Arthrosis of the ankle joint. Symptoms and treatment, remedies, exercises

The ankle joint is often injured as it bears heavy loads. A doctor can diagnose ankle osteoarthritis based on symptoms and prescribe treatment. The disease does not depend on age and sex; tissues thin and break down, which can lead to disability.

Osteoarthritis affects 12% of residents, and the disease most often affects women of retirement age.

As mentioned, the ankle can withstand a huge load. It holds the body upright and allows a person to move. Its violation changes the usual way of life.

Osteoarthritis of the ankle joint (symptoms and treatment may vary) is a chronic disease in which irreversible processes occur in the cartilage.

The disease manifests itself gradually. A healthy person has a smooth joint surface. When overloaded, it promotes easy sliding during physical activity.

With arthrosis, tissue nutrition and metabolism deteriorate. The outer surface of the joint changes, becomes rough, the cartilage touches and inflammation appears. When a person lifts heavy objects, the load falls on the bone, which leads to degenerative disorders.

If treatment is not started, serious pathologies develop. In later stages, the cartilage and tissue are affected, the synovial membrane is irritated, and the joint loses stability. In this case, the support function suffers, movements become difficult.

Types

There are different types of osteoarthritis depending on various criteria:

• causes of onset (primary, secondary);
• stages of osteoarthritis;
• localization of the pathology;
• forms of localization (generalized and local);
• course of the disease (acute and chronic).

Classification criteria	Types of osteoarthritis
place of demonstration	Osteoarthritis of the knee, wrist, ankle, elbow, shoulder and cervical.
cause of the occurrence	primary – develops on its own, without prerequisites; secondary: joint damage occurs due to the development of infectious diseases, mechanical damage, injury, hypothermia and other factors.
location	local damage: symptoms cover a small area of the joint or its individual tissues; generalized: multiple joints or one with complete coverage of all tissues are affected.
course of the disease	acute form: increased intensity of symptoms and their severity, intense pain, morphological changes occur more dynamically; chronic form: the course of the disease is slow, manifested by individual symptoms during exacerbations.

Ankle arthrosis is divided into primary (degenerative processes begin in healthy cartilage due to excessive physical activity) and secondary (destructions are diagnosed, dystrophic changes appear in the cartilaginous tissue).

Internships and degrees

Arthrosis of the ankle joint (symptoms and treatment directly depend on the patient's age) can manifest itself in various ways. For some, many years pass from the appearance of the first symptoms to the critical stage, while for others the disease develops rapidly.

It depends on the age and concomitant pathologies at the beginning of therapy. As ankle osteoarthritis progresses, symptoms become more pronounced.

There are 4 stages of the disease.

1. The first phase is often ignored. Main symptoms: stiffness that occurs in the morning, characteristic creaking when walking. Pathogenic changes are not revealed in the image, the destructive process has already begun.
2. Stiffness in the morning continues for a longer period. It will take 20-30 minutes to develop the leg. Some patients experience lameness. On an x-ray you can see stage 2 disease by bone growth and bone displacement.
3. In stage 3, symptoms become more pronounced. Painful sensations appear in a calm state, the patient cannot do without painkillers. Lameness becomes noticeable and crutches are sometimes required. The joint swells, changes, the muscles thin and decrease in volume. The joint space narrows, as can be seen on the x-ray, and osteophytes form.
4. The last stage develops in the absence of treatment. Cartilage is destroyed, joint surfaces grow together. The patient cannot walk.

There are different degrees of osteoarthritis:

1. First degree– The x-ray shows no changes or joints. There is a slight morning stiffness. At this point it is necessary to start treatment.
2. In the second degreeactivity becomes difficult, a crunch is heard when walking, swelling is observed. The x-ray shows a decrease in the inter-articular space. The person limps and the morning stiffness lasts longer.

3. In the third degreeclearly pronounced cruciarthrosis, deformation of the joints. Muscles atrophy even more, movements become limited. Constant rest is necessary. The pain does not disappear even in this state.
4. To the last degreeThere is practically no joint space, activity is almost impossible. Radiography allows you to diagnose a large number of osteophytes. Only surgery is prescribed.

Ankle osteoarthritis appears gradually, so treatment should begin when the first symptoms appear to prevent the condition from worsening and complications from occurring.

Symptoms

Arthrosis of the ankle joint is characterized by several symptoms (affect the method of treatment):

• The pain is initially moderate and occurs only during physical activity. As time passes, the pain becomes stronger and bothers you at rest;
• with injuries and dislocations swelling and inflammatory manifestations appear and an increase in temperature is observed in the area of the injury;
• "dry" clicking accompanied by pain;
• dislocation, as the cartilage tissue becomes thinner and degrades, the joint loses stability. The bones are displaced and fall out of the joint capsule;
• joint stiffness;

• when walking, a person gets tired quickly;
• in the last stages the joint becomes deformed.

