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Arthritis Diet and Exercises

Causes & Treatments for Ankle Arthritis – Ben Wehrli, DPM


In many kinds of arthritis, progressive joint
deterioration occurs and the smooth cushion and cartilage in joints is gradually lost.
This is evident in ankle arthritis where the bones rub and wear against each other. Dr.
Benjamin Wehrli of Desert Regional Medical Center tells us that when this occurs it can
be painful and difficult for the patient to walk. A fair amount of people have ankle pain and
for a myriad of different reasons but it could be associated with an injury, an ankle fracture,
recurring ankle sprains, which is probably one of the more common injuries that we deal
with that is out there and is seen in the emergency department and or it could be just
be rheumatoid arthritis- it could be you know autonomic or immune causes of it, of systemic
arthritis but it’s pretty common. Typically it starts in the ankle joint, can be pretty
localized as it progresses you may get some referred pain. The other thing that might
happen is you can have an antalgic gait so because your ankle hurts, subconsciously you
can walk different to compensate for it so you can get pain and stiffness elsewhere that
is associated with your body trying to compensate for the pain in the ankle. Most arthritis
in the ankle is probably more systemic or an aging process like osteoarthritis. That’s
a lot more common than what we call post traumatic arthritis and that’s either from recurrent
ankle injuries like sprains, high ankle sprains or it’s from fractures. Depending on the severity
of it, if it’s not too bad where you’re just starting to notice it, you can do anti inflammatories
over the counter, you can do some stretching and range of motion exercises, make sure it’s
not you know, stiffness, you can alter your activity level so if you have an ankle flare
up that you’re not quite sure what it is, just kind of decrease your activity, do anti
inflammatories, ice, elevate. All the good things that we do when we injure ourself.
If it get’s to the point that it’s really debilitating and you are unable to do things,
obviously you should seek you know a professional opinion and have them look at it and make
sure it’s not any kind of infection or trauma or injury. Patients need to see their doctor
early before the pain gets worse. If I can see individuals earlier before they get to
the point that they have a lot of pain in there, there’s things that we can do preventatively
with like orthotics: if it’s a mechanical access problem to where they’re not aligned
right, there’s orthotics that we can do to kind of help align that. If it’s early on,
there’s things that we can do through a scope to clean up extra pieces of bone or scar tissue
or things like that; even do what we call micro fracture if you have a cartilage deficit
and it’s not large we can go in there and poke holes in the bone and allow fibrocartilage
to form in there- so there’s a lot of things that we can do early on to prevent some of
the end stage procedures down the road and if you get to the point to where you’re looking
in ankle replacement it’s a procedure that has still options afterwards. Ankle fusion
is pretty much the end all. An ankle replacement will allow us to still have motion in the
ankle. It’s very good tried and true procedures out there in implants that we now have and
the good thing about that is it allows you to have a lot less pain or pain for your range
of motion and you will decrease the chances of getting arthritis in adjacent joints. We’re
starting to see a trend more to replacements than fusions because of the literature shows
that about 10 to 15 years there’s a 92, 95 percent survival rate which is comparable
to hips and knees. So it’s a very good alternative.

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