Rheumatic inflammation of soft periarticular tissues

What is leg swelling

Swelling of the legs is an external manifestation of the accumulation of fluid in the body. At the same time, the limb itself noticeably increases in size, the skin on it becomes loose, and when pressed, dents appear that do not disappear instantly.

Swelling usually occurs in the evening, although it can still cause discomfort the next morning. It is localized:

• in the feet;
• in the ankles;
• in the legs;
• from socks to knee.

Depending on the reasons, either one leg or both may swell. Symmetrical distribution often indicates generalized edema, which may be a symptom of a life-threatening condition.

If this trouble appears rarely, then you can fight it with folk remedies. The regularity of occurrence indicates a disease of the internal organs. Therefore, it is important to establish the nature of the swelling.

Why is arthritis of the ankle and foot dangerous?

The disease is dangerous because it often goes unnoticed and leads to a complete loss of joint function, that is, the person becomes disabled. Acute purulent complications of ankle arthritis are also dangerous.

Arthritis of the foot and ankle begins gradually, unnoticeably

Stages

There are several stages of disease development. The inflammatory process develops gradually, turning into a degenerative-dystrophic one:

1. Early – inflammation
   . The synovial membrane swells, and inflammatory exudate appears in the joint cavity. Pain is moderate, swelling and redness are absent or only slightly expressed.
2. Explicit – inflammatory-proliferative process
   . The synovial membrane increases in volume, erosions appear on the cartilage, and soft granulations of connective tissue grow in the articular cavity (the process of proliferation - growth). The inflammatory process intensifies. Externally, this is manifested by increased swelling, redness and pain.
3. Progressive - mild ankylosis
   . The cartilage is destroyed, soft granulations turn into dense connective tissue that grows in the joint cavity. Bone growths appear. The joint gradually loses its mobility. Pain, swelling and redness continue to bother you constantly or during exacerbations.
4. Advanced - complete immobility (bone ankylosis).
   There is no cartilage tissue, bone growths connect the articular surfaces of the ankle, which eliminates movement in the ankle and foot (ankylosis of the ankle). The pain is constant, arthritis of the foot develops with limitation of its function.

Possible complications

If ankle arthritis is left untreated or treated independently with home remedies, the following complications may develop:

• purulent processes - abscesses, phlegmon, sepsis;
• subluxations and dislocations of the ankle;
• development of foot arthritis;
• immobility of the ankle and inability to move without assistive devices.

Causes of leg swelling

When there is too much fluid in the tissues, it means that there is a malfunction in the functioning of the body. Most often, swelling is caused by:

• protein metabolism disorder;
• damage to cell membranes, increasing their permeability;
• changes in pressure differences in tissues and vessels;
• impaired blood circulation.

There are many reasons for such failures. Some are temporary (allergic reaction, bruise, infection). Others indicate the development of pathologies of the lower extremities (varicose veins, thrombophlebitis). Still others indicate serious diseases of the internal organs (heart, kidneys, lymphatic system).

A person cannot independently determine why his foot is swollen: because of uncomfortable shoes or because of a blocked blood vessel. Therefore, you should not postpone a visit to the doctor for subsequent treatment.

Why does one leg swell?

If the swelling is asymmetrical, its cause is localized directly in the affected limb. Swelling may occur due to bruises on the legs or more serious injuries:

• ankle joint injuries;
• meniscus tear;
• separation of the calf muscle;
• bone fracture;
• tissue compression.

Venous edema is also most often unilateral. Varicose veins cause fluid stagnation, but they are localized in one limb where the vessels are affected. This is indicated by the characteristic venous network.

Thrombophlebitis disrupts blood circulation, and at the same time the outflow of fluid from tissues. In this case, swelling is accompanied by other unpleasant symptoms: fever, pain, compaction in the blockage area.

General information about the disease

Arthritis of the ankle joint is an inflammatory process that has different origins, symptoms and course. The disease can be independent (primary) or develop against the background of some existing process (secondary). Arthritis is divided into acute and chronic. ICD-10 code M00 – M99.

The ankle joint is a movable joint formed by three bone structures: the heads of the tibia and fibula of the leg and the talus of the foot. To the right and left of the talus are bony elevations - the ankles. The peculiarity of the joint is its resistance to external influences, in this it is much superior to the knee joint. It has a good blood supply and innervation and is protected by ligaments that firmly hold it in the desired position.

