Arthritis Of The Foot & Ankle

Arthritis is a condition that causes joint inflammation, swelling, and pain. The condition occurs when the lubricating cartilage in the joint wears away, leaving irregular cartilage and bone to rub against bone causing pain. This condition is common in people over the age of 50, but can start at younger ages. Several diseases can result in arthritis, but trauma and rheumatoid disease are the most common causes in the ankle.

Rheumatoid and Inflammatory Arthritis

Rheumatoid arthritis (RA) is an autoimmune disease where the body’s immune system turns against itself. Rather than working to protect the joints, the body actually produces substances that cause joint inflammation and destruction. RA is a long-term disorder that causes inflammation of multiple joints and surrounding tissue throughout the body. Of those individuals who suffer from RA, nearly 90 percent develop symptoms at the ankle or foot. In most cases, these symptoms initially appear in the toes and then involve the rear portion of the foot and ankle.

Other inflammatory types of arthritis that can affect the foot and ankle and deserve mention include gout, psoriasis, lupus (SLE), ankylosing spondylitis (AS), and Reiter’s syndrome.

Post-traumatic Arthritis

Previous trauma is the single most common cause of ankle arthritis. Such injuries include previous fractures, joint dislocations, or severe ankle sprains, which can occur years before arthritis begins. These injuries can cause permanent damage to joint cartilage surfaces that helps to cushion joints. With time, the damage to cartilage worsens and the joints lose that protective covering. Ultimately, the bones in the joint grind against each other with little or no cartilage left. This causes joint inflammation, swelling, and pain.

Rheumatoid and Inflammatory Arthritis

Rheumatoid arthritis (RA) is an autoimmune disease where the body’s immune system turns against itself. Rather than working to protect the joints, the body actually produces substances that cause joint inflammation and destruction. RA is a long-term disorder that causes inflammation of multiple joints and surrounding tissue throughout the body. Of those individuals who suffer from RA, nearly 90 percent develop symptoms at the ankle or foot. In most cases, these symptoms initially appear in the toes and then involve the rear portion of the foot and ankle.

Other inflammatory types of arthritis that can affect the foot and ankle and deserve mention include gout, psoriasis, lupus (SLE), ankylosing spondylitis (AS), and Reiter’s syndrome.

In the foot and ankle, the most common symptoms of arthritis include pain, swelling, stiffness, and deformity. Pain may be felt in various areas including the ball and sole of the foot. Walking may be affected. Corns and bunions might develop as the toes develop arthritis. Corns are also known as hammer toes or claw toes.

If the ankle and the hindfoot are affected, the bones may shift position in the joints. This can cause the arch on the bottom of the foot to collapse, which causes much pain and difficulty in walking.

Some of the conditions associated with arthritis, such as hammer toes, can be corrected through surgery. In cases where joints have actual and severe arthritic changes, the most successful surgical option is joint fusion. This is often performed on the patient’s big toe, the heel, the middle portion of the foot, and the ankle. In this procedure, the joint’s cartilage is removed and the joint is locked in place with plates, screws, or a rod through the bone. This creates one solid bone. There will be a loss of motion, but the goal is to improve pain and function. The complete replacement or arthroplasty of the ankle joint with an artificial joint may be possible in certain patients.