Arthritis can affect any joint in the body but it is more common in the small joints of the foot and ankle. It also affects surrounding soft tissues.
Each foot consists of 28 bones and more than 30 joints. The joint where the shinbone and ankle meets is the most frequently affected joint. The three-foot joints comprise the heel bone, the outer mid foot bone, the inner mid foot bone, and the junction between the big toe and foot bone.
There are more than one hundred different types of arthritis, with several affecting the ankle and foot. All types might make it difficult for you to walk and engage in enjoyable physical activities.
Some evidence suggests that a high frequency of recreational sports is connected with an increased risk of foot and ankle arthritis.
Unfortunately there is no cure for ankle arthritis. But there are a number of therapeutic options that can reduce the progression of the disease and alleviate symptoms. Many people with ankle arthritis are able to manage their pain, remain active, and live full lives when they receive the appropriate treatment.
Types of Foot and Ankle arthritis
The most common types of arthritis that affect the ankle include:
OA is a “degenerative joint disease” in which the cartilage(soft tissues) cushioning the ends of a joint slowly deteriorates. The protective space between the bones narrows down as the cartilage deteriorates, becoming ragged and rough. This may cause painful osteophytes/ bone spurs to form as bones rub against bone.
The most common cause of osteoarthritis is age-related wear and tear on a joint. However, in many cases, any previous ankle injury such as repeated sprains could be the cause of ankle osteoarthritis. This injury can directly cause damage to the cartilage or alter the function of the ankle joint, resulting in cartilage degeneration over time.
In addition to age and ankle injury, other risk factors for OA include a family history of disease and obesity.
Post-traumatic arthritis in the foot or ankle can develop as a result of an injury, even if it occurred years ago. This might be from a dislocation, fracture, or an ankle sprain which can damages cartilage and result in early joint degeneration.
“Rheumatoid arthritis” is a “chronic inflammatory condition” in which our “body immune system attacks” itself. Rheumatoid Arthritis (also known as RA) affects both ankle joints. Signs of RA in the ankle joint may include difficulty with ramps, slopes, and climbing stairs. As Rheumatoid Arthritis of the ankle joint worsens, standing and walking can become uncomfortable.
Other types of inflammatory arthritis that affect the ankle joint include psoriatic arthritis and peripheral spondyloarthritis.
Gout is a type of ankle arthritis that occurs when excessive levels of uric acid in the blood accumulate and exacerbate joints. For many people, the initial sign of gout is pain and swelling in the big toe. Gout attacks can also affect other joints.
This chronic arthritis develops following an infection of the digestive tract, genitourinary tract, or digestive tract. Knees, foot, and ankle joints are the most commonly affected as a result of reactive arthritis.
How To Diagnose Foot and Ankle Arthritis
If ankle arthritis is suspected, the orthopaedic surgeons will look at your medical history to make the diagnosis. They’ll inquire about the onset of your symptoms, the location of your pain, and how they impair your daily activities. They will conduct a physical examination in which they will inspect your ankle to look for swelling and tenderness in the joints, which are initial signs of arthritis.
They will also ask the patients to undergo different tests to determine the root cause of the problem. For example, they will ask for “blood tests” that evaluate swelling and antibodies to rule out “inflammatory arthritis”. In case of gout, they will ask for testing of “joint fluid” to detect “uric acid crystals”. Occasionally, a bone scan may be useful to rule out these disorders. In addition to these specific tests, X-rays and other imaging tests can also help in confirming a diagnosis and assessing the severity of the joint damage caused by ankle arthritis.
Foot and ankle arthritis treatments
In the early stages, foot and ankle arthritis can be managed with nonsurgical treatment, if you have not received any other treatments previously. Your physician may suggest a variety of treatment alternatives.
Some lifestyle modifications can help treat foot and ankle arthritis and decrease the disease’s progression. These alterations include:
Reducing the number of stressful activities that may aggravate ankle arthritis. For example, to reduce the stress on your foot and ankle, you should switch from high-impact sports such as tennis or jogging to low-impact ones such as cycling or swimming.
Keeping a healthy weight aids in relieving stress on the joints. Losing weight improves joint function and reduces ankle pain. Therefore, avoid “processed and high-sugar foods”, especially in case of gout. Additionally, eat a healthy diet because your ability to exercise may be limited during these conditions. But doing some physical activity and adopting a nutritious diet are effective approaches to lose weight.
Some gentle exercises can help improve the range of motion, flexibility, and strength of the foot and ankle muscles in case of ankle and foot arthritis. Your physician or physical therapist can assist you in developing an individualized exercise program that is tailored to your needs and lifestyle.
Although physical therapy frequently relieves stress on arthritic joints, in certain cases it can make the joint pain worse. This occurs when ankle motion increases the friction between arthritic joints. If physical therapy worsens your ankle joint discomfort, your doctor will discontinue this treatment.
Foot and ankle braces
Foot and ankle braces may be helpful in treating ankle arthritis. Use a custom-made well-fitted leather brace for arthritis of the ankle and hindfoot. The use of a brace, such as an ankle-foot orthosis, may help to improve mobility. Additionally, using shoe inserts or custom-made shoes with s rocker bottoms and stiff soles can help ease pain and pressure on the same joint. In addition, if joint shape changes or deformity is present, a shoe insert can be used to straighten the foot and ankle. This also helps to reduce pain.
“Nonsteroidal anti-inflammatory drugs” like naproxen or ibuprofen can be used to reduce joint swelling and for pain relief. Cortisone is also a highly effective anti-inflammatory drug that can be injected into the damaged cartilage of an arthritic joint. Although steroid injections can relieve pain and reduce joint swelling, the effects are temporary.
Surgical Treatment options for foot and ankle arthritis
You may need different types of surgeries to manage foot and ankle arthritis. Orthopedic surgeons can recommend the most appropriate surgical procedure depending on the kind and severity of your arthritis. Following are some surgical treatments to treat foot and ankle arthritis:
In the early stages of arthritis, “arthroscopic surgery” can be beneficial. In this type of ankle surgery, a tiny tool about the same size of a pencil is introduced into a joint to make small incisions. An orthopaedic surgeon views the image projected by the device onto a display. The orthopaedic surgeons may then use miniature forceps, knives, and shavers to remove loose cartilage and clean the joint region. Arthroscopic surgery can also assist in the removal of any foreign tissue or bone spurs present in the joint.
Ankle Fusion (Arthrodesis)
It is a type of fusion surgery also known as arthrodesis that involves fusing bones together. In this surgery, plates, screws, and rods are used to allow the bones fuse together so that after healing, the adjacent bones stay joined. Moreover, Arthrodesis completely fuses the bones of the joint, turning two or more bones into a single, continuous bone.
Total ankle replacement
Total ankle replacement surgery involves the replacement of the ankle joint with an artificial implant or plastic joint surfaces and is performed in extremely rare cases. This type of ankle replacement improves arthritis pain and provides patients with greater mobility than fusion. In addition, the ability to move the previously arthritic joint reduces the tension on the adjacent joints.
This decreases the risk of getting arthritis in adjacent joints. As with any other form of joint replacement surgery, an ankle implant may become loose or fail over time. If the implant failure is severe, the replacement joint might be replaced with a new implant; this is known as revision surgery.
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