Arthritis of the ankle develops at any age. In children it is predominantly juvenile idiopathic arthritis (JIA), in women it is rheumatoid lesions, in men it is reactive arthritis.

Why do both legs swell?

If by the end of the day both lower limbs are swollen, it means that excess fluid is present throughout the body. Most often this condition is caused by:

• heat;
• excessive fluid intake;
• obesity;
• uncomfortable shoes (tight, high heels, completely flat soles);
• flat feet;
• unhealthy diet (lots of salty and spicy foods in the diet);
• standing on your feet for a long time or in an uncomfortable position.

Fluid stagnation in these cases is caused by improper load distribution. None of the above indicates a threat to life, and the swelling goes away in a day or two. For some, it is enough to take off their shoes and relax, while others resort to folk remedies to relieve discomfort. But symmetrically swollen legs can also indicate more serious diseases that require urgent treatment.

When general swelling indicates danger to life

Sometimes swelling of the lower extremities is a symptom of a general imbalance in the body's hydrobalance. In the case of heart failure, the body's main muscle cannot cope with pumping blood. The fluid in the body is distributed unevenly, and too much accumulates at the bottom. If the patient stands or sits in one position for a long time, his feet and legs swell.

Kidney failure can also lead to swelling. It appears not only on the legs, but also on the arms, face (mainly under the eyes), and abdominal wall.

If cardiac edema develops gradually (over weeks), then renal edema develops very quickly. With cardiac diseases, the skin becomes colder, with kidney diseases it maintains a normal temperature.

Fluid retention can also be caused by lymphedema, which is damage to the lymphatic vessels. The swelling in this case is dense; after pressing on the skin, there is no indentation.

Symptoms of Ankle Arthritis

Despite the significant differences in the course of different clinical forms of the disease, they also have many common symptoms that can be used to suspect arthritis of the foot or ankle. It's worth paying attention to them.

First signs

In the acute course of arthritis of the ankle joint, severe pain occurs in the ankle and foot, tissue swelling, redness of the skin and increased temperature over the site of inflammation. Sometimes the patient’s general condition suffers: fever, chills, and malaise appear. With such complaints, patients immediately consult a doctor. With adequate treatment, the inflammatory process can almost always be cured. If left untreated, the inflammation subsides, becomes chronic and gradually leads to dysfunction of the limb.

The situation is much more complicated with chronic arthritis of the foot and ankle. They begin gradually, imperceptibly. The patient does not always pay attention to such “little things” as moderate pain in the ankle and foot, stiffness of movement in the morning and does not immediately seek medical help. This usually happens much later, when more characteristic signs of the disease appear.

Obvious symptoms

Over time, the symptoms of ankle arthritis become steadily worse. The pain intensifies, often bothering you at night and in the morning. Morning stiffness lasts for at least half an hour and this period increases. Swelling in the area of ​​sore joints, ankles and the entire foot can be so significant that the foot does not fit into the usual type of shoes. A crunch appears in the joints.

Arthritis of the ankle joint can have a progressive, constant or wavy course with exacerbations and remissions. Obvious symptoms of the disease force the patient to see a doctor. But this does not happen at the initial stage.

But don’t lose heart: this disease can be treated at any stage.

Why do feet swell during pregnancy?

During pregnancy, the outflow of fluid is often disrupted. This is explained by large-scale changes occurring in the body:

• weight gain;
• changes in hormonal levels;
• compression of the inferior vena cava by the enlarging uterus;
• decreased mobility;
• diet correction.

In most cases, swelling is considered as a variant of the physiological norm. There is no need to resort to drug treatment; it is enough to keep the situation under control. However, the spread of edema throughout the body can result in serious pathologies, such as preeclampsia.

The expectant mother should monitor the dynamics of the increase in calf circumference, blood pressure and the ratio of fluid consumed and excreted. The kidneys experience increased stress during pregnancy, so at the first alarming symptoms it is better to be examined by a nephrologist.

