How to Treat Arthritis Ankle

Arthritis can affect any of the 30+ joints in the foot and ankle, making daily movement and simple activities painful and challenging. These joints bear most of our weight in day-to-day activities; thus, they are prone to wear. Similarly, without their proper function, even basic tasks like walking or standing can become difficult.

Foot and ankle arthritis impacts balance and mobility. Over time, untreated arthritis in the essential joints can lead to a reduced range of motion, further weakening surrounding muscles and soft tissues and increasing the risk of falls and other injuries.

We'll say it head-on: there’s no cure for arthritis. However, treatments can help manage symptoms so you can still enjoy activities you love. In this guide, we'll explore what arthritis in the ankle is, what causes it, and the various options available for relief and treatment.

What Is Arthritis Ankle?

Arthritis ankle, or ankle arthritis, is the inflammation of the ankle joint and surrounding structures, leading to pain, stiffness, and limited movement. It is a chronic condition that occurs when the cartilage in the ankle joint breaks down, damaging the joint. As the cartilage inside the ankle joint wears away, bones start to rub against each other, causing pain and irritation.

This condition can result from autoimmune diseases like rheumatoid arthritis. About 1% of the population in Singapore has RA, the most common form of inflammatory arthritis (IA) in the country. This is equivalent to about 45,000 people.

An arthritic ankle can also develop from wear and tear, known as degenerative joint disease.

Which Structures of the Ankle Are Affected?

The ankle joint includes bones, cartilage, soft tissues, and surrounding muscles. In arthritis, the primary structures affected include:

• Cartilage (specifically the tibia, fibula, and talus): This cushions the bones, but in arthritis, it wears down, leading to joint space narrowing.
• Synovium: This tissue lining becomes inflamed in conditions like inflammatory arthritis.
• Bone Spurs: These can develop around the joint as it adapts to increased stress, contributing to pain and limited mobility.

The distal ends of the tibia and fibula (lower leg bones) and the superior surface of the talus (ankle bone) are the main areas where cartilage damage occurs in ankle arthritis. The primary joint affected is the tibiotalar joint, which is the primary ankle joint responsible for up and down movement. While the ankle cartilage is the primary focus, the ligaments surrounding the ankle joint can also be affected by inflammation and degeneration, contributing to instability.

Types of Arthritis Ankle

Several types of arthritis can affect the ankle:

• Osteoarthritis (OA): Caused by wear and tear over time, leading to progressive damage
• Rheumatoid Arthritis: An autoimmune disease where the immune system attacks the joint lining
• Psoriatic Arthritis: Linked to psoriasis, an autoimmune disease that causes joint pain
• Post-Traumatic Arthritis: Occurs after an ankle injury, like a fracture or ligament tear

Who Is Prone to Developing Arthritis in the Ankle?

People with a history of ankle injuries, such as sprains or fractures, are more likely to develop post-traumatic arthritis. Other risk factors include family history, autoimmune diseases, age, and conditions like gout, where uric acid crystals can damage the joint.

Symptoms of Arthritis Ankle

Ankle arthritis symptoms often develop gradually but can significantly affect your routine and activities. Common symptoms include:

• Persistent ankle and foot pain
• Swelling and warmth around the joint
• Reduced range of motion
• Increased pain with activity
• Stiffness, especially after periods of inactivity

How Ankle Arthritis Affects Daily Living

Ankle arthritis can make activities like walking, standing, or climbing stairs difficult and uncomfortable. Reduced mobility and pain may affect your ability to enjoy recreational activities and, in severe cases, lead to changes in gait, contributing to further strain on the affected joints.

What Causes Arthritis Ankle?

Multiple factors can cause arthritis in the ankle:

• Wear and Tear: Osteoarthritis often develops over time due to repetitive stress and ageing.
• Autoimmune Diseases: Rheumatoid and psoriatic arthritis result from the immune system attacking healthy tissue.
• Previous Injuries: Fractures or repeated ankle injuries can lead to post-traumatic arthritis.
• Genetic Factors: Family history may increase the risk of arthritis in the ankle and other joints.

How Is Ankle Arthritis Diagnosed?

