Osteoarthritis 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 or sex; Tissues are thinned and destroyed, which can lead to disability.

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

As we have already mentioned, the ankle can withstand an enormous load. It keeps the body upright and allows the 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 occurs gradually. A healthy person has a smooth joint surface. When overloaded, it encourages easy sliding during physical activity.

With osteoarthritis, tissue nutrition and metabolism deteriorate. The outer surface of the joint changes, becomes rough, the cartilage is touched and inflammation appears. When a person lifts heavy objects, the load falls on the bone, causing degenerative disorders.

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

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There are several types of osteoarthritis based on several criteria:

• causes of appearance (primary, secondary);
• stages of osteoarthritis;
• localization of 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 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: increased intensity of symptoms and their severity, severe pain, morphological changes occur more dynamically; chronic form - the course of the disease is slow and is 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 patient's age) can occur in several 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 diseases when therapy was started. As ankle osteoarthritis 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, characteristic crunching when walking. Pathogenic changes are not revealed in the picture, 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 experience lameness. Stage 2 pathology can be seen on an x-ray through bone growths and bone displacement.
3. In stage 3, symptoms become more pronounced. Painful sensations appear in a calm state, the patient cannot do without pain relievers. The limp becomes noticeable and crutches are sometimes needed. The joint swells, changes, the muscles become thinner 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 come together. The patient cannot walk.

There are several degrees of osteoarthritis:

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

3. in third gradeClearly pronounced cruzarthrosis, deformation of the joints. The muscles atrophy further and movements become limited. Constant rest is required. The pain does not go away even in this state.
4. in the last gradeThere 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, 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 (they affect the treatment method):

• The pain is initially moderate and occurs only during physical activity. Over time, the pain becomes stronger and bothersome at rest;
• with injuries and dislocations, swelling and inflammatory manifestations appear, and there is an increase in temperature in the injury area;
• "dry" click accompanied by pain;
• dislocation, as the cartilage tissue becomes thinner and breaks down, the joint loses stability. The bones shift and fall from the joint capsule;
• joint stiffness;

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

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

Reasons for appearance

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

The provoking factors are:

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

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

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

Diagnosis

The diagnosis of osteoarthritis consists of studying the existing symptoms and the data obtained from the 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 elevated level of ESR and C-reactive protein. This means that the pathology has already begun.

Instrumental methods are used to confirm the diagnosis:

1. Simplebone scanIt is the most reliable method. Muscles do not perceive X-rays equally: 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 in the joint, the shape, size and location of structures relative to each other, the state 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 views with the foot displaced inward. If there are corresponding symptoms (narrowing of the joint space, osteophytes and other signs), osteoarthritis is diagnosed.

2. Nuclear magnetic resonanceIt determines the alteration 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 of the image represents the bones, since their water content is much lower, and the muscles, nerves and discs appear lighter. The 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. MRI imageIt very precisely examines the ligamentous structure of the joint, muscle tissue and cartilage. Thanks to the study, a specialist can evaluate the condition of the leg joints, which makes it possible to identify pathology from the beginning of its development. The procedure is painless and lasts about 30 minutes.

   During the procedure, the person receives radio waves and strong magnetic radiation. 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 accurate diagnosis. The device produces waves that reflect off the tissues and are recorded on the screen. The doctor examines the image and makes a diagnosis. For greater image clarity, a gel is used that eliminates 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 determining 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 worse and they are not detected during the scan. This includes places where malignant tumors have appeared. In warm areas, isotopes are collected more actively and are clearly detected during scanning. These areas indicate the appearance of inflammatory processes.

   This study makes it possible to separate osteoarthritis 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 having a child, breastfeeding and taking medications containing barium.

6. Joint punctureIt is a procedure in which the doctor inserts a needle into the joint cavity to extract 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 what stage of development it is in. For ankle osteoarthritis, a puncture is performed in the anterior part between the outside of the ankle and the tendon of the extensor digitorum longus.

When to see a doctor

If osteoarthritis treatment is not started on time, work incapacity and, sometimes, disability occur. 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, it is necessary 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 exertion, at the end of the working day;
• it is difficult to find a comfortable position for your legs at night;
• the joints swell, the skin turns red;
• there is a sharp pain, it is difficult to move;
• crackling 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

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

To prevent osteoarthritis, experts recommend following certain rules:

• wear comfortable, well-fitting shoes without heels;
• maintain proper nutrition, drink enough clean water;
• choose a suitable vitamin and mineral complex;
• exercise;

• walk outdoors more often;
• avoid excessive tension in the legs;
• avoid hypothermia;
• be periodically observed by doctors;
• abandon 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 exacerbation of the disease and saturate the body with the necessary substances.

1. It is necessary 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 bedtime.
5. Steam, bake, boil food.

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

Treatment methods

Once the diagnosis is confirmed, treatment should be started immediately. It is impossible to completely get rid of osteoarthritis, the main thing is to slow down the destructive processes and increase the period of remission. For this, various techniques are used.

Medicines

Various medications are used to treat osteoarthritis:

1. Anti-inflammatoryand pain relievers eliminate the source of inflammation and relieve pain. Tablets and ointments are used. The sooner anti-inflammatory medications are taken, the better the chances of saving the joint.
2. GlucocorticoidsThey are used if the above medications do not produce the desired result. They are produced in the form of an injectable solution and are injected into the joint.
3. Chondroprotectorsnecessary to slow down the process of cartilage destruction.

The doctor develops the treatment regimen and dosage of medications based on the severity of symptoms, concomitant diseases and other factors. Self-medication is strictly prohibited so as not to aggravate the situation.

Traditional methods

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

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

1. Burdock leaves are washed well and applied with the soft side to the skin. The plant is fixed with a bandage or transparent film and left overnight.
2. Heat sea salt (buckwheat, sand) in a pan, pour into a linen cloth and apply to the painful area. Keep until the salt cools. This is an effective way to relieve pain.
3. Pour triple cologne on lilac, leave in a dark place for 2 weeks, rub the sore area 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 treating doctor. This is not the only measure, but a complement to the main therapy.

Other methods

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

As a general rule, the indications for surgery are:

• repeated and primary arthrosis of 3-4 degrees;
• complications;
• severe, prolonged pain that radiates 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.

For osteoarthritis 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 the bones fusing, causing 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 performs a visual examination and evaluates the condition of 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. endoprosthesescarried out in especially serious cases. It allows you to replace a joint damaged in a certain part or in its entirety. Prostheses with modernized mechanics are used that last up to 20 years.

The main contraindications for surgery are children under 12 years of age, joint fistulas, 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;
• decrease 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.

In order for gymnastics, medication and folk treatment to be 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 contour 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 the joint to be well fixed. The bandage is used only during periods of remission, when the exacerbation passes.

Osteoarthritis 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.