Ankle Pain

2024 Author: Josephine Shorter | [email protected]. Last modified: 2024-01-07 17:49

Ankle pain

The ankle joint has a complex structure. The talus of the foot is connected to the bones of the lower leg. The connection is held by three groups of strong ligaments. The articular surfaces are covered with cartilage tissue. The joint cavity is filled with synovial fluid.

The ankle joint only provides flexion of the foot. The joint does not perform lateral bending and rotation. If these movements are carried out forcibly, then damage to the ankle occurs, which is accompanied by pain and swelling.

All diseases that cause pain in the ankle can be divided into:

• Diseases associated with damage to the ankle joint and foot (dislocations, subluxations, ligament rupture, fractures).
• Dystrophic diseases (deforming arthrosis of the ankle joint).
• Inflammatory joint diseases.
• Achilles tendon disease.

Diseases associated with injury to the ankle of the foot

Most often, injuries to the ankle joint are associated with injuries that occur when the foot is tucked inward or outward, when a person falls from a height to the heels, when the foot is damaged by heavy objects that have fallen on the foot. Of these, damage to the ligaments and fractures of the ankles are most often recorded. Immediately after the injury, edema appears, which is associated with rupture of blood vessels.

Trauma is always accompanied by severe pain. If both ankles are fractured, the foot is displaced either inward or backward due to subluxation. Often, on palpation, bone fragments can be identified. When the foot is squeezed, the vessels rupture and extensive hematomas of the rear of the foot appear.

When the ligamentous apparatus is damaged along with a fracture of the ankles, the talus is displaced, forming a dislocation of the joint.

Subluxation of the ankle joint occurs in obese people or in case of weakness (failure) of the ligamentous apparatus, which can be repeated several times. With frequent subluxations, the articular cartilage begins to be damaged, which eventually leads to the development of arthrosis.

Ligament sprains are common in trauma practice. It occurs when awkward movement while walking or running, when the entire body weight is moved to one joint. It would be correct to say not stretching, but a rupture of either the entire ligament or part of its fibers.

With a slight sprain, the ligaments are eroded at a microscopic level. A significant amount of fibers can also be eroded. If severely injured, the ligament can rupture completely. Sometimes it is an independent disease. But often a complete rupture of the ligaments is accompanied by dislocations, subluxations and fractures. Objectively, there is swelling of the joint, severe pain appears, sometimes a hematoma of soft tissues appears.

Ligament rupture is diagnosed using X-ray. X-ray shows joint displacement and fractures. With the help of MRI, you can see a picture of a layer-by-layer image of the ligaments, tendons, fractures and cracks.

Treatment of ligament injuries is based on several postulates:

• Protect the joint from stress (the imposition of fixing means - eight-way bandages, plaster casts, splints, the use of an orthosis).

• Relief of pain and swelling with the help of drugs (non-steroidal anti-inflammatory drugs and novocaine blockade), the application of pressure bandages and cold compresses.
• Evacuation of blood poured into the joint cavity in case of injury.
• Rehabilitation measures (exercise therapy, massage and the use of physiotherapy techniques in the form of diadynamic currents, paraffin applications, UHF therapy, etc.).

The ligaments heal well even after a complete rupture. If the rupture of the ligaments is insignificant (at the micro level), then a cooling bandage and rest are sufficient. As a rule, recovery takes up to 10 days.

In case of rupture of a significant part of the ligament fibers, it is necessary to wear a fixing device - an orthosis for 10 days. The orthosis limits the mobility of the limb, thereby reducing the stress on the joint and accelerating the recovery time. You can apply an eight-way bandage or splint for 2 to 3 weeks. It is necessary to conduct a course of exercise therapy. The treatment lasts about 1 month.

With a complete rupture of the ligament, a plaster cast or plaster splint is applied. If a complete rupture is accompanied by a fracture and / or dislocation of the foot, then 2 joints are immobilized at once - ankle and knee.

With extensive hemorrhages in the joint and periarticular tissues, surgical intervention is performed (stitching the ligaments and removing the damaged tissue).

