in your ankle joint, you should consult a rheumatologist.The doctor will prescribe exercises, medications and determine the cause of the disease.If you have diabetes or gout, seeing an endocrinologist will be helpful;If you have atherosclerosis in your lower extremities, it is helpful to see a vascular surgeon and a cardiologist.The orthopedist plays an important role in treatment - he not only helps you choose the right orthopedic shoes and insoles, but also performs surgery if necessary.If you are overweight, you need to be examined by a nutritionist and choose a suitable diet.Non-pharmacological treatment is carried out with the participation of a physiotherapist.