Arthritic Foot & Ankle Care

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The pain and stiffness you feel in your feet and ankles as you age  could be arthritis. If left untreated, this nagging pain can get worse  over time, eventually making it difficult to walk even short distances.  Severe arthritis can restrict your mobility,     but with proper treatment, you can minimize the pain and maximize  your quality of life.

Arthritis is a broad term for a number of  conditions that destroy the workings of a normal joint. Arthritis may  occur in your back, neck, hips, knees, shoulders or hands, as well as  your feet and ankles. Almost half of people in their 60s and 70s have     arthritis of the foot and/or ankle, but not all of them have  symptoms.

There are many different types of arthritis. The most  common type, osteoarthritis, results from wear and tear to joint  cartilage, the cushioning between joints that allows them to glide  smoothly. The damage can cause inflammation, redness, swelling, and     pain in the joint.

Also, a sudden and traumatic injury such as a broken bone, torn ligament, or moderate ankle sprain can cause the injured joint to become arthritic in the future.  Sometimes a traumatic injury will result in arthritis in the injured  joint even though the joint received proper medical care at the time of  injury. This type of arthritis, called post-traumatic arthritis, is the most common type that affects the ankle.

Another less common type, rheumatoid arthritis,  is an inflammatory condition caused by an irritation of the joint  lining. People with rheumatoid arthritis for at least 10 years almost  always develop arthritis in some part of the foot or ankle.

The foot has 26 bones and more than 30 joints. Tough bands of tissue  called ligaments hold these together. The muscles, tendons, and  ligaments work together with the many joints of the foot to control  motion and weight bearing position. This smooth motion  makes it possible for a person to walk well. When you get arthritis  in the foot, you develop pain and limited motion so that you cannot walk  as well.

Arthritis can develop in any of these joints but some are more commonly affected than others. A foot and ankle specialist can help you locate the source of your pain and determine the best course of treatment.

If  your foot and ankle surgeon suspects you have arthritis, he or she will ask you to have a complete medical history and physical  examination. X-rays and laboratory tests often can confirm the type and  extent of the arthritis. Other tests  such as a bone scan, CT scan, or MRI may be used to evaluate your  condition.

Once your surgeon confirms you have arthritis, he or she will  recommend a treatment regimen. Proper treatment of foot and ankle  arthritis addresses both pain and joint deformity. In cases of trauma to  the foot or ankle, cartilage can be lost or damaged, leading to inflammation and pain. Over a lifetime of wear and tear,  many patients lose cartilage in their joints, with pain only developing  late in life.  Pain and inflammation also can result from inflammatory arthritis, which is less common.  In any  case, if left untreated, the arthritic foot and ankle eventually may  become deformed.

There are no treatments that can repair damaged cartilage, but there are ways you can reduce pain and possibly slow down further damage.  Non-surgical options often include medications by mouth (anti-inflammatories), injections (steroids or other), physical therapy, weight loss, changes in shoes, or orthotics such as pads in your shoes or custom-made braces. 

Injections  are a common treatment for arthritis that delivers medication directly to the affected joint.  A strong anti-inflammatory called cortisone is the most commonly used medication for joint injection.  Depending on the joint, alternatives to cortisone may be used such as artificial joint lubricant (also known as viscosupplementation or hyaluronic acid) or platelet-rich plasma.

When non-surgical treatments fail, surgery may be necessary.  For mild  arthritis cases, this may involve cleaning the arthritic joint by  removing bone spurs that restrict motion. More often, especially with  advanced arthritis, options include eliminating the painful motion of the joint by fusing it or replacing the joint with an artificial joint.  The best surgical option depends on the  joint(s) involved, your activity level, and your treatment goals.  Consult with your foot and ankle surgeon before moving forward with any treatment.

After surgery, you will require a period of rehabilitation when your foot might have to be in a cast and you might have to wear special shoes  or braces for a while. 

Who can help me with my arthritis?
A foot and ankle surgeon can diagnose and treat your arthritis. In addition, other healthcare professionals may care for you, including a  rheumatologist (medical arthritis specialist), physiatrist  (rehabilitation specialist), pedorthist (footwear specialist), physical therapist, orthotist (brace specialist), occupational  therapist, nurse and/or clinical social worker.

Community resources also are available to people with arthritis.  Local chapters of the Arthritis Foundation offer exercise programs, educational information and support groups.

You also play an active role in your treatment.  Seek treatment for arthritis as early as possible to help control pain and reduce damage to joints.  Take medications as directed, exercise, control  your weight, and participate in all aspects of your care.  If you have questions about the need for a test, or the risks or  benefits of your treatment, ask your doctor.  Even with the best treatment, arthritis of the foot and ankle may continue to cause you  pain or changes in your activities. However, proper diagnosis and treatment will help to minimize these limitations and  allow you to lead a productive, active lifestyle.