Osteoarthritis of the Foot and Ankle

Osteoarthritis can affect joints in any part of the body, including the ankle and foot. Early diagnosis and treatment help people with foot osteoarthritis manage their symptoms.

This article discusses osteoarthritis foot and ankle pain, what it feels like, and how it is diagnosed. It also discusses treatment options for helping ease foot pain.

Symptoms of Foot and Ankle Osteoarthritis

What osteoarthritis foot and ankle pain feels like differs depending on what specific areas it affects.

There are 28 bones and more than 30 joints in the human foot. The foot joints that are most commonly affected by osteoarthritis include:

• The ankle (tibiotalar joint)
• The three joints of the hindfoot (talocalcaneal joint, talonavicular joint, calcaneocuboid joint)
• The midfoot (metatarsocunieform joint)
• The great toe (first metatarsophalangeal joint)
• The lesser toes, when they have a hammertoe deformity

Many people experience stiffness as well as pain from osteoarthritis. The affected joint may feel like it needs to be cracked or that it feels out of joint, but popping the joint does not relieve the sensation.

The usual symptoms associated with foot osteoarthritis include:

• Pain and stiffness in the affected foot
• Swelling near the affected joint
• Limited range of motion
• Difficulty walking (it may hurt to walk or bear weight on the affected foot)
• Bony protrusions (spurs)
  

Causes

Osteoarthritis is a degenerative joint disease. Cartilage, which serves as a protective cover and cushion for the ends of the bones that form a joint, gradually wears down. This is due to mechanical wear and tear on the joints of the foot.

Injury can also cause osteoarthritis to develop even years after the injury has occurred. Severe sprains or fractures can lead to osteoarthritis.

Consequently, abnormal foot structure and abnormal foot mechanics can also cause osteoarthritis to develop. People with flat feet or high arches are at greater risk for developing foot osteoarthritis.

Diagnosis

When diagnosing foot osteoarthritis, your healthcare provider must differentiate osteoarthritis from other types of arthritis. The practitioner will consider your medical history and your description of the symptoms. The healthcare provider will ask questions that will help to formulate your diagnosis, such as:

• When did the pain start?
• Is the pain continuous or does it come and go?
• Have you injured the foot? If yes, when and how was it treated?
• Are the symptoms worse at night or following weight-bearing activity (i.e., walking, running)?
• Are the symptoms associated with one or both feet?

Your healthcare provider will also perform a physical examination. Your foot will be examined for swelling, bone spurs or other deformities, limited range of motion, and pain that occurs with movement. A gait analysis may be performed to evaluate your stride while walking and the strength of your feet.

Lastly, imaging studies of the bone structure of the affected foot will likely be performed. Evidence from x-rays, CT scans, or MRI may be used to help diagnose foot osteoarthritis.

Foot and Ankle Osteoarthritis Treatment

Treatment options for foot osteoarthritis are aimed at relieving symptoms. There are non-surgical and surgical options. Your healthcare provider will likely recommend one or more non-surgical options first. Non-surgical options include:

• Nonsteroidal anti-inflammatory drugs or analgesics (to relieve pain and swelling)
• Shoe inserts (to add support or provide extra cushioning)
• Orthotics (custom-made shoes or supports)
• Mortons extension (an orthotic that limits motion and helps with arthritis in the big toe)
• Ankle foot orthotics (braces that can be made to restrict motion to ankle, rear foot, and midfoot)
• Physical therapy or exercise (to improve range of motion and stability)
• Steroid injections (to deliver anti-inflammatory medication to the joint directly)
• Dietary supplements

If non-surgical options are ineffective, your healthcare provider may suggest surgery to relieve pain and restore function. Common surgeries for foot and ankle osteoarthritis include arthroscopy, microfracture to remove spurs, joint fusion, or joint replacement.