Prolonged pain in ankle joint needs review
Ten months ago I had a total ankle replacement due to worn-out cartilage. I still suffer from soreness and some pain, especially when I bear weight. I go to the gym on a regular basis — rowing machine, treadmill, bicycle — to try to ensure good ankle movement. I think it helps, but there does not seem to be any end in sight, especially regarding the pain. Any suggestions? TOTAL ankle replacement is a relatively new procedure compared to hip and knee joint replacement surgery. Fundamentally it is more difficult to achieve a good result, because the range of movement at the ankle is far greater than these other joints. The general thinking is that it takes about three months to recover from a total ankle replacement. The recovery phase can take longer in some people, but the fact you are continuing to have symptoms after 10 months would suggest that you need to have the specialist look again at your ankle. It may be simply that you need more time to recover, or perhaps you have been doing too much too soon on that ankle before the bone achieved maximum strength. It is also possible that you may have had a complication of the surgery, such as loosening of the components of the replacement. A reassessment by the orthopedic surgeon is certainly warranted. Linda Calabresi is a GP and editor of MedicalObserver. Send your queries to firstname.lastname@example.org I know that omega 3 fatty acids are good for you. Are there any other natural sources of these, other than fish? THE three most important omega 3 fatty acids in nutrition are alpha-linolenic acid (ALA), eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Aside from cold-water, oily fish, which are high in EPA and DHA, other good sources of omega 3 fatty acids include flaxseed oil, which is high in ALA. The body is able to synthesise all the other important fatty acids from ALA. Strangely enough, kiwifruit also contain a high percentage of omega 3 fatty acids, as do walnuts, one of the few varieties of nuts that do. The evidence would suggest it is certainly worthwhile trying to increase your omega 3 fatty acid intake, as they have been shown to have beneficial effects on a number of medical conditions including cardiovascular disease, depression and arthritis. While a healthy diet is always the preferred option, if eating omega-3 rich foods is difficult for you, there are always supplements. After many years of suffering episodes of giddiness, my 63-year-old mother has recently been diagnosed as having Meniere’s Disease. Is this something that can be cured or is she likely to continue to have these attacks into the future? MENIERE’S disease generally involves a triad of symptoms, namely episodes of vertigo or dizziness, increasing deafness, and tinnitus — a buzzing or ringing noise in the ear. Your mother is unlucky in that Meniere’s is a relatively rare condition affecting only about one in 2000 people, but on the plus side, while the symptoms can be distressing, the condition is not fatal. It is thought to be caused by an abnormality of the fluid in the inner ear, that part of the ear that deals with balance and hearing. Unfortunately Meniere’s is a progressive disease, with all the symptoms getting worse over time, in particular the deafness. While there is no known cure for Meniere’s, there are a number of treatments that are effective in lessening the symptoms, especially the attacks of giddiness. These include diuretics and a low-salt diet. Avoiding nicotine and caffeine has also been shown to help. In severe cases surgery may be necessary.