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Ankle and foot arthritis
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Arthritis is inflammation of one or more of your joints. It can cause pain and stiffness in any joint in the body, and is common in the small joints of the foot and ankle.
There are more than 100 forms of arthritis, many of which affect the foot and ankle. All types can make it difficult to walk and perform activities you enjoy.
Although there is no cure for arthritis, there are many treatment options available to slow the progress of the disease and relieve symptoms. With proper treatment, many people with arthritis are able to manage their pain, remain active, and lead fulfilling lives.
Types of Foot and ankle arthritis
Osteoarthritis. Osteoarthritis, also known as degenerative or “wear-and-tear” arthritis, is a common problem for many people after they reach middle age.In osteoarthritis, the cartilage in the joint gradually wears away.
As the cartilage wears away, it becomes frayed and rough, and the protective space between the bones decreases. This can result in bone rubbing on bone, and produce painful osteophytes (bone spurs).
Rheumatoid Arthritis. Rheumatoid arthritis is a chronic disease that can affect multiple joints throughout the body, and often starts in the foot and ankle. It is symmetrical, meaning that it usually affects the same joint on both sides of the body.
Posttraumatic Arthritis. Posttraumatic arthritis can develop after an injury to the foot or ankle. Dislocations and fractures—particularly those that damage the joint surface—are the most common injuries that lead to posttraumatic arthritis.
Symptoms of ankle and foot arthritis
The symptoms of arthritis vary depending on which joint is affected. In many cases, an arthritic joint will be painful and inflamed. Generally, the pain develops gradually over time, although sudden onset is also possible. There can be other symptoms, as well, including:
Pain with motion
Pain that flares up with vigorous activity
Tenderness when pressure is applied to the joint
Joint swelling, warmth, and redness
Increased pain and swelling in the morning, or after sitting or resting
Difficulty in walking due to any of the above symptoms
Treatment of foot and ankle arthritis
There is no cure for arthritis but there are a number of treatments that may help relieve the pain and disability it can cause.
Initial treatment of arthritis of the foot and ankle is usually nonsurgical. Your doctor may recommend a range of treatment options.
Lifestyle modifications. Some changes in your daily life can help relieve the pain of arthritis and slow the progression of the disease. These changes include:
- Minimizing activities that aggravate the condition.
- Switching from high-impact activities (like jogging or tennis) to lower impact activities (like swimming or cycling) to lessen the stress on your foot and ankle.
- Losing weight to reduce stress on the joints, resulting in less pain and increased function.
Comprehensive treatment for ankle and foot arthritis
Physical therapy. Specific exercises can help increase range of motion and flexibility, as well as help strengthen the muscles in your foot and ankle.
Although physical therapy often helps relieve stress on the arthritic joints, in some cases it may intensify joint pain. This occurs when movement creates increasing friction between the arthritic joints.
Assistive devices. Using a cane or wearing a brace—such as an ankle-foot orthosis (AFO)-may help improve mobility. In addition, wearing shoe inserts (orthotics) or custom-made shoes with stiff soles and rocker bottoms can help minimize pressure on the foot and decrease pain.
Medications. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen, can help reduce swelling and relieve pain. In addition, cortisone is a very effective anti-inflammatory agent that can be injected into an arthritic joint. Although an injection of cortisone can provide pain relief and reduce inflammation, the effects are temporary.
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Surgical treatment for ankle and foot arthritis
Your doctor may recommend surgery if your pain causes disability and is not relieved with nonsurgical treatment. The type of surgery will depend on the type and location of the arthritis and the impact of the disease on your joints.
Arthroscopic debridement. This surgery may be helpful in the early stages of arthritis. Debridement (cleansing) is a procedure to remove loose cartilage, inflamed synovial tissue, and bone spurs from around the joint.
During arthroscopy, your surgeon inserts a small camera, called an arthroscope, into your foot or ankle joint. The camera displays pictures on a television screen, and your surgeon uses these images to guide miniature surgical instruments. Because the arthroscope and surgical instruments are thin, your surgeon can use very small incisions (cuts), rather than the larger incision needed for a traditional, open surgery.
Arthroscopic surgery is most effective when pain is due to contact between bone spurs and the arthritis has not yet caused significant narrowing of the joint space between the bones.
Arthrodesis (fusion). Arthrodesis fuses the bones of the joint completely, making one continuous bone out of two or more bones. The goal of the procedure is to reduce pain by eliminating motion in the arthritic joint.
During arthrodesis, the doctor removes the damaged cartilage and then uses pins, plates and screws, or rods to fix the joint in a permanent position. Over time, the bones fuse or grow together, just like two ends of a broken bone grow together as it heals.
Total ankle replacement (arthroplasty). In total ankle replacement, your doctor removes the damaged cartilage and bone, and then positions new metal or plastic joint surfaces to restore the function of the joint.
Although total ankle replacement is not as common as total hip or total knee replacement, advances in implant design have made it a viable option for many people.
