Foot and Ankle Arthritis

Foot and ankle arthritis is diagnosed and treated by the Podiatry Division of Premier Medical Group.

What is foot and ankle arthritis?

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Foot and ankle arthritis are general terms for localized joint inflammation. Arthritis of all types involves inflammation in and around joints, which often leads to pain, stiffness, and swelling. When smooth, cushioning cartilage in joints is lost, bones begin to wear against each other. Arthritis results from this progressive joint deterioration. Previous injury, like an ankle fracture, is one of the most common causes of foot and ankle arthritis because damaged cartilage can lead to accelerated inflammation.

There are 28 bones and more than 30 joints in each foot. This means foot and ankle arthritis may feel especially acute, even though the ankle is affected less often than other joints. There are a few common foot and ankle joints especially prone to arthritis development, including where the ankle and shinbone meet, the joint of the big toe and foot bone, and the three joints of the foot that involve the heel bone, the inner mid-foot bone, and the outer mid-foot bone.

 

What are the types of foot and ankle arthritis?

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There are several different types of foot and ankle arthritis. The important differences between these conditions are determined by the underlying cause and the speed with which the arthritis develops. See below for detailed explanations of many common forms of foot and ankle arthritis.

Osteoarthritis
Osteoarthritis is a use injury that develops as people age. Known colloquially as “wear and tear” arthritis, this is one of the most common forms of the condition. A doctor may also refer to osteoarthritis as degenerative joint disease, or age-related arthritis. The condition forms as joint cartilage tissues break down resulting in pain, swelling, and possible deformity. Osteoarthritis changes usually occur slowly, over many years, though there are occasional exceptions. Osteoarthritis in the foot and ankle are often indicated by tenderness or pain, swelling, stiffness, and a reduced ability to move, walk, or bear weight.

Rheumatoid Arthritis
Rheumatoid arthritis is a chronic and progressive inflammatory disease that results in painful deformity and immobility over time. While the most common form of rheumatoid arthritis occurs in the fingers and wrists, but it can also affect feet and ankles. The condition often impacts smaller joints first, like those that exist in the foot, and then moves on to larger joints, like the ankles. Rheumatoid arthritis can impede walking and cause considerable discomfort and may, over time, lead to permanent changes in the shape of foot and ankle joints. These permanent changes can also lead to callouses, bunions, nodules, and corns. In addition to joint inflammation, other symptoms of rheumatoid arthritis can include fatigue, muscle weakness, fever, and weight loss.

Post-Traumatic Arthritis
Post-traumatic arthritis is a common form of osteoarthritis and occurs after a physical injury, of any kind, to a joint. These injuries often occur during sports, a vehicle accident, a fall, or any other source of physical trauma. These injuries can change the cartilage and/or the bone, which may make the joint wear out more quickly over time.    

Psoriatic Arthritis
Psoriatic arthritis affects people who have psoriasis, which is a condition that includes red patches of skin often topped with whiteish skin legions. Psoriatic arthritis is indicated by joint pain, stiffness, and swelling, and it can impact any part of the body. This form of arthritis gets worse over time, and while there may be periods where the body goes into remission, psoriatic arthritis may be disabling without treatment of symptoms.

What are the symptoms and early signs of arthritis in the feet and ankles?

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Like arthritis in other parts of the body, arthritis in the feet and ankles is indicated by tenderness or pain, stiffness, and swelling. Often, the first sign of arthritis in the feet and ankles is persistent tenderness, typically in one or two small joints. Over time, these symptoms may expand to include a reduced ability to move or walk. Bone spurs may often occur, causing a lumpy or deformed joint. Less commonly, arthritis may be accompanied by tingling and numbness in the feet and toes, which is usually caused by nerve irritation over time.

What does foot and ankle arthritis pain feel like?

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Foot and ankle arthritis pain can include a range of sensations. The most common are dull, persistent tenderness and stiffness caused by swelling. The pain is generally minimal, and most people with foot and ankle arthritis describe the experience as uncomfortable rather than painful. However, in more advanced cases of arthritis, such as rheumatoid arthritis and progressed osteoarthritis, the pain may be constant and even debilitating.

Some forms of foot and ankle arthritis, such as arthritis in foot arch, can also feel unstable, or like the joint may “give out.” Arthritis in the foot and ankle can also cause tingling and numbness in the feet and toes, a result of nerve irritation around the affected joint.

Foot and ankle arthritis may sometimes feel acute. Some people with the condition describe a sharp, throbbing, shooting, or stinging pain in the affected area, though this is not often persistent. Usually, this acute pain happens when the afflicted joint is stressed or strained. Though more common in the foot arch or in the toes, this sensation can also occur with arthritis in the top of the foot.

