The enthesopathy It is a pathology that affects the junction between the tendons and the corresponding bone; this condition causes extreme pain and is considered highly debilitating for those affected.
Caused by inflammation of the tendons, trauma, or repetitive stress and pressure on the affected area, enthesopathy can affect different parts of the body and it mainly affects those who practice a lot of physical activity or high-impact sports.
In this article, we will focus on the types of enthesopathy that mainly affects the area of the ankles and feet, focusing on the different treatments recommended for treating enthesopathy.
Conservative treatments for enthesopathy
When receiving a diagnosis of enthesopathy, doctors usually recommend a conservative therapeutic approach.
What is meant by conservative treatmentsThese treatments are considered minimally invasive because they involve pain management, stress reduction, and inflammation in the affected area, all without resorting to surgery.
Let's see together what these conservative treatments are for treating enthesopathy.
Rest and lifestyle changes
Rest is certainly the first thing recommended to alleviate the symptoms of the disease.
Reduce excessive stress and overload activities of the affected area, in this case the feet and ankles, helps manage pain and reduce inflammation. All this allows for the gradual healing of the damaged tissues.
If initially rest is recommended as such, therefore the cessation of any stressful activity on the affected part, with the passage of the right amount of time it will be possible to resume physical activities, provided that they are changed. Therefore, it will be advisable to do somecontrolled physical activity and not excessive with targeted exercises, or opt for sports that do not contribute to further aggravate the situation such as ARTISTIC.
Orthopedic insoles and braces
Especially for enthesopathy affecting feet and ankles, the use of insoles and braces it is particularly suitable.
In fact, insoles and braces are very useful for support a delicate area such as the foot and heel and, above all, it helps to cushion impacts due to the normal mobility of the foot, as well as to correct probable posture problems.
Not only that, i guardians, above all, they can also be used to immobilize the affected part, when necessary, to promote the regeneration of injured tissue.
Physiotherapy and rehabilitation programs
La physiotherapy It's always a suitable and recommended treatment. With the support of a physiotherapist, you can not only improve the flexibility of your feet and ankles through targeted exercises, but also strengthen the muscles surrounding the affected tissues.
Thanks to a studied and personalized path, perhaps also using ultrasound therapy or tecar therapy, it will be possible to reduce inflammation and pain and shorten the total recovery time.
Taking nonsteroidal anti-inflammatory drugs
Also called NSAIDs, nonsteroidal anti-inflammatory drugs are the most recommended drugs to treat enthesopathy.
NSAIDs are prescribed for treat pain e reduce inflammationNonsteroidal anti-inflammatory drugs are usually found in the form of ointments and lotions or in pills.
However, there is also the option of being able to take an NSAID for infiltrative route, or through injections on the affected areaThis modality is preferred when there is a need for a faster and more effective effect, therefore, when pain and inflammation are almost unbearable.
The use of nonsteroidal anti-inflammatory drugs should always be prescribed and monitored by the attending physician.
Surgical treatments
If enthesopathy has become a debilitating problem and even conservative treatments have not managed to eradicate it, the only solution appears to be the surgical treatment.
there different types of surgical treatments and, to make an informed choice about the most appropriate type of treatment, it will be necessary to evaluate both the severity of the enthesopathy and the patient's needs and expectations.
Minimally invasive surgery
La minimally invasive surgery It is certainly the most requested surgical treatment by patients affected by calcaneal enthesopathy (the one that affects the heel).
This intervention, by its very definition minimally invasive, involves the removal of damaged and inflamed tissueas well as the repair of the affected part, all through some mini-engravings.
This treatment is also preferred because it provides fairly short recovery times.
Tendon repair or replacement
Tendon repair is a surgical treatment that is taken into consideration when the enthesopathy is particularly severe, so much so that it involves the near-total repair or replacement of the damaged tendon.
The procedure therefore involves the partial or total removal of the damaged tissue and its reconstruction or replacement. Repair can be achieved using specific and specialized suturing techniques or through grafts.
For obvious reasons, recovery times are significantly longer compared to a minimally invasive surgery, recovery is divided into a period of complete immobility, followed by a period of personalized and intensive rehabilitation.
Osteotomy and decompression
These two treatments are taken into consideration when the enthesopathy is related to a bone malformation or to one tissue compression.
The osteotomy It is designed to cut or reshape the malformed bone, so as to reduce the pressure exerted on the area affected by the inflammation.
La decompression, instead, involves the removal of parts of the bone or tissue to relieve the tension that oppresses the injured part.
Osteotomy and decompression are particularly indicated for particularly serious enthesopathies that can also affect the knees in particular.
Post-operative recovery and rehabilitation
Whatever surgical treatment is chosen, each type of intervention must always be followed by a post-operative recovery period.
Following surgery, the patient must prepare for a period that will include several phases, from rest to the restoration of full mobility.
As already mentioned, each operation has a different recovery time but, usually, recovery times are between 6 and 12 weeks.
During this period of time the patient will initially have to to rest, with the foot and ankle well immobilized so as not to immediately stress the recently operated area. The following will follow: phases of recovery of elasticity and muscle strength, preparatory phases to best face the phase of partial restoration of mobility.
Always under the supervision of the doctor and specialists, we will arrive at the full restoration of mobility to finally return to normality and to carrying out all daily activities.
Following your doctor's advice and completing all the rehabilitation phases step by step is crucial to avoiding potential complications and promoting a full recovery.
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