Foot and ankle arthritis Pona ngoikore ki te waewae me te whatīanga raparapa
Feet and ankle joints are a common place for people to get arthritis. This is inflammation in your joints that can make it difficult to walk comfortably and do the things you enjoy. There are treatments available to help.
What causes foot and ankle arthritis
Several conditions can increase your risk of getting arthritis. But arthritis in your ankle is most often caused by having broken or injured your ankle before.
Some foot conditions can also cause arthritis in your ankles or feet, including:
- bunions
- hammertoe
- mallet toe
- overlapping toes.
Symptoms of foot and ankle arthritis
If you have arthritis in your feet or ankles, your joints may be:
- swollen
- often tender or painful
- red or hot
- not able to move much
- stiff, especially in the morning
- painful when you walk.
Diagnosing foot and ankle arthritis
To diagnose arthritis in your ankles or feet, your healthcare provider, physiotherapist or podiatrist will examine your feet or ankles. They will also ask you questions about the pain, how bad it is and how it affects you.
You may need an x-ray to confirm that you have arthritis, but this is not always necessary.
Self-care for foot and ankle arthritis
There are many things you can do yourself to:
- decrease the pain
- minimise the effect arthritis has on your life
- slow the speed at which it gets worse.
Keeping active is one of the best things you can do to manage your arthritis. It can help to:
- reduce your pain
- keep you moving
- restore your flexibility
- protect your joints against further damage.
Regular physical activity can help to strengthen your joints, muscles and bones. You do not need to worry you will wear out your joint if you use it too much.
You may also worry that pain during physical activity means you are causing harm. But some pain is OK and will not cause harm.
If you have a lot of pain during physical activity or feel a sharp pain, you should stop and ask your healthcare provider for advice. You should also get advice if you have pain that is worse than usual the morning after your physical activity.
It is important to find an activity you enjoy as you are more likely to stick with it. Activities that are good for arthritis include:
- tai chi
- walking
- cycling
- swimming
- water-based exercises
- gentle exercise classes.
If you are not sure which activities are right for you, talk to your healthcare provider. There are likely to be several initiatives in your community to help adults get physically active. Some may be free or subsidised but you may have to pay for others.
Arthritis and exercise — Arthritis New Zealand (external link)
The shoes you wear can play a major part in the amount of pain you feel and how much movement you have. To decrease the pain and make sure you have as much movement as possible:
- wear flat shoes — high heels push your body weight forward on to the front of your feet, increasing the pressure on your arthritic joints
- make sure you have enough room around all your toes, so your shoes do not rub your toes at all
- try to wear shoes made of natural materials — they let more air in, which is better for your skin and you are less likely to develop other painful problems such as blisters and skin infections
- choose rubber soles — these cushion your feet better and absorb more of the shock
- choose shoes with laces, Velcro, or buckles across the middle of your foot — they hold the shoe firmly without squashing your toes
- wear shoes that enclose the back of your heels, as these provide more support and stability.
There is no special diet to help with foot and ankle arthritis. But eating a wholefood, mainly plant-based diet can help control inflammation and help improve your overall health.
If you are overweight, losing a little weight will also reduce inflammation and reduce the strain on your feet and ankles.
Arthritis is a changeable condition. Some days you may have no pain and other days you will.
Having pain can be the hardest part of having arthritis. Healthy lifestyle changes can be helpful, such as:
- eating well
- staying active
- having a good sleep routine
- managing stress.
Arthritis New Zealand has a service called Arthritis Assist that can help you to live well with arthritis. The Arthritis Assist team is made up of:
- health coaches
- a healthcare educator
- a pharmacist.
They can answer your questions and provide information and support. You can contact them on 0800 663 463
Arthritis Assist — Arthritis New Zealand (external link)
Treating foot and ankle arthritis
Usually foot and ankle arthritis is treated through lifestyle changes explained above and treatments such as:
- orthotics (devices such as splints, braces or insoles for your shoes)
- pain relief
- physiotherapy.
If these do not work, your healthcare provider may recommend surgery.
Orthotics
Special shoe inserts called orthotics can be custom-made to support your foot. Orthotics can improve the way your foot works and provide cushioning to minimise any pain. Orthotics are made by orthotists or podiatrists.
Podiatrists can also provide bracing. Bracing supports your affected joint and limits how much it moves. This reduces pain while you are walking and can help to prevent any further deformity.
Foot care
Arthritis can often lead to corns and calluses forming over deformed joints. It is important not to let the hard skin build up, as it can cause more pressure and discomfort. See a podiatrist to treat any corns or calluses.
Medication
Your healthcare provider or musculoskeletal specialist can prescribe anti-inflammatory medicine. In some cases, they can provide steroid injections into affected joints.
Exercises
Physiotherapists can help with exercises to strengthen your muscles. This may give you greater stability and help you avoid an injury that could make your arthritis even worse.
Surgery
If your foot or ankle arthritis is disabling and other treatments are not helping, your healthcare provider may recommend surgery.
Surgery for arthritis is done by orthopaedic (bone) surgeons. The type of surgery will depend on:
- exactly where the arthritis is
- what type of arthritis it is and
- how it is affecting your joints.
Your surgeon may recommend more than one type of surgery. They will talk with you about the details of the surgery, its risks and benefits and what to expect when you are recovering.
Keyhole surgery (also called an arthroscopic debridement) is often used in the earlier stages of arthritis.
Debridement means cleaning. It removes any loose cartilage, bone spurs, or other tissue from around the joint. This surgery usually helps to improve your mobility, but your arthritis is still likely to continue getting worse.
If your arthritis has progressed further, you may need fusion surgery — also called arthrodesis. This surgery fuses the bones of the affected joint, making two or more bones into one continuous bone. It aims to reduce pain by stopping any movement in the arthritic joint.
During fusion surgery, the surgeon removes the damaged cartilage. They then use pins, plates and screws or rods to fix the joint into a permanent position. Over time, the bones fuse, or grow together, just like the two ends of a broken bone grow together as it heals.
While the main aim of this surgery is to reduce your pain, it can sometimes improve your mobility too.
Some people find the metal used in the surgery can be quite irritating, especially when wearing certain shoes. If this happens to you, talk to your surgeon about another operation to take the metal out once the bone has healed. You will usually need to wait at least 12 months after the original surgery to have the metal removed.
Recovering from surgery
After surgery, you will usually have one night in hospital, followed by up to 6 weeks in a cast or moonboot.
Your surgeon will talk to you about your recovery before your surgery. You can expect you will:
- not be able to put any weight on your ankle and foot for some time — you will need to use crutches to get around
- not be able to drive while your leg is in a cast or moon boot
- have physiotherapy to strengthen your ankle and get it moving again
- need some time off work — how long depends on what your job is and whether there are any light duties you can do
- have regular appointments with your surgeon including x-rays to make sure the fused bone is healing well.
Surgery will probably reduce your pain and make it easier to walk. But it might not change the way your foot looks. You may still need to wear orthotics after surgery.