What is the treatment for foot and ankle arthritis?

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A doctor will prescribe treatment for foot and ankle arthritis depending on the stage of the condition and how the symptoms manifest. If your arthritis in the foot and/or ankle is minimal, you may find comfort in home remedies and exercises. However, if you have advanced arthritis, a doctor may recommend a surgical treatment. See below for several popular treatment options.

Home Remedies and Exercises
If you suspect you have arthritis in the foot and/or ankle, you should limit impact activities, which include running and jumping. Activity modification is an essential part of ankle arthritis treatment. Similarly, people who are overweight may benefit from weight loss or control; losing weight decreases the pressure placed on the foot and ankle joints and can alleviate some tension.

There are also several strengthening exercises and stretches that are beneficial to people with mild arthritis. Mild exercise can ease arthritis pain and stiffness, but be careful to not overdo it.

Medications and Non-Surgical Treatments
In mild foot and ankle arthritis, shoe modifications can alleviate pain and stiffness. Cushioned inserts can help alleviate symptoms, and a “rocker bottom” on a shoe sole can help support the joint. To prevent excessive motion in the affected part of the body, a brace may also be recommended to help hold the ankle joint in position. These braces are known as ankle-foot-orthoses, or AFOs, and are available at most pharmacies.

In addition to these modifications, some with foot and ankle arthritis may benefit from anti-inflammatory medications. Similarly, cortisone injections can be extremely helpful in managing this form of arthritis, especially if you experience acute pain and flare-ups. These injections cannot be performed regularly, but an occasional shot is helpful for most patients.

Surgical Treatments
Surgery may be recommended in severe cases of foot and ankle arthritis. Ankle arthroscopy, which shaves down bone spurs to promote joint motion, is helpful for patients with limited ankle arthritis. If the ankle arthritis is more advanced, ankle fusion surgery may be recommended. This procedure removes the worn-out portion of the joint, and then permanently holds the bones in a position to assist motion. Fusion and replacement surgeries are also available for various foot joints; one popular procedure fuses the big toe joint to limit the range of motion and eliminate the source of pain.

As with all procedures, it is important to weigh the options that will best address your form of ankle and foot arthritis. If you opt for surgery, be sure to take the recommended recovery period seriously to limit the potential for further injury.

What is the best diet and exercise for foot arthritis?

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Some people with foot and ankle arthritis may benefit from an anti-inflammatory diet, which may reduce chronic pain caused by osteoarthritis and rheumatoid arthritis. Avoiding processed foods and eating vegetables, fruits, beans, whole grains, and foods with Omega-3 fatty acids, like wild salmon and avocadoes, is a great place to start.

Some studies suggest that people with arthritis should avoid nightshades, which include eggplant, tomatoes, red bell peppers, and potatoes. These fruits and vegetables contain solanine, a chemical believed to worsen arthritis pain. While there is no data to support this claim, doctors recommend paying close attention to your arthritis pain flares after consuming nightshade vegetables.

In most cases, the best diet and exercise for foot arthritis is whatever keeps your weight under control and your joints limber but not overworked. If you are overweight and experiencing arthritis symptoms, it is important to alleviate as much pressure from the joints as possible. In some cases, this could mean losing weight. While this may not be a primary concern, it can help with symptom management.

Exercise is also an important part of foot arthritis symptom management. While you should avoid impact activities, like running and most sports, toe flexion stretches can alleviate some pain.

How can I prevent arthritis in the feet and ankles?

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There are several steps you can take to prevent or delay arthritis symptoms. If you are working to prevent arthritis in the feet and ankles, do not be afraid of maintaining a moderate exercise routine. Consider low-impact activities, like walking, yoga, and biking, which can help maintain a healthy weight without putting extra stress on the foot and ankle joints. Moreover, taking the time to stretch before and after exercise is key to having a healthy routine.

If you are particularly worried about developing foot and ankle arthritis, you can elect to have your gait analyzed. A podiatrist can examine the foot for biomechanical issues, like abnormally high arches or inward-falling ankles, and recommend shoe inserts that can postpone the symptoms indicative of arthritis.

In most cases, it is difficult, if not impossible, to prevent arthritis. Many types of arthritis are thought to result from a combination of genetic predisposition and environmental triggers. However, you can work toward maintaining a healthy, joint-mindful lifestyle to minimize symptoms if and when they occur. By maintaining a healthy diet, a stretching and mild exercise routine, and keeping mindful of potential injury and pain, you can stay on top of arthritis pain.