Arthritis is inflammation of one or more joints. It can cause pain and stiffness in any joint in the body; however, it is very common in the small joints of the foot and ankle. There are many forms of arthritis that can affect the foot and ankle and make it difficult to walk.
During standing, walking and running, the foot and ankle provide support, shock absorption and balance. Three bones make up the ankle joint, which enables up and down movement. There are 28 bones in the foot and more than 30 joints that allow for a wide range of movement.
In your joints, the ends of the bones are covered with articular cartilage, a slippery substance that helps the bones move smoothly over each other during movement. Joints are also surrounded by a thin lining called synovium. Synovium produces a fluid that lubricates the cartilage and reduces friction during movement.
The major types of arthritis that affect the foot and ankle include: osteoarthritis, rheumatoid arthritis and post-traumatic arthritis.
- Osteoarthritis: Mostly related to old age, it usually occurs in people over 50 years old, but can occur in younger people as well. The cartilage that cushions the joint softens and wears away. The bones then rub against one another causing foot and ankle pain and stiffness. Osteoarthritis develops slowly and worsens over time. Osteoarthritis may also be caused or accelerated by obesity and family history.
- Rheumatoid arthritis: This is the most common form of a group of disorders referred to as inflammatory arthritis. Most often, rheumatoid arthritis starts in the foot and ankle and can affect multiple joints throughout the body. It is symmetrical, so it affects the same joint on both sides of the body. This is an autoimmune disease where the immune system attacks its own tissues. Immune cells attack the synovium covering the joint, causing it to swell. Overtime, the synovium invades and damages the bone and cartilage, as well as ligaments and tendons and may cause serious joint deformity and disability.
- Post-traumatic arthritis: Develops after an injury to the foot or ankle. Dislocations and fractures are the most common injuries that lead to post-traumatic arthritis. This causes the cartilage between joints to wear away and can develop many years after the initial injury. An injured joint is much more likely than an uninjured joint to become arthritic even if the injury is properly treated.
What are the signs of arthritis in your ankles?
- Pain with motion
- Pain that flares up with vigorous activity
- Tenderness when pressure is applied to the joint
- Joint swelling
- Increased pain and swelling in the morning
- Difficulty in walking
To determine whether you have foot or ankle arthritis, your physician will ask you for a complete medical history, have you describe your symptoms and conduct a physical examination. An X-ray, CT scan or MRI may be necessary to confirm your diagnosis.
There is not a cure for foot and ankle arthritis; however, there are many nonsurgical options for people suffering from the disease. Nonsurgical treatment options include: rest, ice, anti-inflammatory medications such as ibuprofen, orthotics, braces, physical therapy or steroid injections.
Surgery may be recommended by your physician if pain does not improve after nonsurgical treatment and cartilage damage is extensive. Your orthopedic physician will determine the best surgery options for you.
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