Pain in the ankle
Last reviewed: 23.04.2024
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There are many causes of pain in the ankle. According to the US National Library of Medicine and the National Institutes of Health, ankle pain includes discomfort in one or both ankles and can be accompanied by swelling and bruising of the ankles, along with an inability to support a person's body weight.
Dislocations and subluxations in the ankle joint
Usually both subluxations and dislocations of the ankle are supplemented by fractures of the ankles. Most often dislocations and subluxations occur in the place where the talus bone connects to the heel bone. This is called subtalar dislocation of the foot. Then the ankle becomes much thicker, deforms, and the heel area is also deformed. Heel instead of being turned outwards turns inside.
When the foot is squeezed, there are also dislocations and subluxations of the tarsal bones or metatarsal bones. They provoke deformation of the foot, then the dislocated bones protrude to the sides or to the rear of the heel. On the foot you can see a large hematoma (on its back).
The most affected by injuries and dislocations of the ankle joint, as well as its subluxations, are people with obesity or those who have too weak a ligamentous apparatus. When a person goes, he at the slightest uncomfortable movement turns his leg inward, and there is swelling of the joint, which is called a traumatic edema.
With proper treatment and gentle schedule, it passes in three weeks. If, except for this injury, nothing else was damaged, the ankle joint can fulfill its role completely after 1-2 months.
Causes and Symptoms
Violent joint movement exceeding the norm, as a rule, leads to deformation of the joints and ligaments. Although ankle pain is often the result of trauma, it sometimes occurs as a result of a disease affecting the musculoskeletal system. In the process of injuries, there is a rupture of ligaments and joint capsules, which are vital structures for supporting the bone. After dislocation, the affected bones of the affected limb may be in the wrong position; fractures are also a problem with serious impairment.
An important factor in the diagnosis of dislocation or subluxation is the force of the fall or stroke, in particular, the loss of function of a particular limb site. Immediately after dislocation, the place of injury is almost always swollen, and painful sensations are felt when pressing on the ankle area.
If a joint injury, including ligament rupture or subluxation, a strong, small chipped bone can be ripped out with foot support structures. Chronic recurrent dislocations can occur without severe pain due to the sluggish state of the surrounding muscles and other tissue supporting tissues.
Risk factors that can increase susceptibility to recurrent dislocation, subluxation of small joints, are the articular surfaces (congenital) that form before birth and / or other diseases of ligaments and tissues around the joint. Some babies are born with hip dislocations. Children with both sexes and all ages are affected.
Diagnostics
Having a detailed medical history and physical examination of the doctor is the first step in the correct diagnosis of dislocations and subluxations of the ankle joints. The first method of diagnosis is X-ray.
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Treatment
Immediately after the dislocation of the ankle joint, the use of ice is useful for reducing swelling and pain. If the patient needs to be transported, it is important to reduce the ankle motion (immobilization) to zero. For a while, gypsum or tires can be used to immobilize and ensure proper alignment of the ankle bones.
Treatment and alignment of the bone after dislocation is the first task of the doctor. This method can include simple maneuvers that are designed for repositioning bones or surgical procedures to restore joint joints in their normal position.
General or local anesthesia can be used to help make joint bone reduction, perhaps by relaxing the muscles in the cramp. Acetaminophen or aspirin is sometimes used to control pain, and other medications may be prescribed by the doctor if the pain is very severe. In case of relapses, surgical reconstruction or joint replacement may be required. It is not recommended to try to direct the dislocation of the joint by yourself.
Prevention
When a person engages in strenuous sports or other hard work, the joints of the ankle joints can be protected by elastic bandaging wraps, tapes, pads on the knee and shoulder, or special supporting stockings.
Maintaining the muscles surrounding the joint will also help prevent their destruction and atrophy. Long-term problems with ankle joint dislocations can also be prevented by providing sufficient time for the injured joint to allow it to rest and heal until resumption of full activity.
Features of pain in the ankle
Pain in the ankle because of injuries can affect the ankles, tendons, cartilage or blood vessels located near the ankle. Pain in the ankle joint can be given to the knee and shin.
There are many people who love sports, who understand the essence of pain in the ankle joint. Popular sports such as tennis, hockey, field hockey, football, American football, baseball and softball, offer to rely on your feet constantly. It would be more accurate to say on the joints of the feet. All the same, sport is a daily task that many people constantly perform. Ankle joints perform the most important functions, which stop due to pain. What are the causes of pain in the ankle?
Fractures of the ankles
According to the American College of ACFAS, an ankle fracture is a partial or full ankle rupture associated with bone injuries. Ankles are one of the most common places for fractures, and ankle fractures are often caused by rapid and strong foot movements inward or outward. It is difficult for a person to distinguish an ankle fracture from a bruise, but they are still significantly different.