Deforming arthrosis of the ankle joint (osteoarthritis)

Deforming arthrosis is a rather serious disease that leads to disability and disability. Most often, the disease develops after injuries of the ankles of the tibia, fracture of the head of the fibula, and injuries of the talus. Irregularities resulting from trauma, when moving, injure the articular surfaces, which causes joint and muscle pain.

The joint swells, there is a restriction of its mobility and a violation of gait. Inflammation and destruction of the joint begins with the articular cartilage and ends with its gross deformation. The patient's ability to work decreases, disability often occurs.

The main symptoms of osteoarthritis are pain and swelling that gets worse with walking. A crunch appears in the joint. Joint mobility is limited gradually and reaches significant levels over time.

Treatment of osteoarthritis is aimed at preventing the occurrence of inflammation in the joint (relieving pain, reducing swelling), which should improve its motor function.

• Non-steroidal anti-inflammatory drugs. Reduces the level of inflammation in the joint and reduces pain. They are represented by a very wide range of drugs: Indomethacin, Diclofenac, Ibuprofen, Aertal, Voltaren, Navalis, etc.
• Normalization of metabolic processes in cartilage tissue (chondroprotectors glucosamine and chondroitin sulfate). These substances help repair damaged cartilage tissue and improve joint fluid production. Their effect is especially pronounced in the initial stages of osteoarthritis, and their use is completely useless with almost complete destruction of cartilage (3rd stage).

Chondroprotectors are available in the form of injections, ointments, creams and gels. Their representatives: Artra, Rumalon, Structum, Alflutop, etc.

Arthritis

Gout, systemic lupus erythematosus and ankylosing spondylitis cause inflammation of the ankle. Joint inflammation occurs when microbes enter the injured joint from the blood and lymph.

Inflammatory arthritis occurs with pronounced symptoms: severe pain, stiffness in the morning, swelling and redness in the joint area, increased body temperature, a significant decrease in physical activity.

There are many causes of ankle arthritis. So with ankylosing spondylitis, as a result of an increased level of aggression of the own immune system against its tissues, an inflammatory process is formed in the tissues of the joint. Elastic connective tissue structures begin to be replaced by bone tissue, which leads to complete immobility of the joint.

With gout, uric acid crystals are deposited in the tissues of the joint. Gouty granulomas form around the joint.

Post-traumatic arthritis is the most common form of arthritis. It occurs when ligaments, bones, cartilage and joint capsule are damaged.

Reactive arthritis occurs when an infection from other organs enters the joint. Most often from the intestines and genitourinary system. Today, the disease is not fully understood. It is believed that genetic predisposition plays a large role.

On the subject: All information about arthritis!

The disease always begins acutely and is accompanied by a deterioration in the general condition. There is swelling, swelling of the joint, a change in the color of the skin. Reactive arthritis often includes a symptom complex: inflammation of the mucous membrane of the eye, urethra, intestines and skin. Treatment for reactive arthritis includes joint immobilization, prescription of non-steroidal anti-inflammatory drugs and antibiotics, and vitamin therapy. If necessary, drugs are injected into the joint. The therapeutic effect is fixed by exercise therapy, massage and physiotherapy.

Achillite

Pain in the ankle joint can be caused by inflammation of the Achilles tendon, which occurs during overload in athletes, congenital defects (shortening of the tendon at birth) and in women, when, with prolonged wearing of high-heeled shoes, the tendon begins to shorten, with the deposition of calcium salts in the tendon, arthritis, including gouty. The disease is accompanied by severe pain due to inflammation of the place where the heel bone and the Achilles tendon meet. The aim of treatment is to relieve inflammation and pain, "loosening" fibrous formations, destruction of calcium salts, restoration of blood flow: Appointment of non-steroidal anti-inflammatory drugs (effective local use in the form of ointments and gels). Appointment of physiotherapy (shock wave therapy).

Author of the article: Kaplan Alexander Sergeevich | Orthopedist

Education: diploma in the specialty "General Medicine" received in 2009 at the Medical Academy. I. M. Sechenov. In 2012 completed postgraduate studies in Traumatology and Orthopedics at the City Clinical Hospital named after Botkin at the Department of Traumatology, Orthopedics and Disaster Surgery.