Osteoarthritis of the ankle joint is a disease associated with degenerative-dystrophic changes of the articular cartilage, often accompanied by inflammatory processes of the adjacent tissues.
The ankle joint is formed by the articulation of the large and small tibial bones with the ramus of the foot; blood supply to the joint is through the tibial arteries, and sensitivity is provided by the branches of the tibial nerves. Feature of the joint is its high mobility, as well as the ability to withstand daily loads within a person’s weight.
The epidemiology of arthrosis is as follows: most often the disease is observed in persons of both sexes in the age group after 45-50 years, with deforming arthrosis with early development observed in people suffering from obesity.
Causes of disease
Blood supply to the articular cartilage slows down over time. The absence of properly organized physical exertion (dynamic), age-related mechanical wear of the hyaline layer, an increase in the viscosity of the synovial fluid leads to a gradual destruction of the cartilage, a compensatory growth of bone osteophytes and a decrease in the mobility of the foot.
At a young age, the same processes can develop with chronic injury to the foot (for example, when playing football, dancing), as a result of a sports injury, with frequent dislocations of the limb. Excessive weight significantly increases the load on the ankle joint, which accelerates its destruction; genetic susceptibility to diseases of the musculoskeletal system is another factor that can influence the development of arthrosis.
Main reasons, accelerating pathological processes in bone and articular tissue, can be:
- working conditions associated with the constant presence on the feet;
- wearing high heels;
- congenital disorders of the development of the joints of the limbs;
- systemic diseases (rheumatoid arthritis, gout, metabolic disorders, endocrine diseases, varicose veins and thrombophlebitis).
Depending on the reason for the appearance There are two types of arthrosis:
- Primary. The main reason is mechanical wear of the joint due to age-related changes or high loads; in some cases, the causes of primary (idiopathic) arthrosis remain unexplained, most often in children and adolescents.
- Secondary. The disease manifests itself as a result of the harmful effects of hormonal disruptions, metabolic disorders, or against the background of other diseases of the body. This group can also include post-traumatic arthrosis resulting from damage to the ankle joint.
Symptoms and signs of ankle arthrosis
At the initial stage of the development of the disease, pain in the ankle area after intense loads, playing sports, during long walking or climbing stairs is manifested.
The characteristic signs of the disease are also:
- stiffness of the joint and muscles upon waking;
- a specific crunch in the joint when moving or sharply waving a leg;
- clicks, creaks when bending a limb;
- the inability to step on the foot without warming up the joint;
- frequent subluxations of the legs, weakness of support, fatigue of the extremities;
- swelling of the joint area;
- in periods of exacerbations – redness, hyperthermia of the joint area, which most often means the addition of inflammatory joint disease (arthritis);
- atrophy of muscles and ligaments due to involuntary reduction of the load on the joint or stepping on the outer side of the foot.
If arthrosis develops on the background of a serious ankle injury, palpation of the surface of the joint may cause irregularities, dents or pathological bulges.
Degree of development
With the development of deforming arthrosis of the ankle allocate 3 stages, characterized by the following diagnostic features:
- Initial (first). Pain in the joint occurs only after significant stress, sometimes there is a slight swelling of the affected area. X-ray image reflects a slight narrowing of the lumen of the joint space.
- The second. Pain is not associated with physical exertion; the crunch and creaks of the joint are clearly heard during a sudden movement, there is pronounced morning stiffness in the limb. When diagnosing with the help of X-rays, obvious changes in hyaline cartilage are visible, the joint space narrowed at least 40% of the original height.
- Third. Joint pains often become unbearable; their duration can reach several days. The patient may be very limp, while there is a deviation of the axis of the tibia to the right or left. Examination of the patient reveals the growth of compensatory osteophytes, atrophy of the ligaments and muscles, and bone deformity.
What could be the consequences?
The outcome of such a process often becomes curvature of the lower leg (bending in or out), limiting the activity of the limb, as well as its complete immobility.
Dysfunction of the ankle and the growth of osteophyte bones often leads to squeezing of blood vessels and nerve roots, the addition of thrombosis, synovitis and bursitis.
Diagnosis of the disease
The main task of diagnostic measures is to differentiate arthrosis of the joint from various types of arthritis, especially rheumatoid and gouty. After performing a complete blood count, it is determined that there are no deviations in the ESR and leukocyte indices, with the exception of cases of the appearance of secondary diseases – bursitis, synovitis. It is mandatory to take blood for biochemical analysis (for rheumatoid samples and the concentration of c-reactive protein, uric acid, as well as immunogram indicators), which in arthrosis most often correspond to the norm.
To determine the degree of development of arthrosis of the ankle joint, an x-ray examination is performed, and to assess the atrophy of bones, muscles, and ligaments, an MRI or radioisotope scan is performed.