Diagnostics

To establish the correct diagnosis, taking into account the origin of the disease, the doctor first asks the patient about the onset and duration of the disease, its symptoms, and diseases of close relatives. Then a thorough examination of the patient is carried out to identify painful areas, the state of the ankle and foot function. The diagnosis is confirmed by laboratory and instrumental studies:

• Laboratory tests
  - blood, urine, joint fluid taken by joint puncture (puncture) or during arthroscopy. The following are revealed: the severity of inflammation, the presence of infection, metabolic and hormonal disorders, autoimmune processes.
• Instrumental studies
  :
  Ultrasound
  - an increase in the volume of the synovial membrane, the presence of a large volume of exudate;
• X-ray of the ankle and foot
  – bone changes: narrowing of the joint space, bone growths, deformities;
• MRI and CT
  are the most informative studies; they reveal any changes;
• arthroscopy
  - examination of the internal articular surface using optical equipment (arthroscope).

Treatment of leg swelling

The treatment package depends on the cause of the unpleasant symptom. If it is not associated with serious diseases, but is caused by improper distribution of the load, it is enough to locally relieve the swelling. This can be done at home.

If it is caused by local reactions (bruise, allergy, infection), then it is necessary to provide the victim with the necessary assistance:

• treat the damaged area;
• apply ice;
• give medicine.

Sometimes this can be done at home, sometimes medical attention is required. After a few days, the swelling will disappear as the tissue heals.

Drug treatment under the supervision of a phlebologist is required for varicose veins and thrombophlebitis. If the disease is advanced, surgery may be required. After restoration of venous tone and normal blood circulation, external symptoms will disappear.

Frequently asked questions about the disease

I dance professionally, but recently my ankle joint has started to hurt on one side. Which doctor should I see?

You can start with a traumatologist. If necessary, he will refer you to another specialist.

Do you join the army if you have ankle arthritis?

If there is persistent impairment of articular function, do not take it.

Patients are often interested in how to treat arthritis of the joints of the foot and ankle. This is the wrong approach. You need to look not for a cure for this disease, but for a clinic that will help you cope with it. The Moscow Paramita clinic has everything necessary to help any patient with ankle arthritis. Contact us, you won’t regret it!

Literature:

1. Grazhdanov K.A., Barabash A.P., Barabash Yu.A., Kauts O.A., Zuev P.P. Technology of treatment of purulent arthritis of the ankle joint // Modern problems of science and education. – 2021. – No. 3.
2. Martinovich AB, Infected injuries and post-traumatic deformities of the ankle joint. // Diss. Candidate of Medical Sciences Minsk 1990. - P. 128.
3. Perez Busquier M., Calero E., Rodriguez M. et al. Comparison of aceclofenac with piroxicam in the treatment of osteoarthritis. Clin Rheumatol 1997;16(2):154–9.
4. Kornasoff D., Frerick H., Bowdler J. et al. Aceclofenac is a well-tolerated alternative to naproxen in the treatment of osteoarthritis. Clin Rheumatol 1997;16(1):32–8.

Themes

Arthritis, Joints, Pain, Treatment without surgery Date of publication: 12/14/2020 Date of update: 04/03/2021

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How to relieve swelling after a bruise

Treatment for a leg bruise usually comes down to eliminating pain and swelling. The swelling in this case is caused by damage to the blood vessels and the accumulation of fluid from them under the skin. The latter puts pressure on the nerve endings, hence the pain. So eliminating swelling also helps to get rid of unpleasant sensations.

You can help a bruised limb at home:

• stretch and provide peace;
• apply a wet towel, ice or a heating pad with cold water;
• apply a tight bandage.

You can also resort to drug treatment. External agents containing troxerutin or heparin will help. They strengthen capillaries, optimize blood viscosity and relieve inflammation.

Approach to treating the disease at the Paramita clinic

Treatment of arthritis of the foot and ankle in our clinic is carried out after a preliminary examination using modern laboratory and instrumental techniques. After the diagnosis is established, an individually selected comprehensive treatment is prescribed, which includes:

• the latest Western methods of treating this pathology;
• Eastern techniques that restore balance in the functioning of all organs and systems of the body, which helps eliminate the pathological focus.

This approach allows you to quickly eliminate inflammation and pain, suppress the progression of the disease and restore limb function. At the Paramita clinic they will help you even with advanced disease!

We combine proven techniques of the East and innovative methods of Western medicine.
Read more about our unique method of treating arthritis

How to relieve leg swelling caused by heat

The best medicine in this case is gravity. Arriving home and throwing away the shoes that have become a vice, it is enough to lie down and place your feet higher (at a minimum - on several pillows, at a maximum - against the wall).

When it becomes easier to move, you need to take a shower. Ideally, a contrasting one that trains blood vessels, but you can limit yourself to just cool. In this case, you should direct the pressure to the feet: such a hydromassage will restore blood circulation.

