What is ankle arthritis?

Most ankle arthritis is caused by osteoarthritis (OA) however there are also other forms of arthritis that can affect the ankle joint such as rheumatoid arthritis.

In a normal ankle, smooth cartilage lines the ends of the bones which form the ankle joint (the tibia and the talus bones). In OA of the ankle, this cartilage wears away causing friction between the bony surfaces and pain when weight bearing. Pain can also be caused by fragments of cartilage becoming detached in the joint.

Arthritis is a common cause of ankle pain. Ankle arthritis often develops following a severe injury to the ankle. Ankle arthritis may cause the ankle to feel very stiff and sore in the mornings or after rest before the foot is able to ‘warm-up’. 

Treatment for arthritis involves reducing the force going through the feet (e.g. weight loss, using a cane or support when walking etc.) and wearing appropriate footwear. For example, a rocker-bottom shoe with a firm sole will help to immobilise the ankle to reduce the load going through the ankle. An ankle brace may help to immobilise the ankle in more severe cases.

What does ankle arthritis feel like?

In the early stages of the condition, people with ankle arthritis may notice very little in the way of symptoms. As the condition progresses, the most common symptom is pain in the ankle joint that is often felt deep within the joint. With time pain can become more frequent to the point where the ankle is painful even with rest.

Other symptoms of ankle arthritis can include:

  • Swelling around the joint, particularly after long periods of weight bearing or high impact activity
  • Ankle stiffness
  • Ankle instability, or a feeling that the joint might give way
  • Bone spurs causing the joint to look lumpy
  • Deformity of the ankle joint
  • In some cases there may tingling or numbness in the feet and toes caused by irritation of nerves around the ankle joint.

What causes ankle arthritis?

Possible causes of ankle arthritis include:

  • Previous injury or trauma such as an ankle fracture or ankle sprain can cause damage to the cartilage and increase the chance of OA developing. A prior infection of the ankle joint can also increase OA development (eg, if the infection caused cartilage damage).
  • Rheumatoid arthritis can affect the ankle joint, causing inflammation and cartilage damage.
  • There is some evidence to suggest that genetics plays a part in the development of arthritis, so people with a family history of arthritis may be more prone to developing this condition.
  • Being overweight puts increased pressure on ankle joints which can increase risk of developing arthritis and joint damage.

How is ankle arthritis treated?

Early conservative treatment can be very useful for ankle arthritis. Treatment recommended by your podiatrist may include:

  • Avoiding high impact activities such as running and jumping. (Lower impact activities such as swimming and cycling put less pressure on the joints).
  • Footwear advice and shoe modifications to support and reduce stress on the ankle joint (eg, shoes with a rocker sole may be beneficial).
  • Custom foot orthotics to protect the ankle joint and further reduce ankle pain. (Standard orthotics rarely give sufficient relief from pain caused by ankle arthritis).
  • An ankle-foot orthosis (AFO) may be recommended. This is a special brace that is designed to control the motion of the ankle joint and support the foot.
  • Specific exercises may be recommended to strengthen muscles around the ankle joint.
  • Anti-inflammatory medication can help to reduce pain and inflammation in the joint.

If conservative treatment does not adequately address symptoms of ankle arthritis then surgical options may need to be considered.

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