Foot & Ankle Arthritis: Recognizing and Managing Different Types

May 30, 2024 | By: Raleigh Orthopaedic Team

Arthritis is a common condition that can cause pain, stiffness, and inflammation in the joints. It affects millions of people worldwide and can significantly impact daily living. While arthritis can target any joint in the body, the foot and ankle are particularly vulnerable due to the constant weight-bearing and movement they endure. Understanding the different types of arthritis and how they affect the foot and ankle can help in managing symptoms and maintaining mobility.

Types of Arthritis

Osteoarthritis (OA) – OA is the most common type of arthritis, often referred to as “wear-and-tear” arthritis. It occurs when the cartilage that cushions the ends of the bone in the joints gradually wears down.

Rheumatoid Arthritis (RA) – RA is an autoimmune disease that causes the body’s immune system to attack the joint lining (synovium), leading to inflammation, joint damage, and deformity.

Symptoms Throughout the Foot and Ankle

The most common symptom of foot and ankle arthritis is pain and inflammation. Symptoms of RA typically appear in both feet, unlike OA which typically begins isolated at one joint.

Forefoot (Toes and Ball of the Foot) – Arthritis in the big toe typically affects the first metatarsophalangeal joint, which is located at the base of the big toe and connects the toe to the rest of the foot. Often, there is swelling around the big toe joint or difficulty moving and bending the toe. A bump, like a bunion or bone spur, can develop on top of the big toe joint and be aggravated by rubbing against the inside of a shoe.

Midfoot (Top of the Foot) – RA and OA can cause the ligaments that support the midfoot to become weak and, as a result, the arch collapses. Without proper arch support, the front of the foot will migrate outward. Over time, this can create a bony prominence (bump) to form on the inside and bottom of the foot, changing the overall shape of the foot. This change in shape can make it difficult to find comfortable footwear or wear shoes at all.

Hindfoot (Heel Region) – Arthritis in the hindfoot affects the three joints below the ankle and above the heel. In the initial stages, people may experience difficulty walking on uneven ground or gravel. This is because the degeneration caused by arthritis can shift the bones in the foot out of their normal positions, changing the overall alignment and impeding on the side-to-side motion of the heel region. Pain beneath the fibula (smaller lower leg bone) on the outside of the foot or discomfort along the posterior tibial tendon (main tendon that supports the foot arch) may indicate rheumatoid arthritis.

Ankle – Symptoms may include difficulty navigating inclines such as ramps or stairs. As OA or RA progress, walking and standing may become uncomfortable or painful.

Nonsurgical Treatment

Treatments for arthritis of the foot and ankle will depend on the severity of the disease. Nonsurgical treatment options include:

  • Physical Therapy – to safely stretch and strengthen the foot and ankle joints, and improve mobility and function.
  • Medications such as non-steroidal anti-inflammatories (NSAID’s), like ibuprofen or naproxen, to reduce pain and inflammation.
  • Assistive devices such as orthotics or braces, which will help minimize the pressure from prominent bones/bumps of the foot or support the joints of the foot and ankle.
  • Corticosteroid (cortisone) injections – typically a temporary measure to reduce inflammation in the joint.

Surgical Treatment

Your doctor may recommend surgery if nonsurgical treatment options for arthritis symptoms fail to provide pain relief, or if there is extensive cartilage damage. The goal of surgery is to relieve the pain of arthritis and make it possible to perform daily activities more easily.

Fusion of the affected joints is the most common type of surgery performed for arthritis. This procedure involves taking two bones that form a joint and fusing them together into one bone. During the surgery, remaining cartilage is removed and the two bones are held together with screws and plates, preventing the bones from moving. Fusion reduces pain by limiting joint motion and preventing further shifting.

Other surgical options are available to address issues related to arthritis of the foot and ankle. The surgeon will discuss the appropriate options for each individual case.

Schedule an appointment

The Raleigh Orthopaedic Clinic board-certified, fellowship-trained foot and ankle specialists, Dr. BooneDr. Casale, Dr. Ray and Dr. Logel, provide comprehensive and specialized care for a wide variety of foot and ankle conditions. They also work closely with Raleigh Orthopaedic Clinic’s podiatrist, Dr. Simmons, to utilize conservative treatment options whenever possible. The foot and ankle specialists at Raleigh Orthopaedic are dedicated to quality outcomes and are trained to treat strains, sprains, fractures, tendon injuries, and more. Our foot and ankle specialists are available at all of our clinics in Wake County, NC.

Raleigh Orthopaedic offers online scheduling so CLICK HERE to schedule or call us at (919) 781-5600 to schedule an appointment with one of our orthopedic specialists.

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The material contained on this site is for informational purposes only and DOES NOT CONSTITUTE THE PROVIDING OF MEDICAL ADVICE, and is not intended to be a substitute for independent professional medical judgment, advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare providers with any questions or concerns you may have regarding your health.