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

The ankle joint is often injured because it bears heavy loads. A doctor can diagnose ankle osteoarthritis based on symptoms and prescribe treatment. The disease does not depend on age and gender: tissues become thin and destroyed, which can lead to disability.

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

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

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

The disease occurs gradually. A healthy person has a smooth articular surface. When overloaded, it promotes easy slippage during physical activity.

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

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

Types

There are several types of osteoarthritis depending on several criteria:

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

Classification criteria	Types of osteoarthritis
demonstration site	knee, wrist, ankle, elbow, shoulder and cervical osteoarthritis.
cause of occurrence	primary – develops on its own, without prerequisites; secondary – joint damage occurs due to the development of infectious diseases, mechanical damage, injuries, hypothermia and other factors.
location	local damage - symptoms cover a small area of the joint or its individual tissues; generalized - several joints are affected or one with complete coverage of all tissues.
course of the disease	acute form - increase in the intensity of symptoms and their severity, severe 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 occur in several ways. For some, many years pass from the onset of the first symptoms to the critical stage, while for others the disease develops quickly.

It depends on the age and concomitant diseases when therapy was started. 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 clicking sound when walking. Pathogenic changes are not revealed in the image, the destructive process has already begun.
2. Morning stiffness continues for longer. It will take 20 to 30 minutes to develop the leg. Some patients present with lameness. On an x-ray you can see stage 2 pathology 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 necessary. The joint swells, changes, the muscles become thinner and decrease in volume. The joint space narrows, as seen on an x-ray, and osteophytes form.
4. The last stage develops in the absence of treatment. Cartilage is destroyed, joint surfaces grow together. The patient is unable to walk.

There are several degrees of osteoarthritis:

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

3. In the third degreeClearly pronounced crusarthrosis, 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. In the last degreeThere is practically no joint space, activity is almost impossible. X-ray allows you to diagnose a large number of osteophytes. Only surgical intervention is prescribed.

Ankle osteoarthritis appears gradually, which is why treatment should be started when the first symptoms appear, to avoid worsening the condition and the occurrence of complications.

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. Over time, the pain becomes stronger and uncomfortable at rest;
• with injuries and dislocations, swelling and inflammatory manifestations appear, as well as an increase in temperature in the area of the injury;
• "dry" click accompanied by pain;
• dislocation, as the cartilaginous 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, you should immediately consult a doctor.

Reasons for the appearance

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

The provoking factors are:

• injuries, dislocations and bruises;
• age-related disorders of 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;
• wear uncomfortable shoes;
• endocrine system diseases;
• osteochondrosis.

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

Diagnosis

The diagnosis of osteoarthritis consists of studying existing symptoms and data obtained in research. Since there are no tests that can clearly determine the pathology, doctors recognize laboratory methods as insufficiently effective.

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

To confirm the diagnosis, instrumental methods are used:

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

   The image allows you to analyze the condition of the bone surfaces of the joint, the shape, size and location of the structures relative to each other, the condition of the tissue and the size of the joint space. Thanks to these data, the degree of pathology can be determined.

   

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

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

   The dark tone in the image represents the bones, as their water content is much lower and the muscles, nerves and discs appear lighter. Diagnosis reveals even minor disorders in bone tissue and joints. The procedure is indicated before joint replacement. The only negative aspect is the high cost of diagnosis.

3. Magnetic resonance imagingvery accurately examines the ligamentous structure of the joint, muscle tissue and cartilage. Thanks to the study, a specialist can assess the condition of the leg joints, which makes it possible to identify the pathology at the very 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 must be remembered that the magnetic field is dangerous for the physiological state. MRI is prohibited in case of neuropsychic disorders, pregnancy and the presence of metal objects in the body.

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

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


5. Bone scintigraphy– 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 first there are no isotopes, the blood flow to them is weaker and they are not detected during scanning. This includes places where malignant tumors have arisen. In hot areas, isotopes are collected more actively and are clearly detected during scanning. These areas indicate the occurrence of inflammatory processes.

