Ankle arthritis is when the cushioning between the ankle bones (cartilage) wears away, causing pain and swelling. Treatments include pain relievers, physical therapy, and sometimes surgery.
What is ankle arthritis?
Ankle arthritis is when the rubbery cartilage that lines the ankle bones becomes damaged and worn away. This type of arthritis is called osteoarthritis. The more the cartilage wears away, the worse the arthritis gets. Eventually, the bones may begin to touch (“bone-on-bone” arthritis). Symptoms usually include pain, swelling, and stiffness.
There is no cure for arthritis, but there are several ways to treat your symptoms. These include rest, ice, bracing, and pain-relieving medications.
Symptoms
Arthritis pain may start gradually, but it can start suddenly in some patients. Ankle arthritis symptoms may come and go, with “good” and “bad” periods. The pain is worse with movement, and may be worse when you walk longer distances, especially on uneven surfaces. It’s also more painful when you go up and down hills and stairs. Your ankle joint can become stiff first thing in the morning or if you sit for long periods of time.
Some people have a “giving way” sensation in the ankle because the muscles around the area weaken. If the ankle arthritis is severe, the joint may become deformed.
Main symptoms
Pro Tip
Arthritis symptoms can be very limiting at times. There may be “good” periods where the ankle is not very painful and you have only mild limitations, and “bad” periods where it is hard to put weight on the leg and do normal daily activities. —Dr. Ben Schwartz
Ankle arthritis quiz
Take a quiz to find out what's causing your ankle arthritis.
Causes
Ankle arthritis often develops for reasons that aren’t clear. It can be inherited from your parents or develop after an injury to the ankle, such as a broken bone. Ankle arthritis is less common than arthritis in other joints, like the knees and hips.
Dr. Rx
Weight loss is an underappreciated way of reducing arthritis pain. Pressure on the ankle is five times body weight when walking and up to 13 times body weight when running! —Dr. Schwartz
Treatment for arthritis of the ankle
At-home care
You can often treat ankle arthritis with at-home care. It may take 2–6 weeks of regular treatment to notice improvement in symptoms. Care includes:
- Rest
- Icing the ankle
- Elevating the ankle
- Compressing the ankle with an ACE wrap or nylon ankle sleeve (available at drugstores and online)
- Wearing a lace-up ankle brace. Braces don’t necessarily prevent arthritis from getting worse, but you may find that wearing one can make it easier to walk and be active.
OTC medications
- Antiinflammatory drugs (NSAIDs) like ibuprofen (Advil, Motrin) and naproxen relieve pain and reduce inflammation. They tend to be better at treating arthritis pain than acetaminophen (Tylenol), which does not reduce inflammation.
- It’s important to take NSAIDs regularly rather than only when the pain is at its worst. It can take 1–2 weeks of regular use to notice an improvement, so don’t stop taking them too soon. While most people can take NSAIDs safely for a few weeks, you should check with your doctor.
- A topical NSAID, like diclofenac (Voltaren), can be applied directly to your ankle.
Herbal supplements
There are many different types of supplements available for the treatment of arthritis, but there’s limited evidence showing that they work.
The most commonly used supplements for arthritis include glucosamine/chondroitin, turmeric, and MSM (methylsulfonylmethane). Some studies show they may help symptoms, but there's no evidence that they reverse or prevent arthritis from getting worse.
Topical pain relievers such as CBD oil, arnica gel, and Biofreeze, which you apply to your skin, are also available over the counter.
Medical care
You may be referred to a foot and ankle specialist (usually an orthopedic surgeon or podiatrist) for treatment. They may do an ankle X-ray to help confirm the diagnosis of arthritis and determine how severe the arthritis is.
Prescription NSAIDs
If OTC NSAIDs are not helping enough, you may need a prescription pain reliever. See a healthcare provider if at-home care doesn’t improve your symptoms or if the pain and swelling are severe. Prescription NSAIDs include:
- Meloxicam (Mobic)
- Celecoxib (Celebrex)
- Diclofenac (Voltaren)
- Nabumetone (Relafen)
Injections
Cortisone injections can help reduce pain and inflammation that doesn’t improve with medication or in people who cannot take NSAIDs for medical reasons.
Physical therapy
Your doctor may recommend physical therapy to help reduce stiffness and improve strength in the ankle joint. Therapy includes strength and flexibility exercises and cold and hot therapy.
Surgery
Surgery for ankle arthritis is very uncommon. It’s for people who don’t improve after several months of non-surgical treatment and who have pain that severely limits their everyday activities. There are two main surgical treatments for ankle arthritis:
- Ankle replacement, in which the arthritic parts of the joint are removed and replaced with metal and plastic parts.
- Ankle fusion, which uses plates and screws to align the joint. This stops pain by eliminating any motion at the arthritic joint.
Is walking good for arthritis in the ankle?
Low-impact exercise like walking is good for keeping arthritic joints from getting too stiff and maintaining your strength and conditioning.
Wear a supportive pair of shoes that has a stiff sole when you walk. Some people find shoes with a rocker bottom helpful in reducing pressure on the ankle joint.
Other low-impact activities like riding a bike (stationary or road) and swimming can help you remain active without putting too much stress on the arthritic ankle.
Being active will not necessarily damage the joint or make the arthritis get worse more quickly. But a good rule of thumb is: If it hurts, don’t do it.
Pro Tip
Ankle replacement is not nearly as common as hip or knee replacement. Previous ankle replacement designs had high failure rates. However, newer ankle replacement designs have improved in longevity, and it is becoming more common. —Dr. Schwartz
Preventative tips
There are a few things you can do to help keep your ankle joint healthy.
- Do regular low-impact activity. Varying the activities can help lower the chance that you’ll aggravate the arthritis or cause a flare-up of your symptoms.
- Maintain a healthy weight, which can reduce the amount of stress on your ankle.
- If you have ankle arthritis, avoid high-impact activities such as running and jumping. These place more pressure on the joint and can worsen swelling and inflammation.
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