If at least one symptom occurs, consult a doctor immediately.

Reasons for appearance

Osteoarthritis of the ankle joint (symptoms and treatment are often caused by age-related changes) affects older generations. Recently, the pathology has been observed among young people.

The provoking factors are:

• injuries, dislocations and contusions;
• age-related disorders in joints and ligaments;
• inflammatory processes;
• overweight;

• violation of metabolic processes;
• congenital foot deformity and flat feet that appeared during life;
• hereditary predisposition;
• excessive physical activity;
• use uncomfortable shoes;
• diseases of the endocrine system;
• osteochondrosis.

Less synovial fluid is produced, causing less nourishment of the cartilage. The joint space narrows, which can lead to bone fusion. Cross arthritis occurs, which cannot be reversed. Despite this, treatment must be prescribed immediately to prevent progression of the disease.

Diagnostics

The diagnosis of arthrosis consists in the study of existing symptoms and data obtained from research. Since there are no tests that can clearly determine the pathology, doctors recognize that laboratory methods are not effective enough.

During remission, the indicators are normal, during relapse, a blood test shows an increase in the level of ESR and c-reactive protein. This means that the pathology has already started.

To confirm the diagnosis, instrumental methods are used:

1. Simpleradiographyit is the most reliable method. Muscles do not perceive X-rays in the same way: the soft ones transmit them, while the hard ones absorb them. The study reveals the disease itself and its consequences.

   The image allows you to analyze the state of the bone surfaces in the joint, the shape, size and position of the structures relative to each other, the state of the tissue and the size of the joint space. Thanks to this data it is possible to determine the degree of the pathology.

   

   If the ankle is affected, the diagnosis is made in the lateral, posterior and posterior views with the foot moved inward. If corresponding symptoms are present (narrowing of the joint space, osteophytes and other signs), arthrosis is diagnosed.

2. Nuclear magnetic resonancedetermines the disruption of the functioning of hydrogen molecules under the influence of a strong magnetic field. Allows you to explore the areas of the body that contain water.

   The dark shade in the image represents bones, as their water content is much lower, while muscles, nerves and discs appear lighter. Diagnostics also reveal minor disorders in bone tissue and joints. The procedure is indicated before joint replacement. The only negative is the high cost of diagnostics.

3. Magnetic resonance imagingvery carefully examines the ligament structure of the joint, muscle tissue and cartilage. Thanks to the study, a specialist can evaluate the condition of the joints of the lower leg, allowing you to identify the pathology at the beginning of its development. The procedure is painless and lasts about 30 minutes.

   During the procedure, radio waves and strong magnetic radiation affect the person. It should be remembered that the magnetic field is dangerous for the physiological state. MRI is prohibited in case of neuropsychological disorders, pregnancy and presence of metal objects in the body.

4. Ultrasoundallows for an accurate diagnosis. The device produces waves that are reflected by the tissues and recorded on the screen. The doctor examines the image and makes a diagnosis. For image clarity, a gel is used that removes air and ensures easy movement on the surface.

   The advantages of this procedure are health safety, affordable price and high accuracy.


5. Bone scan– a study that allows you to determine pathological disorders in bones using isotopes. A special substance containing labeled atoms is injected into the patient's body. Pathological areas are divided into cold and hot.

   In the former there are no isotopes, the blood flow to them is poorer and they are not detected during the scan. This includes places where malignant tumors have appeared. In hot areas, isotopes are collected more actively and are clearly detected during scanning. These areas indicate the occurrence of inflammatory processes.

   This study allows us to distinguish arthrosis from similar diseases with similar clinical signs; Based on the results, the doctor makes a prognosis and prescribes treatment.

   The main contraindications to the study are carrying a child, breastfeeding and taking barium-containing drugs.

6. Joint punctureis a procedure in which the doctor inserts a needle into the joint cavity to withdraw synovial fluid for analysis.

   This biomaterial continues to be studied in the future; Based on the results, the specialist determines the characteristics of the disease and what stage of development it is in. In ankle arthritis, a puncture is made in the anterior part between the external ankle and the extensor digitorum longus tendon.

When to see a doctor

If treatment of arthrosis is not started on time, inability to work and sometimes disability occurs. Some patients are in no hurry to ask for help because they don't know which doctor to make an appointment with. At the first symptoms, it is necessary to visit a rheumatologist who will diagnose dystrophic and inflammatory changes in the joint.

You should contact him if:

• there is discomfort and pain in the joints after excessive load, at the end of the working day;
• it is difficult to find a comfortable position for the legs during the night;
• joints swell, skin turns red;
• there is a sharp pain, it is difficult to move;
• creaking and clicking sounds appear;
• the joints are deformed.

With the help of modern diagnostic and therapeutic techniques it is possible to avoid surgery and preserve the functioning of the joint.

