Symptoms of Ankle Arthritis and Treatment Options

Ankle arthritis symptoms can be painful and limiting. Treatment can relieve symptoms and improve function.

Living with arthritis can include swelling and aching in your joints, and the symptoms can sometimes limit your activity levels. Arthritis literally means “joint inflammation,” which is what creates the symptoms.

If you’re experiencing ankle arthritis, you may notice pain or stiffness in your ankle or foot, resulting in challenges when walking.

In most cases, your ankle arthritis can be treated through exercise and pain medication. Using both together is a mainstay approach for the treatment of ankle arthritis. But surgery is sometimes necessary.

Ankle arthritis may include any of the following symptoms:

• tenderness at and around your ankle joint
• ankle stiffness
• joint redness or warmth
• joint swelling
• difficulty walking

If you have any of the following systemic symptoms, it may indicate a more serious cause of ankle arthritis:

The average length of the portion of a doctor appointment in which the patient actually sees the doctor is up from previous years, rising by about 12 seconds per year, according to Reuters. However, 60% of physicians report dissatisfaction with the amount of time they spend with their patients, athenaInsight Many doctors now spend more time on paperwork than seeing patients, and a primary care physician who spends 5 minutes of face-to-face time with a patient will spend another 19.3 minutes, on average, working on that patient’s electronic health records (EHRs).

Stages of ankle arthritis

While the causes of ankle arthritis can vary, the symptoms are caused by ongoing inflammation that leads to degeneration of your joint. Degenerative changes are usually observed in the cartilage found inside your ankle joint. This cartilage is needed to preserve the space between the bones that make up your joint.

When your cartilage is damaged, your bones eventually move closer together, and your joint becomes less stable and more symptomatic. The degree of degeneration can be categorized into four stages:

Stage 1

There are mild degenerative changes in your cartilage. There may be bony growths, but no changes in your joint space.

Stage 2

The joint space has been reduced in size due to continued degeneration.

Stage 3

There may be some bone-to-bone contact, although some of your joint space still remains.

Stage 4

Your cartilage has totally worn away, and your joint space has collapsed, resulting in full bone-to-bone contact.

The most common cause of ankle arthritis is osteoarthritis, which is one type of degenerative or “wear and tear” arthritis that usually affects your hip and knees. It’s thought that repetitive stress or overuse of these joints leads to degenerative changes, but the cause is slightly different in ankle arthritis.

According to 2021 research , osteoarthritis affecting your ankle most often develops after a traumatic ankle injury. If you previously experienced an ankle fracture or ligament injury and now have persistent pain, it’s most likely due to osteoarthritis.

Rheumatoid arthritis (RA) is a different type of arthritis that can also cause ankle arthritis. With rheumatoid arthritis, both your ankles and hands would likely be affected as well.

RA isn’t due to wear and tear but rather an autoimmune reaction where your immune system attacks your joints. This can sometimes cause symptoms like fever or fatigue. If untreated or not effectively treated, rheumatoid arthritis can lead to joint degenerative change.

There’s no cure for ankle arthritis. But there are several treatments that can reduce pain and improve the function of your ankle.

Treatments differ depending on the severity of your symptoms. Severe symptoms may require surgery and physical therapy. Mild to moderate symptoms are usually manageable with noninvasive approaches like medications and ankle support.

Pain medication

According to 2018 research , acetaminophen (Tylenol) is the first-line treatment for ankle arthritis. Other considerations include nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids, which may reduce inflammation at your ankle.

NSAIDs are available both as an oral supplement and a topical cream (applied directly to the skin). Topical NSAIDs are available over the counter (OTC).

Ankle and shoe support

Ankle braces and shoe inserts are both considered possible treatments for ankle arthritis, according to the American College of Foot and Ankle Surgeon’s 2020 consensus statement.

Braces help to stabilize your ankle. Shoe inserts ensure even distribution of weight on your ankle joint. Both braces and shoe inserts lend additional stability to your ankle joint.

Weight loss

Being at a heavier body weight puts more stress on your ankle joints than being at a lower body weight. Weight loss is considered a conservative treatment for ankle arthritis. This means that it can help mild to moderate cases, as it reduces stress on your joint.