   This study makes it possible to separate arthrosis from similar diseases with similar clinical signs, and based on the results, the doctor makes a prognosis and prescribes treatment.

   The main contraindications for the study are carrying a child, breastfeeding and taking medications containing barium.

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

   This biomaterial continues to be studied in the future, based on the results the specialist determines the characteristic features of the disease and at what stage of development it is. In ankle osteoarthritis, a puncture is made in the anterior part between the outside of the ankle and the extensor digitorum longus tendon.

When to see a doctor

If treatment for arthrosis is not started on time, inability to work, and sometimes disability, occurs. Some patients are in no rush to seek help because they don't know which doctor to make an appointment with. At the first symptoms, it is necessary to consult a rheumatologist who diagnoses 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 your legs at night;
• joints swell, skin turns red;
• there is a sharp pain, it is difficult to move;
• crunching and clicking sounds appear;
• the joints are deformed.

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

Prevention

Arthrosis of the ankle joint (symptoms and treatment can be checked with a doctor) can be prevented.

To prevent osteoarthritis, experts recommend following some rules:

• wear comfortable shoes that fit well and without heels;
• maintain adequate nutrition, drink plenty of 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;
• give up bad habits;
• do a series of exercises to warm up the ankle joint.

It is especially important to adjust your diet. Nutritionists agreed on a menu that will prevent the disease from worsening and saturate the body with the necessary substances.

1. You need to eat frequently and in small portions.
2. Drink at least 2 liters of clean water.
3. Avoid sweet and salty foods.
4. Do not eat food 4 hours before bed.
5. Steam, bake, boil food.

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

Treatment methods

Once the diagnosis is confirmed, treatment must be started immediately. It is impossible to completely get rid of 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

Several medications are used to treat osteoarthritis:

1. Anti-inflammatoryand analgesics eliminate the source of inflammation and relieve pain. Pills and ointments are used. The sooner anti-inflammatory medications are taken, the greater the chance of saving the joint.
2. Glucocorticoidsare used if the above medications 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 medications are set by the doctor based on the severity of symptoms, concomitant diseases and other factors. Self-medication is expressly prohibited so as not to worsen the situation.

Traditional methods

Regarding traditional methods of treating arthrosis, doctors recognize their beneficial properties and positive effects. Traditional medicine is also used to prevent diseases.

The main recipes for treating 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 plastic wrap and left overnight.
2. Heat sea salt (buckwheat, sand) in a frying pan, pour it onto a linen cloth and apply to the sore spot. Hold until the salt cools. This is an effective way to relieve pain.
3. Pour triple cologne over the lilac, leave in a dark place for 2 weeks, rub the wound twice a day.
4. Grind eggshells into powder, take 0. 5 tsp. 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, they resort to radical measures - surgery.

As a rule, indications for surgery are:

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

For arthrosis of the foot, the following surgical interventions are used:

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 that the bones will fuse, which leads to immobility, so it is used very rarely.
2. Arthroscopyis a minimally invasive procedure in which the doctor cuts the joint and inserts an arthroscope. The surgeon performs a visual examination and assesses the condition of the intra-articular structures and, if necessary, removes parts of the damaged joint or blood clots from the synovial fluid. With this operation the risk of relapse is very high.
3. Endoprosthesescarried out in particularly serious cases. Allows you to replace a damaged gasket in a certain part or in its entirety. Prosthetics with modernized mechanics are used and last up to 20 years.

The main contraindications for 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:

• inability;
• deformation that cannot be restored;

• 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, medicines and folk treatment more effective, it is recommended to use special orthopedic devices that reduce the load on the joint. This includes an orthosis and a fixation bandage.

The orthosis completely follows the contours of the ankle, increases range of motion, relieves swelling and pain. The fixation bandage has the same effect as the orthosis. It is made of soft elastic fabric that allows you to secure 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 not fully treated, leads to serious consequences and complete immobility of the joint. Diagnosis at the initial stage, careful attention to symptoms and competent therapy make it possible to avoid surgical intervention.