Prevention

Osteoarthritis of the ankle joint (symptoms and treatment can be consulted by the doctor) can be prevented.

To prevent arthrosis, experts recommend following some rules:

• wear comfortable shoes that fit correctly and without heels;
• maintain proper nutrition, drink enough clean water;
• choose a suitable vitamin and mineral complex;
• exercise;

• take walks outdoors more often;
• avoid excessive stress on the legs;
• avoid hypothermia;
• be regularly observed by doctors;
• abandon bad habits;
• do a series of exercises to warm up the ankle joint.

It is especially important to adapt your diet. Nutritionists have agreed on a menu that prevents exacerbation of the disease and saturates the body with the necessary substances.

1. You need to eat often and in small portions.
2. Drink at least 2 liters of clean water.
3. Avoid sweet and salty foods.
4. Don't eat food 4 hours before going to sleep.
5. Steam, bake, boil foods.

Fasting and a strict diet for arthrosis are strictly prohibited to prevent the leaching of calcium necessary for the restoration of bones and cartilage.

Treatment methods

Once the diagnosis is confirmed, treatment should begin immediately. It is impossible to completely eliminate arthrosis, the main thing is to slow down the destructive processes and increase the period of remission. Various techniques are used for this purpose.

Medicines

Various drugs are used to treat osteoarthritis:

1. Anti-inflammatoryand painkillers eliminate the source of inflammation and relieve pain. Compresses and ointments are used. The sooner anti-inflammatory drugs are taken, the greater the chance of saving the joint.
2. Glucocorticoidsare used if the above drugs do not bring the desired result. They are produced in the form of an injectable solution and injected into the joint.
3. Chondroprotectorsnecessary to slow down the process of cartilage destruction.

The treatment regimen and dosage of drugs are established by the doctor based on the severity of symptoms, concomitant diseases and other factors. It is strictly forbidden to self-medicate so as not to aggravate the situation.

Traditional methods

As for traditional methods of treating arthrosis, doctors recognize their beneficial properties and positive effects. Traditional medicine is also used as disease prevention.

The main recipes for the treatment of ankle arthrosis are as follows:

1. Burdock leaves are thoroughly washed and applied with the soft side to the skin. The plant is fixed with a bandage or cling film and left overnight.
2. Heat sea salt (buckwheat, sand) in a pan, pour it onto a linen cloth and apply to the sore spot. Hold until the salt turns cold. This is an effective way to relieve pain.
3. Pour the triple cologne on the lilac, leave in a dark place for 2 weeks, rub the sore spot twice a day.
4. Grind eggshells into powder, take 0. 5 teaspoons. before meals.

The use of traditional treatment methods must be agreed with the attending physician. This is not the only measure, but an addition to the main therapy.

Other methods

When conservative therapy does not bring positive effects, radical measures are resorted to: surgery.

As a rule, indications for surgery are:

• repeated and primary arthrosis of 3-4 degrees;
• complications;
• severe, prolonged pain radiating to the knee;
• obvious lameness;
• paralysis of the leg muscles;
• deterioration of the flexion-extension properties of the joint and the support capacity of the foot.

The following surgical interventions are used for foot osteoarthritis:

1. Arthrodesis– surgery to immobilize the joint. Its task is to restore the lost ability to support the limb. The main disadvantage is the likelihood of the bones fusing together, which leads to immobility, so it is used very rarely.
2. Arthroscopyit is a minimally invasive procedure in which the doctor cuts the joint and inserts an arthroscope. The surgeon conducts a visual examination and evaluates the condition of the intraarticular structures and, if necessary, removes parts of the damaged joint or blood clots from the synovial fluid. With this operation the risk of recurrence is too high.
3. Endoprosthesiscarried out in particularly serious cases. It allows you to replace a joint damaged in a certain part or completely. Prostheses with modernized mechanics that last up to 20 years are used.

The main contraindications to surgery are age under 12 years, joint fistulas, diabetes mellitus, cardiac dysfunction and infectious diseases.

Possible complications

If treatment is delayed or absent, the following complications may occur:

• disability;
• non-recoverable deformation;

• inactivity and immobility of the joint;
• decline in quality and standard of living.

In addition to these complications, the chronic course of the disease is accompanied by pain, discomfort and inability to lead an active lifestyle.

To make gymnastics, medications and folk treatments more effective, it is recommended to use special orthopedic devices that reduce the load on the joint. This includes an orthosis and a fixing bandage.

The orthosis completely follows the contours of the ankle, increases freedom of movement, relieves swelling and pain. The fixing bandage has the same effect as the orthosis. It is made of soft elastic fabric that allows you to fix the joint well. The bandage is used only during periods of remission, when the exacerbation passes.

Arthrosis of the ankle joint is a serious disease that, if completely untreated, leads to serious consequences and complete immobility of the joint. Diagnosis at the early stage, careful attention to symptoms and competent therapy allow you to avoid surgical intervention.