If a person has suffered an ankle injury, it is important that she is diagnosed as soon as possible. The diagnosis of a qualified health professional can lead to the need for proper treatment, which in turn can accelerate the recovery process. ACFAS notes that ankle fractures and sprains of the ankle sometimes occur simultaneously.
Common symptoms associated with ankle fractures include pain in fracture sites, inability to walk and significant diffuse or localized tumors around areas of damage.
Tunnel syndrome (tarsal)
Tarsal tunnel syndrome is a nerve damage to the ankle as a result of their compression, including the posterior tibial nerve and its branches. The tunnel is located just below the bony protuberances on the inner side of the ankle.
Tarzal tunnel syndrome is a neuropathy, in which the posterior tibial nerve of the ankle contracts, as it were passing through a tunnel. This syndrome can be caused by a variety of factors, including arthrosis of the ankle joint, diabetes, tendovaginitis, ankle injury.
The common symptoms associated with a tarsal tunnel syndrome include the following: pain and tingling in the ankle and around it, in the legs, provokes swelling of the legs, sensations of fever and cold in the legs, and pain in the ankle in standing or for long periods of time.
Tendonitis
According to the National Institutes of Health, tendonitis is inflammation, irritation, and swelling of the Achilles tendon. These are thick tendons in the calcaneus, connecting the bones to the calf muscles. The Achilles tendon becomes inflamed and is often the cause of repeated ruptures or inflammation of the tendons or arthritis, which can lead the ankle to injury or infection.
Runners, basketball players and athletes - as well as representatives of other sports that require active jogging and jumping from a person, have a greater risk of developing Achilles tendonitis. Arthritis associated with Achilles tendonitis is more typical for middle-aged and elderly people. Common signs and symptoms associated with tendonitis of the Achilles tendon include the following: pain when walking or running, giving off to the Achilles tendon, as well as pain and swelling in the ankle joint.
Gout
Pain in the ankle troubles people as soon as they get older. Bunches and tendons do not support their knees, elbows and ankles as well as they did before, when people were younger. In addition, inflammation caused by overuse or age-related diseases increases the risk of chronic joint pain. The ankle joint can be very painful and causes a lot of questions about its treatment.
A common disease that can hit the ankle in the middle of the night is called gout. You can wake up with sharp pains giving off in the thumb, ankle or other joints, such as the ankles and knees. Although the pain can last several days and subside, it can re-emerge at any time in the future.
More than 2 million people in the US alone suffer from gout, which affects men more than women. The disease usually develops in men after 30 and women after they have passed through menopause. Men are more likely to suffer from gout if they are overweight, and if they have problems with high blood pressure.
Gout can be a consequence of hereditary arthritis, other diseases. The body tries to compensate for deposits in the joints that cause inflammation and severe pain in the ankle, ankles, knees and other areas of the legs. If you suffer from gout and joint pain, a diet can be one of the factors that can help you stay in shape.
Fracture of calcaneus
The heel bone in the lower part of the leg is usually called the heel bone. This bone helps to support the leg, and this is important for movements with ordinary walking. The heel bone is responsible for turning the foot inside and out.
How is a calcaneus fracture?
Fracture of the calcaneus is almost always the result of injuries. Usually they arise as a result of a fall from a height, such as a fall from a ladder. Other causes of calcaneus fracture include car accidents and sports injuries.
Problems with the calcaneus as a source of pain in the ankle joint often arise in runners for long distances. Cracks in the ankle are different types of injuries due to traumatic fractures, and their treatment should be discussed with the attending physician.
What are the symptoms of a calcaneus fracture?
Fractures of the calcaneus can cause significant swelling and pain in the foot, shin. Symptoms of a calcaneal fracture include:
- Inability to walk
- Swelling of the feet
- Bruises on the leg
- Severe pain in the heels
Most fractures of the calcaneus are closed, the skin is not damaged. When the skin around the fracture of the calcaneus is broken, this may represent an open fracture. Open fracture requires surgical treatment.
What is the treatment of the fracture of the calcaneus?
Fractures of the calcaneus can suggest the imposition of gypsum after surgery. Without surgical treatment, pain in the ankle joint is also recommended for patients who suffer from poor blood circulation or diabetes; these patients are at risk of developing complications after foot surgery.
Patients who smoke also have a very high risk of complications associated with surgery after a fracture of the calcaneus. The operation should be carefully considered for these patients, and some doctors refuse surgery if the patient does not agree to quit smoking.
Surgical treatment of calcaneus fractures usually involves an incision on the outside of the foot, and a metal plate or screws in the broken bone. The doctor will try to restore the normal position of the bone and return the cartilaginous surface as close to normal as possible.
