Arthritis is a general term for a group of more than 100 diseases that can involve inflammation and swelling in and around the joints and soft tissue of your feet and ankles.
With many kinds of arthritis, foot and ankle joints wear down over time. You slowly lose the smooth “cushioning” cartilage inside them. As a result, your bones rub against each other and wear down, and the soft tissues can, too. After some time, the joint might not work or move the way it should.
What causes it?
The two main types of arthritis — osteoarthritis and rheumatoid arthritis — damage joints in different ways.
This is the degenerative, wear-and-tear kind of arthritis. It occurs as the cartilage in the joint gradually wears away and the protective space between your bones decreases. When it gets to the point that the bones are rubbing against each other, bone spurs are created. Osteoarthritis develops slowly and causes pain and stiffness that gets worse as you age. Risk factors include family history and obesity.
Rheumatoid arthritis is a chronic autoimmune 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 your body. When you have rheumatoid arthritis, immune cells attack your joint covering, causing it to swell. Over time, the covering invades and damages your bone and cartilage, as well as ligaments and tendons, and may cause serious joint deformity and disability. Its exact cause is unknown, and even though it’s not an inherited disease, research shows that some people have certain genes that make them more susceptible.
How do you know you have it?
The symptoms of arthritis vary depending on which joint is affected, and most arthritic joints are painful and inflamed. Pain will develop gradually over time, although sudden onset is also possible. Other symptoms are:
- 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 walking due to any of the above symptoms
How we fix it
The OSI foot and ankle team is here to listen, discuss your concerns, and examine you for signs and symptoms of foot and ankle arthritis. Our goal is to have you back on your feet, pain free, enjoying the activities you love. While you’re under our expert care, you may undergo the following to determine the best course of care:
- Physical exam: We’ll discuss your overall medical history, examine your foot and ankle, talk about any previous injury and symptoms, and even look at your shoes to see if they show uneven wear. Your OSI doctor will do a gait analysis to see how you’re walking and if your pain is creating a limp.
- X-rays: A weight-bearing x-ray is the most valuable test in diagnosing the severity of arthritis. It will show narrowing of the joint space, changes to the bone, and the formation of any bone spurs.
- MRI or CT scan: Magnetic resonance imaging or computed tomography are sometimes necessary to determine the condition of the bone and soft tissues.
- Lab tests: A blood test may be necessary to determine which kind of arthritis you have. If rheumatoid arthritis is suspected, you may be referred to a rheumatologist.
Initial treatment of foot and ankle arthritis is usually nonsurgical, and treatment options vary.
- Lifestyle modifications. Minimize activities that aggravate the condition, switch to low-impact exercises like swimming or cycling, and change your diet to lose weight and reduce stress on your joints.
- Physical therapy. Specific exercises can help increase range of motion and flexibility, as well as help strengthen the muscles in your foot and ankle.
- Assistive devices. Using a cane or wearing a brace might help improve your mobility, and orthotics can minimize pressure on the foot and decrease pain.
- Non-steroidal anti-inflammatory medications (NSAIDs) like ibuprofen and naproxen reduce pain and swelling. Cortisone injections can provide temporary pain relief.
If your pain causes disability and is not relieved with nonsurgical options, your OSI doctor will discuss the following surgical options:
- Arthroscopic debridement
- Arthrodesis (fusion)
- Total ankle replacement (arthroplasty)
Most OSI patients experience pain relief after surgery, and the quality of your life will be improved. Full recovery can take from 4 to 9 months, depending on how severe your condition was. Foot and ankle surgery can be painful, and you can expect discomfort. However, with the care of your OSI team, you should be able to resume your normal daily routine within 3 or 4 months.