Surprisingly, many patients do not take discomfort in the ankle seriously - they say, it will hurt and it will stop. Meanwhile, pain in the joint, limitation of physical activity and swelling can indicate various, and sometimes very serious, problems.
In this article we will look at when ankle pain can occur in healthy people, which doctor treats ankle pain, and what to do if the ankle hurts. However, first things first.
The ankle joint is a mobile connection between the bones of the lower leg and foot. Anatomically, it consists of the tibia, fibula and talus, enclosed in an articular capsule and surrounded by ligaments. This complex block joint gives us the ability to walk - it is responsible for the movement of the foot in all planes. Rotating your foot and rising on your toes is simply impossible with a sore ankle.
Pain in the ankle joint: causes
Causes of ankle pain
The ankle is characterized by pronounced mobility and strength, but at the same time it is a very vulnerable joint, especially on the outside. Among the factors predisposing to the development of ankle diseases is a high body mass index. For the same reason, joints suffer in pregnant women.
All causes of ankle pain can be divided into 3 large groups:
- Traumatic,
- Infectious (inflammatory),
- Dystrophic-degenerative.
Let's look at each group with an example.
How to treat?
Due to the fact that ankle arthritis has similar symptoms to some other joint diseases, it is unlikely that you will be able to make a correct diagnosis yourself. Therefore, you will have to be patient and strong and go to a professional. The rheumatologist prescribes individual complex treatment, consisting of medications and physiotherapeutic procedures. Excellent results are obtained by subsequent physical therapy, carried out under the supervision of a doctor.
You should not take any medications without the advice of a doctor. Many have serious side effects and are not prescribed to everyone. As a rule, conservative treatment begins with pain relief, followed by the use of nonsteroidal anti-inflammatory drugs. If the result is not the best, glucocorticosteroids will be needed. Everything happens exclusively under the supervision of a doctor. If ankle arthritis is caused by an infection, you will have to take a course of antibiotics. To improve immunity, the doctor prescribes vitamin complexes. Among physiotherapeutic procedures, cold therapy, hydromassage, and ultrasound give good results. Surgical methods are used only when drug treatment does not produce results. Today there are and have proven themselves:
- osteotomy, the purpose of which is to evenly distribute the load on both sides of the joint;
- endoprosthetics, that is, replacement of a joint with its artificial analogue;
- arthrodesis, when special screws hold the joint in its normal position, preventing its deformation.
Diet plays an important role in the treatment of ankle arthritis, the symptoms of which are complex and varied. You will have to limit protein foods, but plant foods are welcome. It is very good for joints to eat fatty fish, various jellied meats and jellies. Fish is rich in omega-3 fatty acids, and dishes containing gelatin are rich in collagen, which helps in the restoration of joint tissue. The prognosis depends on the cause of the inflammatory process. However, the disease always occurs with relapses. Reactive arthritis is more treatable, but rheumatoid or psoriatic arthritis is more difficult. They provoke deformation of the joint and lead to its immobility. Therefore, it will take much more effort from the patient and the doctor to delay the development of destructive processes.
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The nature of pain in various pathologies, accompanying symptoms
Ankle injuries
The most common type of traumatic ankle injury is a sprain or subluxation of the foot. When walking, running, or jumping, you may step on your foot awkwardly and twist it inward, overstretching the ankle ligaments. The more fibers are damaged, the more severe the nature of the damage and the more pronounced the pain symptoms. In addition to pain, the leg will react with pronounced swelling, and often a bruise appears.
Fractures are less common in this joint. However, jumping or falling from a great height can cause a fracture of the heel bone or ankle. The symptoms are similar to those of a dislocation or sprain, but much more intense. You cannot step on your foot, and when you feel the injured joint, a sharp, unbearable pain occurs. The heel thickens and seems to turn towards the outer surface.
Arthritis of the ankle
The general name for all inflammatory joint lesions is arthritis. Depending on the type of microorganism that causes it, arthritis can be viral or bacterial. When measles, chickenpox or gonorrhea spread throughout the body, it can also affect the joints. A characteristic rash appears around the affected joint, and the skin over it changes color. The patient often complains of aching pain in the ankle, but motor function is preserved. Similar symptoms are characteristic of tuberculous arthritis.
However, if there is intense bursting, throbbing pain in the joint, this may lead the doctor to think about purulent arthritis. With such a reactive course of the disease, general health worsens, fever, chills and a feeling of weakness occur.
Osteoarthrosis (arthrosis) of the ankle joint
Professional athletes who subject their ankles to sprains and hyperextensions over and over again develop degenerative osteoarthritis over time. Due to multiple traumatization of the surfaces of the ankles, fibula and tibia, their surface loses its natural smoothness. Physiological sliding in the joint is disrupted, movements become more and more painful, ankles swell, which even affects the choice of clothing and shoes.
However, not only athletes are susceptible to arthrosis; nowadays, more and more young people complain of pain in the joint after rest, which goes away with movement, as if they need to “disperse”. In the early stages of the disease, joint destruction can be stopped and slowed down.
