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Ankle Arthritis Overview

by Jaydee Vykoukal, PT, DPT January 28, 2021 0 Comments

arthritic ankle

Arthritis often occurs in the feet and ankles. Nearly half of people aged over 60 have ankle arthritis but don’t notice any symptoms. Arthritic ankles and feet, when not addressed early, can prevent you from leading a healthy and active lifestyle. It may even lead to other serious illnesses secondary to changes in your activity levels. The impact of ankle arthritis on your life can be more serious than you might think. In this guide, we provide the knowledge you need to manage your ankle arthritis: causes and symptoms.

Ankle Arthritis Explained

Arthritis of the ankle is an inflammatory degenerative condition in which the ankle’s articular cartilage, essential for normal shock absorption and joint mechanics,  thins and begins to break down. After that, abnormal bony growths (bone spurs) might develop around the joint. Inside a healthy ankle joint is cartilage about 1 to 1.7 mm thick. It is tough and dense. Once the smooth cartilage lining breaks down, inflamed tissue known as synovitis occurs.

What Causes Arthritic Ankles?

Understanding the root cause of your arthritis ankle pain may help your doctor recommend an effective course of treatment. The condition most commonly results from five major causes and risk factors.

1. Family History

The chances of developing ankle arthritis is increased by a genetic predisposition.

2. Advanced Age

The likelihood of developing arthritis in ankle joints increases with age. The ankle cartilage thins over time.

3. Joint Stress

If your regular activities stress your ankles—such as extreme sports or rigorous workout routines—you’re more likely to suffer from arthritis in your feet and ankles.

4. Underlying Medical Conditions

Studies found out that 10–15% of reported cases of ankle arthritis are due to an underlying medical condition. Examples are blood disorders, congenital structural defects, rheumatoid arthritis, and conditions that cause poor circulation.

5. Joint Trauma

The ankle is vulnerable to sprains and other accidents. If a joint has suffered a traumatic injury, it is more prone to ankle arthritis, or “post-traumatic arthritis ankle.” The damage from the injury may heal in time, but the trauma can lead to serious joint changes in the long-term.

Types of Arthritis That Affect the Ankle

Arthritis is an umbrella term for joint inflammation. You may have osteoarthritis of the ankle or rheumatoid arthritis of the ankle. 

Although the two types of arthritis cause inflammatory pain, each has different causes and paths of progression. Rheumatoid arthritis is an autoimmune disease, while ankle osteoarthritis is caused by wear and tear of the joint.

Ankle Arthritis Symptoms

The symptoms of arthritis in the ankle and foot can vary depending on which ligaments or joints are affected. When left untreated, the condition can slowly worsen over time and may interfere with your daily routine. As sudden onset is also possible, it’s important to seek medical attention or physical therapy immediately. Here are the typical signs of arthritis in the ankle.

  • Throbbing Pain

    Weight bearing activities, such as walking or jogging, put strain on your ankle joint and can result in excruciating pain. The pain may be sharp and intense or aching and dull. Once the condition progresses, the pain can become a more frequent occurrence. You may experience chronic pain in the back of the foot, in the lower shin (tibia), or in the middle of your foot.

  • Swelling

    When the ankle cartilage is damaged, the talus, fibula, and tibia bones can grind against one another. This leads to ankle swelling and irritation.

  • Joint Stiffness

    Bone-on-bone friction and inflammation makes the ankle stiff. So when your ankle’s range of motion becomes limited, it can make pointing and flexing your toes for normal daily activities feel difficult.

  • Popping or Crunching Sound

    Some popping in the foot and ankle is normal with everyday movement. However, don’t ignore it when you hear a squeaking sound when flexing your toes, or when you sense a crunching; particularly when there is pain or biomechanical changes associated with it. This is a possible sign that the cartilage is damaged and can no longer adequately protect your bones from fiction.

  • Ankle Instability

    Spending time on your feet, such as with running, standing, or extended walking, may cause the ankle to buckle or lock. This is because joint pain and stiffness changes the way you walk, can cause pain-induced ankle weakness, and lead to poor underlying joint mechanics. 

Diagnosing Arthritis Ankle

If you’re experiencing one of the symptoms of ankle arthritis listed above, make an appointment with a specialist as soon as possible. Your condition can be diagnosed with a comprehensive physical exam, a full medical history, and imaging technology (if needed).

Your doctor will check your ankle for tenderness, signs of inflammatory issues, bone spurs, joint damage, and range of motion. Your doctor may also inspect your shoes for uneven wear and your mechanics with movement. Imaging tests can confirm arthritis in ankle joints or rule out other potential issues—MRIs, arthrocentesis scans, 3D pedCATs, X-rays, and radiographs are all possibilities if necessary.

Treating Your Ankle Arthritis

Regardless of the condition of your ankle, your doctor will prescribe a treatment that is suited to your needs. Several factors will be considered, including your age, bone quality, body weight, alignment, activity level, and severity of ankle arthritis.

Learn More About Treatments & Joint Replacements

While arthritis has no cure, there are many great ways to find pain relief and prevent ankle symptoms. While extreme cases may call for joint or ankle replacement surgery, the most common treatment options involve managing symptoms, restoring range of motion, increasing strength, biomechanics training, nsaids, nonsteroidal anti-inflammatory drugs and more; all which can be done at home or with the guidance for a physical therapist. Continue through this guide to learn more.


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Jaydee Vykoukal, PT, DPT
Jaydee Vykoukal, PT, DPT

JayDee Vykoukal is a Doctor of Physical Therapy, owner of the healthy habit platform Health Means Wealth, and freelance medical writer. She loves traveling and spending time with her family in nature. Her passion is helping others continue to participate in the activities they love through education and proper exercise.

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