Sometimes, if two large pieces of heel bone are broken (compared to many small pieces), this operation can be performed using small incisions. The doctor can recommend proper treatment based on your specific wishes.
After severe fractures of the calcaneus, the leg may be damaged to the bone above the heel. In these situations, the possibility of restoring the cartilaginous tissue of the foot is unlikely.
All patients with a fracture of the calcaneus should also be protected from other types of injuries in the future. Studies have shown that a large number of patients who have a fracture of the calcaneus, also risk a fracture of the lumbar spine (from 10 to 15%). Other injuries are common in patients who have a fracture of the calcaneus, including trauma to the head, neck and other limbs.
What are the complications of calcaneus fractures?
Fracture of the calcaneus, as a rule, this is a fairly serious injury, and they often lead to constant problems of the foot and ankle. Complications of calcaneus fractures can be divided into early and late complications.
Early complications of calcaneus fractures are most likely due to a significant swelling of the bones that may occur after these injuries. In those patients who have undergone surgery to treat the fracture of the calcaneus, a tumor can develop. As already mentioned, patients with diabetes mellitus, smokers and people with poor blood circulation are particularly prone to the development of this complication.
Later complications from calcaneus fracture occur most often due to chronic pain in the legs and arthritis. Pain in the ankle due to arthritis can be chronic after the patient received a fracture of the calcaneus. The risk of developing arthritis as a result of fracture of the calcaneus is usually associated with the severity of the fracture.
Patients often experience problems with chronic pain in the legs, with difficulty wearing some types of shoes, experiencing pain associated with walking, running and prolonged standing in one place.
What is the recovery after a calcaneus fracture?
The recovery period after a calcaneus fracture is an important aspect in determining how quickly the patient will return to his level of activity before injury. Patients will be required to control the weight that falls on their feet, as long as three months. Another critical aspect of treatment is the control of swelling in the ankle, especially in patients undergoing surgery. The best ways to control the tumor include immobilization, rest and the application of ice.
Deforming arthrosis of the ankle
Degenerative diseases of the ankle joint appear less often than arthrosis of the hip joint or shin arthrosis. Deforming arthrosis always manifests itself on the basis of disorders of the ankle joint, legs, or parts of the legs.
These disorders arise as a result of heredity, congenital features and the development of deformation of the ankle joint structure. So there is a systemic disease that leads to the destruction of cartilage of the ankle joint. Like in other joints, trauma or development of arthrosis comes to destruction of the cartilaginous tissue of the ends of the joints.
Osteoarthritis manifests itself as a pain in the ankle joint with restriction of the sphere of its movements. The need for surgical treatment is provided depending on the restrictions in movement, pain and complaints that the patient expresses.
The type of surgical treatment is determined by the purpose planned earlier. For arthrosis of the ankle, a number of measures are diversified. The extreme measure of surgical intrusion is arthroscopic removal of free and half free parts of the leg, excision of the enlarged part of the synovial membrane from within the part and joints.
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Prospects
In addition, a medical examination in this case allows you to determine the size and extent of ankle injury and a plan for more distant treatment prospects. Until recently, immobilization was the only and decisive way to solve the problem of ankle pain due to arthrosis. However, this resulted in movement restrictions that are irreplaceable and could lead to secondary changes in neighboring joints.
The last years of research have made it possible to preserve the movements of the ankle even in the advanced forms of degenerative diseases. Just like for other large joints, now there is the possibility of alloplasty of the ankle and ankles. Restoration of the ankle joint by the method of prosthetics is not yet effective for all medical orthopedic centers.
The first prosthetic plasty of the ankle joint was carried out in the seventies of the last century. The results were surprisingly weak regardless of the types of prostheses used. These failures have led to the search for new forms and ways of fixing the next generation of prosthetic devices for the ankle joint.
Currently, the methods of treatment associated with the use of prostheses have gained popularity. The average percentage of good and very good indicators after 14 years of observation is 72%. Indications for alloplastic ankle are the results of lesions of the ankle, which develop on the basis of rheumatic diseases or arthropathy in the course of other systemic diseases. This also includes posttraumatic arthrosis in the elderly with a small range of motor activity.
This type of treatment is contraindicated for young and active citizens, for ankle joints after bacterial infections, for legs with impaired muscular activity, with distortion of the shin bone and after numerous injections of steroid injections. The decision on the method of treatment should be considered very carefully.
A healthy lifestyle and diet can be the main factor in reducing the risk of chronic pain in the ankles. Exercise is also a factor in strengthening joints and muscles, lowering blood pressure, can be used to combat age-related diseases such as gout. Light exercises can be used at the beginning of recovery after an ankle injury, and as the joints become more mobile and strong, they can be continued, then more physical activity is allowed.