You can disperse the fluid with light exercises: pulling the toe towards you and away from you, rotating your feet, squatting. But if you don’t have the strength to do this, and your legs hurt, it’s better not to torture them.

Foot baths are also useful. Even plain water will provide relief, but you can enhance the effects with additives. This could be sea salt or herbal infusions. Compresses made from cabbage leaves or bandages soaked in a decoction of birch leaves improve the condition of the limbs.

Treatment of leg swelling due to heart or kidney failure

Patients with heart or kidney failure should be under the supervision of a physician. In acute attacks, resuscitation is required. If the disease takes a chronic form, swelling is removed as it appears with the help of diuretics and nutritional correction. Medicines should:

• stabilize blood pressure;
• remove excess sodium from the body;
• prevent protein loss;
• normalize blood flow speed.

When using diuretics (diuretics), it is important not to exceed the permissible dosage. Otherwise, there is a risk of getting the opposite effect in the form of drug-induced edema during withdrawal. They are caused by the kidneys’ reaction to a sudden change in the mode of fluid excretion.

What to do if the disease worsens

Arthritis of the foot and ankle occurs with painful relapses. In some clinical forms of the disease, exacerbations can be very painful. How to help yourself, reduce pain before the doctor arrives? This can be done like this:

• calm down by taking valerian or motherwort;
• take a tablet of any pain reliever - Analgin, Diclofenac, Ibuprofen, Nise, Paracetamol, etc.; the analgesic effect occurs very quickly after using a rectal suppository with Diclofenac;
• apply pain-relieving ointment (gel, cream), for example, Fastum-gel, to the ankle and foot area;
• call a doctor at home;
• lie on your back on a flat surface and elevate your sore leg, placing a pillow under your shin and heel;
• calmly wait for the doctor to arrive.

Relieving swelling during pregnancy

In the body of a woman carrying a fetus, the concentration of the hormone progesterone increases. It is one of the causes of edema during pregnancy. In no case should it be reduced, because it is this that ensures the attachment of the embryo.

There is no need to fight physiological swelling. The main thing is to prevent it from getting worse. To alleviate the symptoms, you can carry out the mentioned water procedures and adhere to a healthy lifestyle (moderate activity, water consumption within the daily norm, adjusted for restrictions imposed by pregnancy, rest on your side).

The pathological nature of edema can only be determined by a doctor based on test results (in particular, protein in the urine). Having discovered the cause, he will prescribe treatment. It is prohibited to take any medications on your own.

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Prevention

Swelling cannot always be prevented, since it can occur under the influence of uncontrollable factors. There is no way to prevent a bruise or insect bite. But in general, maintaining hydrobalance in the body is easy:

• Observe the drinking regime: fully quench your thirst, but do not drink more than you should.
• Stick to a diet during the hot season: minimize the consumption of salty and spicy foods, eat more fruits, drink tea with lemon instead of coffee.
• Arrange water treatments: contrast showers, foot baths.
• Move more: walking, swimming, aerobics do not allow fluid to stagnate.

In summer, you should avoid tight, high-heeled shoes. It is useful to periodically place your feet on an elevation so that fluid concentrated in the lower part of the body drains. There is no need to abuse medications. Urinary and antihypertensive drugs should be prescribed by a doctor. Any diseases that have a similar symptom must be treated in a timely manner.

Tokareva Lyudmila Georgievna, therapist, medical offices 36.6.

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General clinical recommendations

Arthritis of the foot and ankle is a progressive disease. To prevent its relapse, the patient should follow the following recommendations:

• lead a healthy lifestyle, move more;
• regularly perform physical therapy exercises, go swimming;
• avoid heavy physical activity, hypothermia and stress;
• promptly treat all acute and chronic diseases;
• give up bad habits - smoking and alcohol abuse;
• conduct courses of preventive treatment as prescribed by a doctor.

Prevention

To avoid the development of the disease, genetically predisposed persons, as well as persons whose work involves increased stress on the ankles, should avoid provoking factors that can become a trigger for the development of the disease. These are hypothermia, viral infections, prolonged stress and high physical activity.

Follow a diet: give up fried, fatty, spicy foods, sweets and baked goods, eat regularly. The diet should include: low-fat animal products, vegetables and fruits.

If symptoms of foot arthritis appear, you should immediately consult a doctor.