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

The ankle joint is often injured as it withstands heavy loads. A doctor can diagnose ankle arthrosis 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.

Arthrosis affects 12% of residents, and more often the disease 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.

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 sliding during physical activity.

With arthrosis, tissue nutrition and metabolism deteriorate. The outer surface of the joint changes, becomes rough, 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, severe 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 supporting function suffers, movements become difficult.

Kinds

There are several types of arthrosis depending on various criteria:

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

Classification criteria	Types of arthrosis
place of manifestation	knee, wrist, ankle, elbow, shoulder and cervical arthrosis.
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.
localization	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 - increased 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.

Arthrosis of the ankle 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 cartilage tissue).

Stages and degrees

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

It depends on the age and concomitant diseases when therapy began. As ankle arthrosis progresses, the symptoms become more pronounced.

There are 4 stages of the disease.

1. The first stage is often ignored. Main symptoms: stiffness that occurs in the morning, a characteristic crunch 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 time. It will take 20-30 minutes to develop the leg. Some patients experience lameness. On an x-ray you can see stage 2 pathology by bone growths and bone displacement.
3. At 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 can be seen on an x-ray, and osteophytes form.
4. The last stage develops in the absence of treatment. The cartilage is destroyed, the surfaces of the joints grow together. The patient cannot walk.

There are several degrees of arthrosis:

1. First degree– X-ray does not show any changes or articulations. There is slight morning stiffness. At this stage it is necessary to begin treatment.
2. In the second degreeactivity becomes difficult, a crunching sound is heard when walking, 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. The muscles atrophy even more, movements become limited. Constant rest is required. The pain does not go away even in this state.
4. At 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 arthrosis appears gradually, so treatment should begin when the first symptoms appear in order to prevent the condition from worsening and complications from occurring.

Symptoms

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

• The pain is initially moderate and occurs only during physical activity. Over time, the pain becomes stronger and bothers you at rest;
• with injuries and dislocations, swelling and inflammatory manifestations appear, and there is increased temperature in the area of injury;
• "dry" click 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, you should immediately consult a doctor.

Reasons for appearance

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

Provoking factors are:

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

• violation of metabolic processes;
• congenital foot deformity and flat feet that arose during life;
• hereditary predisposition;
• excessive physical activity;
• using uncomfortable shoes;
• diseases of the endocrine system;
• 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 should be prescribed immediately to prevent progression of the disease.

Diagnostics

Diagnosis of arthrosis consists of studying the existing symptoms and data obtained from research. Since there are no tests that can clearly determine 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. Simpleradiographyis the most reliable method. Muscles do not perceive X-rays equally: soft ones transmit them, while hard ones absorb them. The study reveals the disease itself and its consequences.

   The image allows you to analyze the condition of the bone surfaces in 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 this data, the degree of pathology can be determined.

   

   If the ankle is affected, diagnosis is carried out in the lateral, posterior and posterior projections with the foot moved inward. If there are corresponding symptoms (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 areas of the body that contain water.

   The dark shade in the image represents the bones, since their water content is much less, and the muscles, nerves and discs appear lighter. Diagnostics reveals even 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 accurately examines the ligamentous structure of the joint, muscle tissue and cartilage. Thanks to the study, a specialist can assess the condition of the joints of the lower leg, which makes it possible to identify 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 from 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 across the surface.

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


5. Bone scintigraphy– a study that makes it possible 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 poorer, and they are not detected during scanning. 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 makes it possible to separate arthrosis from similar diseases with similar clinical signs; 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 where the doctor inserts a needle into the joint cavity to take 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. For ankle arthrosis, a puncture is made in the anterior part between the outer ankle and the tendon of the long extensor digitorum.

When to see a doctor

If treatment for arthrosis is not started in time, incapacity for work and sometimes disability occurs. Some patients are in no hurry to seek help because they do not know which doctor to make an appointment with. At the first symptoms, you need to visit 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;
• 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.

In order to prevent arthrosis, experts recommend following certain rules:

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

• take walks in the fresh air more often;
• avoid excessive stress on the legs;
• avoid hypothermia;
• be regularly observed by doctors;
• give up bad habits;
• do a set of exercises to warm up the ankle joint.

It is especially important to adjust your diet. Nutritionists have agreed on a menu that will prevent exacerbation of the disease and saturate the body with 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. Do not eat food 4 hours before bedtime.
5. Steam, bake, boil foods.

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 begin 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.

Medications

Various medications are used to treat arthrosis:

1. Anti-inflammatoryand painkillers eliminate the source of inflammation and relieve pain. Tablets 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 drugs do not bring the desired result. They are produced in the form of an injection solution and injected into the joint.
3. Chondroprotectorsnecessary to slow down the process of cartilage destruction.

The treatment regimen and dosage of drugs is drawn up 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

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

The main recipes for the treatment of ankle arthrosis are the following:

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 frying pan, pour into a linen cloth, and apply to the sore spot. Hold until the salt becomes cold. This is an effective way to relieve pain.
3. Pour triple cologne over lilac, leave in a dark place for 2 weeks, rub the sore spot twice a day.
4. Grind eggshells into powder, take 0. 5 tsp. before meals.

The use of traditional methods of treatment 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;
• severe and 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 ability 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 of bones fusing together, 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 conducts 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 too high.
3. Endoprostheticscarried out in particularly severe cases. Makes it possible to replace a damaged joint in a certain part or completely. Prostheses with modernized mechanics are used and last up to 20 years.

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

Possible complications

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

• disability;
• 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 the inability to lead an active lifestyle.

To make gymnastics, medication 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 fixing 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 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 severe 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.