Arthritic Foot Care: Managing Foot and Ankle Arthritis

The feet contain 28 bones and over 30 joints — and any of those joints can develop arthritis. Foot and ankle arthritis is one of the most common — and underrecognized — sources of chronic foot pain. Patients often attribute their symptoms to "getting older" and accept significant limitations that don't need to be permanent. Modern arthritic foot care offers genuine options for maintaining mobility and reducing pain at every stage.

Types of Arthritis That Affect the Feet

Osteoarthritis

The most common type. Osteoarthritis is wear-and-tear arthritis — the cartilage that cushions joint surfaces gradually wears away, leading to bone-on-bone contact, inflammation, and pain. Most commonly affects:

• The big toe joint (first MTP joint) — hallux rigidus

• The midfoot joints

• The ankle joint

• The subtalar joint

Risk factors include age, prior injuries, obesity, occupation, and genetics.

Rheumatoid Arthritis

An autoimmune condition where the immune system attacks the joints, causing inflammation, joint damage, and deformity. Foot involvement is extremely common — often appearing early in the disease — and affects multiple joints simultaneously, typically in a symmetric pattern.

Post-Traumatic Arthritis

Develops after an injury — often years or decades later. Ankle fractures, severe sprains, and other foot injuries can damage cartilage in ways that lead to arthritis down the road.

Gout

A form of inflammatory arthritis caused by uric acid crystal deposition. Most commonly affects the big toe joint, causing dramatic pain, redness, and swelling during attacks.

Psoriatic Arthritis

Associated with the skin condition psoriasis. Can affect feet with characteristic patterns including dactylitis ("sausage toe") and enthesitis (inflammation where tendons insert into bone).

Other Forms

• Reactive arthritis

• Ankylosing spondylitis

• Charcot arthropathy (most often associated with diabetes)

Symptoms

Arthritis symptoms vary by type and location, but common patterns include:

• Pain in the affected joint, often worse with activity

• Stiffness, particularly in the morning or after periods of rest

• Swelling around the joint

• Reduced range of motion

• Visible joint deformity over time

• Difficulty walking, especially on uneven surfaces

• Pain that radiates to surrounding areas due to gait changes

• Crepitus (grinding or crunching sensations) with joint movement

Inflammatory arthritis (rheumatoid, psoriatic, gout) often causes more dramatic flares with redness, warmth, and severe swelling.

Diagnosis

A podiatrist diagnoses arthritis through:

• Detailed history (pattern of symptoms, joint involvement, family history)

• Physical examination of joint motion, tenderness, and stability

• Gait analysis

• X-rays to visualize joint changes

• Lab work for inflammatory markers and rheumatoid factors when appropriate

• Joint fluid analysis in some cases

• MRI for detailed soft tissue and cartilage assessment

Treatment Approaches

Lifestyle Modifications

• Weight management (each pound matters significantly for foot joints)

• Activity modification (lower-impact exercise, avoiding aggravating activities)

• Appropriate footwear with cushioning and support

• Ice or heat for symptom management

Medications

• Anti-inflammatory medications (NSAIDs)

• Topical anti-inflammatory creams and gels

• Disease-modifying drugs for rheumatoid arthritis

• Specific medications for gout

• Pain management medications when needed

Custom Orthotics and Bracing

Custom orthotics offload painful joints, accommodate deformities, and improve gait mechanics. For ankle arthritis, ankle-foot orthoses (AFOs) or specific bracing can dramatically reduce pain.

Physical Therapy

Specific exercises maintain range of motion, strengthen supporting muscles, and improve gait efficiency. Aquatic therapy is particularly valuable for arthritis patients.

Injections

• Corticosteroid injections for inflammation

• Platelet-rich plasma (PRP) for some patients

Surgical Options

When conservative measures aren't enough, surgical treatment can dramatically improve quality of life:

• Cheilectomy (removing bone spurs and damaged tissue) for early big toe arthritis

• Joint fusion (arthrodesis) for severe arthritis — eliminates the joint motion but eliminates the pain

• Joint replacement for selected cases

• Realignment procedures

• Cartilage restoration techniques in selected patients

Daily Self-Care

• Gentle stretching of feet and calves daily

• Low-impact exercise (swimming, cycling, walking)

• Anti-inflammatory diet considerations

• Adequate rest during flares

• Proper footwear (replace worn-out shoes promptly)

• Heat or ice as needed for symptom relief

• Foot inspection for pressure points and skin changes

When to See a Podiatrist

• Persistent foot or ankle pain that limits activities

• Joint stiffness that doesn't resolve with movement

• Visible joint changes or developing deformities

• Difficulty wearing previously comfortable shoes

• Acute joint flares (sudden severe pain, redness, swelling)

• Diagnosis of any inflammatory arthritis (proactive foot care matters)

• Worsening symptoms despite home care

At Table Mountain Foot and Ankle, we treat foot and ankle arthritis across every type and stage. Effective management can dramatically improve quality of life — even when "cure" isn't the goal. Schedule an appointment to address arthritis pain that's limiting your activities.