Diagnosing ankle arthritis involves a thorough physical examination and reviewing medical history. Doctors may use imaging tests, such as X-rays, magnetic resonance imaging (MRI),and CT scans, to look for joint space narrowing, bone spurs, and cartilage loss. Blood tests can help detect autoimmune markers, and gait analysis might be used to assess movement issues related to the condition.

Treatment for Ankle Arthritis

There is no cure for ankle arthritis, but treatments can help manage symptoms and improve mobility. To treat ankle arthritis, below are two main categories.

Non-Surgical Treatment

Non-surgical treatments aim to reduce pain and slow the progression of arthritis, such as ankle sprain physiotherapy treatment. Let's elaborate:

1. Physical Therapy: Manual therapy and exercises to strengthen surrounding muscles and improve range of motion.
2. Pain Relievers: Nonsteroidal anti-inflammatory drugs (NSAIDs) and other pain relievers help manage discomfort.
3. Shoe Inserts and Supportive Footwear: Orthotic inserts or supportive footwear can improve shock absorption and relieve symptoms.
4. Lifestyle Modifications: Weight loss reduces stress on the ankle, and avoiding high-impact activities can help.
5. Injections: Corticosteroid injections can provide temporary pain relief for severe cases.

Physiotherapy specialists in Singapore, like Phoenix Rehab, tailor a personalised treatment plan that supports joint health, allowing you to engage in daily activities with more comfort and fewer limitations.

Surgical Treatment

In severe cases, surgical options may be necessary to relieve pain and restore function. Common ones include:

• Ankle Arthroscopy: This is a minimally invasive procedure to remove loose cartilage and other debris.
• Ankle Fusion (Arthrodesis): Fuses bones together to reduce pain by eliminating movement in the joint, often recommended for end-stage ankle arthritis.
• Ankle Replacement (Ankle Arthroplasty): Damaged parts of the joint are replaced with prosthetics. Ankle replacement surgery can relieve pain while preserving movement.

Recovery times vary depending on the procedure. Joint replacement surgery recovery can take 6–12 months. You'll also need to take blood clot medications and participate in physical therapy.

Arthroplasty recovery can take close to a year. You'll wear a frame on the outside of your ankle for about three months.

In general, you can expect to:

• Keep your ankle immobilised in a cast or boot for 2–6 weeks.
• Use crutches or a walking aid to get around.
• Participate in physical therapy to regain mobility and strength.
• Resume normal activities after 8–12 weeks, but it may take longer for the ankle to fully heal.

What You Can Do at Home

At home, simple adjustments can provide relief:

• Apply ice or heat to reduce inflammation.
• Rest the ankle and use compression wraps for added support.
• Use gentle stretching exercises to maintain flexibility.
• Wear comfortable shoes with good arch support.

How To Prevent Ankle Arthritis

While some risk factors for ankle arthritis are unavoidable, certain preventive measures may help. To protect against injuries, use appropriate footwear and avoid high-risk activities when possible. To reduce stress in the joints, maintain a healthy weight. And when staying active, engage in low-impact exercises like swimming or cycling to strengthen joints without putting undue strain on them.

How Do You Know If Your Ankle Pain Is Arthritis?

If ankle pain is persistent, worsens with activity, or includes stiffness, swelling, and reduced range of motion, it may indicate arthritis. Consulting with a healthcare provider is essential for an accurate diagnosis.

When To See a Doctor

If ankle pain persists despite home remedies or starts to impact daily activities, it’s time to consult a doctor. A healthcare provider can confirm whether arthritis or another condition is the cause of the pain and recommend appropriate treatments.

What To Ask During Consultation

To get the most out of your consultation, consider asking questions such as:

• What type of arthritis is affecting my ankle?
• Are there specific lifestyle changes I should make?
• What are the non-surgical and surgical options for my condition?
• What can I do to manage pain effectively?
• How will this condition progress?

Conclusion

Although ankle arthritis can be painful and limiting, combining treatments, lifestyle adjustments, and early diagnosis can help manage symptoms and improve mobility. Regular check-ups and understanding treatment options are critical steps to living well with ankle arthritis.