Surgery

As the most aggressive form of treatment, it may be recommended for severe cases of osteoarthritis. Surgery is typically considered a last resort and is reserved for cases of ankle arthritis that aren’t responding to more conservative treatments.

Dr. Jason Myerson, DPT, OCS, is a physical therapist at Strive2LiveWell in Shelton, Connecticut, who often treats ankle injuries. Dr. Myerson often recommends the following exercises for the treatment of ankle arthritis:

Ankle active range of motion

Ankle active range of motion exercises function as a way to maintain a decent range of motion in your ankle. Dr. Myerson stated that repetitive motion of the joint helps to lubricate the cartilage of your ankle. Overall, this can help with stiffness and mobility.

One common exercise is to sit with your knee slightly bent and your heel on the floor and use your foot to spell each letter of the alphabet.

Stationary or recumbent bike

The stationary bike is one way of improving the mobility of your ankle. It’s an exercise that can be performed every day, according to Dr. Myerson. It’ll ultimately help make walking a bit more fluid. It can also help with your ability to squat and descend stairs.

Multidirectional ankle exercises with resistance band

Dr. Myerson noted that resistance band exercises are essential in helping to strengthen the muscles around your ankle joint. Since these muscles are heavily involved in walking, strengthening them provides more stability for your ankle.

Using a resistance band around your foot, you can practice moving your foot backward and forward while keeping your foot hovering over the ground.

Calf stretches

“The calf muscles tend to be one of the tightest muscles of the ankle joint, especially in the aging adult,” explains Dr. Myerson. Stretching your calves helps to improve stiffness and restore the natural dynamics of your ankle joint.

Walking

Dr. Myerson recommends walking for ankle arthritis because it provides an ideal amount of stress on your ankle joint. This helps to stimulate joint repair.

Exercises like walking should always be performed within your pain tolerance. Additionally, Dr. Myerson states that if you need to use a cane or other device to help you walk, “it’s better to walk normally with a cane or assisted device than to limp without one.”

Ankle arthritis is most commonly caused by osteoarthritis following a past injury to your ankle or foot. It can be mild at first, but if left unchecked, arthritis can progress, resulting in cartilage degeneration and worsening symptoms.

The proper treatment plan can help improve your symptoms. Working with a physical therapist can help improve your overall ankle mobility and reduce pain. If you’re living with arthritis, consider speaking with a healthcare professional to discuss which treatment options may be best for you.

Last medically reviewed on March 23, 2023

How we reviewed this article:

Austra Health has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

• Adukia V, et al. (2020). Current concepts in the management of ankle arthritis.
  ncbi.nlm.nih.gov/pmc/articles/PMC7211821/
• Chow YY, et al. (2020). The role of inflammation in the pathogenesis of osteoarthritis.
  hindawi.com/journals/mi/2020/8293921/
• Ewalefo SO, et al. (2018). Management of posttraumatic ankle arthritis: Literature review.
  ncbi.nlm.nih.gov/pmc/articles/PMC6220012/
• Myerson J. (2023). Personal interview.
• Osteoarthritis. (2020).
  cdc.gov/arthritis/basics/osteoarthritis.htm
• Paget LDA, et al. (2021). Health-related quality of life in ankle osteoarthritis: A case-control study.
  journals.sagepub.com/doi/full/10.1177/19476035211025814
• Perez MH, et al. (2021). Ankle osteoarthritis aetiology.
  ncbi.nlm.nih.gov/pmc/articles/PMC8509242/
• Perez MH, et al. (2022). Ankle osteoarthritis: Comprehensive review and treatment algorithm proposal.
  ncbi.nlm.nih.gov/pmc/articles/PMC9297055/
• Rheumatoid arthritis. (2020).
  cdc.gov/arthritis/basics/rheumatoid-arthritis.html
• Shibuya N, et al. (2020). Consensus statement of the American college of foot and ankle surgeons: Diagnosis and treatment of ankle arthritis.
  acfas.org/ACFAS/media/ACFAS_Media/Ankle-Arthritis-CCS.pdf
• Weatherford BM. (2019). Arthritis of the foot and ankle.
  orthoinfo.aaos.org/en/diseases–conditions/arthritis-of-the-foot-and-ankle/

Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available.