Other causes of pain
Among other etiological factors of pain in the ankle, experts note flat feet, tendinitis, and a disease with the unusual name “heel spur.” Varicose veins, neoplasms in this area, or osteoporosis can cause similar symptoms. In addition, wearing tight shoes for a long time also causes discomfort in the lower leg.
Ankle pain: diagnosis
Diagnosis of ankle pain
After interviewing the patient, examining the joint, determining the degree of its mobility and swelling, and after gentle palpation of the ankle, the specialist prescribes an x-ray examination. This simple method reliably shows:
- violation of bone integrity, fracture line,
- narrowing or fusion of the joint space,
- osteoporosis (thinning bones),
- osteonecrosis (bone destruction),
- bone osteophytes (protrusions).
If a more detailed diagnosis is necessary, computed tomography (CT) is prescribed. Magnetic resonance imaging (MRI) is used to examine the ligaments, cartilage and other non-osseous elements of the joint. For vascular pathologies, such as varicose veins or thrombophlebitis, it would not be superfluous to perform an ultrasound with Dopplerography. As a rule, a general and biochemical blood test is prescribed, paying special attention to the leukocyte formula and the value of C-reactive protein.
If arthritis or arthrosis is suspected, a joint puncture can be performed, followed by a cytological examination of the resulting fluid.
Which doctor treats ankle pain?
If symptoms similar to those described earlier occur, it is recommended to consult a traumatologist, orthopedist, surgeon or rheumatologist. Doctors of these specialties will conduct an examination, perform the necessary diagnostics and, if indicated, refer you to an endocrinologist, gynecologist or rehabilitation specialist for additional studies.
Causes and course of the disease
In the initial stage, the disease is accompanied by pain when walking and putting stress on the joint.
As the pain syndrome progresses, it manifests itself even with slight dynamics - any slightest movement or load on the foot.
As a result, patients begin to limit the activity of movements, which over time leads to the formation of adhesions and degeneration of the tendon.
In its advanced form, pain is felt constantly, swelling is noticeable in the joint area, and mobility limitation progresses.
The disease mainly occurs in middle and old age. However, young people who, due to their profession and intense participation in heavy sports, regularly experience increased stress on the ankle area, are also at risk.
The result of ankle damage can also be previous injuries - falls, dislocations, fractures, bruises.
Also, long-term immobilization (immobilization) of the leg can affect the development of pathology of the ankle tendon and muscle tissue, while the process simultaneously affects all tissues, adhesions and micro-tears occur, aggravating the inflammatory process.
Classification of arthritis of the leg
The lesion is classified into various types. Depending on the form of the course, it can be acute or chronic. Due to their occurrence, they are distinguished:
- Primary form. Occurs as a result of direct damage to the joint.
- Secondary form. Develops against the background of extra-articular pathology.
According to the nature of the inflammatory process, arthritis is:
- Nonspecific - purulent.
- Specific - gonorrheal, tuberculosis.
- Aseptic - rheumatoid, reactive.
By area of distribution there are:
- Isolated, monoarthritis.
- Polyarthritis, oligoarthritis. Several joints are affected at the same time.
According to the degree of manifestation, arthritis is divided into:
- Migrating - gout.
- Unilateral, after injuries, infections.
- Bilateral, as a result of systemic pathology.
What are the symptoms of ankle arthritis?
The patient needs to immediately make an appointment with an orthopedist and undergo comprehensive care when the first signs of an inflammatory-destructive disorder are detected. Ankle arthritis - symptoms:
- The acute form is characterized by cramps at night. Pain from ankle arthritis is sharp and sudden. The condition is complicated by edema, hyperemia, and local fever. The motor activity of the feet decreases. The big one feels a migraine, chills, fever, and weakness.
- The chronic form is characterized by the gradual development of spasms. Hyperemia and swelling are quite mild. Movement (flexion, extension, rotation) leads to painful sensations in the limbs. Stiffness in the legs increases in the morning.
Stages of arthritis:
- First. Spasms are relieved by standing still. Slight leg stiffness.
- Second. The pain does not go away with rest. Permanent decrease in foot mobility.
- Third. Sudden loss of ankle mobility. Movement only with the help of crutches or a stick. Unnatural foot deformities, patient disability.
Treatment of ankle ligament inflammation
There are several stages in the treatment of ankle inflammation. the initial one involves stabilization of the condition. To do this, it is important to determine the potential cause of the development of the inflammatory reaction and eliminate it. Then it is important to treat inflammation of the ankle ligaments in a way that will prevent the development of scars and contractures. For these purposes you can use:
- massage and osteopathy, which are aimed at restoring blood microcirculation, normalizing the flow of lymphatic fluid, etc.;
- therapeutic exercises and kinesiotherapy to improve the condition of the muscles, ligaments and tendons of the foot and lower leg;
- laser exposure;
- reflexology;
- electromyostimulation and other types of physiotherapy.
Treatment of inflammation of the ankle ligaments can only be carried out individually. There are no general therapeutic regimens, since they depend on the specific disease that caused such a syndrome. You can visit an orthopedic doctor in our manual therapy clinic absolutely free of charge. We offer free consultation to all patients. During this appointment, the doctor will examine you, make a diagnosis and give all the necessary recommendations regarding treatment.