Foot and Ankle Arthritis: Causes, Symptoms and Treatments

Over the course of a lifetime, our feet and ankles can take a real pounding. Ankles in particular return 50 percent more energy per step than hips and knees, so it’s not surprising that we treat a fair amount of foot and ankle arthritis in our practice at Rebound.

The two most common forms of foot and ankle arthritis are osteoarthritis and post-traumatic arthritis. Osteoarthritis, or “wear and tear arthritis,” is naturally degenerative. Over the years, the cartilage that covers the ends of our bones simply wears out and becomes frayed, causing inflammation, swelling, tenderness or pain, and a reduced ability to walk and bear weight. Post-traumatic arthritis develops after an injury to a foot or ankle, such as a fracture or dislocation. Post-traumatic arthritis can look a lot like osteoarthritis, and affects patients similarly. It can also take a long time, even years, to present. Compared to hip and knee arthritis, which is more commonly degenerative, foot and ankle arthritis is most commonly experienced post-trauma.

The following are the foot joints most often affected by osteoarthritis and post-traumatic arthritis:

• Ankle: The joint where the shinbone (tibia) and ankle (talus) meet
• Hindfoot: The three joints of the foot that involve the heel bone (calcaneus), the inner mid-foot bone (navicular), and the outer mid-foot bone (cuboid)
• Forefoot: The joint of the big toe and first metatarsal bone

There are surgical and nonsurgical methods to treat foot and ankle arthritis. Nonsurgical methods include:

• Steroid medications injected into the joints
• Anti-inflammatory drugs to reduce swelling in the joints
• Pain relievers
• Pads or arch supports
• Canes and braces to support the joints
• Inserts that support the ankle and foot
• Physical therapy
• Custom shoes
• Weight control

If you and your doctor agree that surgery is a viable and desirable option, then there are a couple approaches to consider:

• Fusion surgery. This kind of surgery, also called arthrodesis, involves fusing bones together with the use of rods, pins, screws, or plates. After healing, the bones remain fused together.
• Joint replacement surgery. This kind of surgery involves replacing the ankle joint with artificial implants.

Of course, the best way to prevent arthritis in your feet and ankles is to take good care of them in the first place. Here are few ways to care for your feet and ankles:

• Wear shoes proper-fitting shoes that are shaped like your foot
• Wear shoes that have support — for example, no slip-on shoes
• Wear rubber soles to provide more cushioning
• Exercise and stretch your feet and ankles

Here are some exercises you can do to help keep your feet pain-free, strong, and flexible:

• Achilles stretch. With your palms flat on a wall, lean against the wall and place one foot forward and one foot back. Lean forward, leaving your heels on the floor. You can feel the pull in your Achilles tendon and your calf. Repeat this exercise three times, holding for ten seconds each time.
• Big-toe stretch. Place a thick rubber band around your big toes. Pull the big toes away from each other and toward the other toes. Hold this position for five seconds and repeat the exercise ten times.
• Toe pull. Place a rubber band around the toes of each foot, and then spread your toes. Hold this position for five seconds and repeat the exercise ten times.
• Toe curl. Pick up marbles with your toes.