Treatment of arthrosis of the ankle joint
Extremely important unloading of the ankle, which is achieved by limiting the stay in an upright position, eliminating weight lifting and reducing static loads. It is practiced to reduce the mobility of the joint with bandages, bandages, elastic bandages. In some cases, bed rest may be necessary, and movement with a cane or crutches is recommended.
Drug treatment of ankle arthrosis may include:
- NSAIDs to achieve anelgeziruyuschego effect and relieve inflammation (ibuprofen, brufen, voltaren, movalis, celebrex).
- Local administration of pain medication – anesthetics (lidocaine, ultracain), as well as glucocorticosteroids (methylprednisolone, diprospan, kenalog) in order to relieve severe pain.
- Muscle relaxants and sedatives (mydocalm, sirdalud, tincture of motherwort and valerian) – to eliminate muscle spasm and the general stress state of the patient.
- Hondoprotectors (struktum, glucosamine sulfate, alflutop, ostenil) to slow down the destruction of inter-articular cartilage and normalize the processes of their regeneration. Used in the form of oral administration or intra-articular injections.
- External therapy – ointment Hondroksid, compresses with dimexidum and medical bile, ointments and gels with NSAIDs, baths with bischofite.
Physiotherapy, hardware and other methods of treatment of arthrosis:
- Ultraviolet irradiation, laser and magnetic therapy. Used to relieve muscle spasm and prevent their atrophy.
- Therapy with the use of electromagnetic fields (inductothermia, shock wave therapy, diadynamic microcurrents) to eliminate pain and inflammation.
- The introduction of drugs using phonophoresis, electrophoresis. Most often used for therapy with hydrocortisone, dimexidum, novocaine.
- Acupuncture, massage, manual therapy.
- Thermal procedures – paraffin baths, mud baths, radon and bromine lotions.
- Exercise therapy is recommended in the form of regular performance except for the period of exacerbation of arthrosis.
Surgery may be needed in advanced stages of the disease. – arthrodesis (bonding of bones, as a result of which the joint becomes immobile), endoprosthesis replacement (replacement of the joint with an artificial one).
Treatment of arthrosis folk remedies
Traditional methods of treatment can not only prevent the development of comorbidities and remove acute pain, but also help preserve the health of the joints:
- Anti-inflammatory and anti-edematous action has such a collection: combine a teaspoon of calendula flowers, willow bark, birch leaves and nettle, pour a mixture of 0.5 liters. boiling water, insist 5 hours. Take a course for a month, drinking 250 ml. infusion per day for 3 doses.
- Rubbing the joint with severe pain is recommended infusion of 50 g. Flowers of the plant mullein 250 liters. vodka. Use the tool can be 10 days after being left in a dark place.
- River sand is washed, dried, after which it is slightly heated and applied during exacerbations to sore joints, pouring it into canvas bags. The recipe cannot be used in case of development of ankle arthritis.
- Grate potatoes on a fine grater, and, without pressing, apply to the sore area, then tie with cellophane. This recipe will help to quickly reduce pain.
- Grind a teaspoon of dried leaves of Hypericum, hops, sweet clover. Mix collection with 50 g of petroleum jelly or baby cream, leave for a day at room temperature. Rub as needed into the affected area.
Lifestyle with arthrosis
To effectively treat a disease, you must follow the basic rules:
- To refuse from bad habits – Smoking and, especially, from alcohol consumption. It is proved that alcoholic beverages contribute to the aggravation of blood stagnation in the tissues, therefore, reduce the speed of blood circulation and accelerate the destruction of articular cartilage.
- Every day, with the exception of periods of exacerbation of arthrosis, it is necessary to perform a set of exercises for warming up the ankle joint:
- lie on your back, straighten your legs. At the same time, turn both feet in and out, then drag your toes upwards;
- slightly raise the leg, rotate the foot in the form of circular movements;
- sitting on a chair, press your feet to the floor, then simulate walking, lifting first the toes of your feet, then the heels.
How to eat?
Diet for arthritis should be based on following principles:
- limiting animal fats, as well as meat soups;
- exclusion food intake with preservatives and flavor enhancers;
- sparing cooking mode;
- restriction of salt, refined oils, sweets;
- daily consumption of fruits and vegetables.
To prevent the development of the disease you need, first of all, choose shoes carefully: high heels, hard soles, squeezing or uncomfortable shoes can adversely affect the condition of the ankle joint.
It is necessary to limit the load on the joint., eliminate injuries and injuries, avoiding hard work or excessive physical training, while fully engaged in therapeutic exercises. Metabolic disorders, neuroendocrine diseases require mandatory treatment or correction, which contributes to the improvement of tissue trophism and joint nutrition.
Without fail It is necessary to normalize the weight: eliminating the additional load on the ankle joint, it is possible to prevent its dystrophic changes.