What to Expect From Foot and Ankle Arthritis Treatment

Orthopedic treatment of foot and ankle arthritis typically follows a predictable progression of care. Treatment begins with conservative options and progresses to injections or surgery for patients who continue to experience symptoms. Your recovery timeline will vary based on the treatment you receive, but everyone begins with a comprehensive evaluation of their symptoms.

Continue reading to learn more about what you can expect during each stage of arthritis treatment starting with your initial consultation and ending with recovery from treatment.

Diagnostic Procedures and Clinical Assessment

Foot and ankle arthritis treatment always begins with a thorough clinical evaluation. Your clinician will take time to listen to your concerns, ask about your symptoms, and learn more about how arthritis affects your feet and ankles.

You may be asked questions about:

• Where you feel pain or tenderness

• When your symptoms are worse

• Difficulty with walking or standing for long periods

• Any prior injuries to your feet or ankles

• What kind of activities you do on a regular basis

• Your current footwear habits

After discussing your symptoms and arthritis health history, your clinician will also perform a physical exam. They will watch you walk and check to see how your joints move. You may also receive imaging studies, like X-rays.

Your expectations for treatment will also be considered. Perhaps you’d like to return to exercising or play sports again. Maybe you’d like to walk farther without discomfort. Or you may want to participate in everyday activities with less pain.

Physical Examination and Gait Evaluation

Your clinician will perform a physical examination to look for anything that may be contributing to your arthritis symptoms. They will look at the alignment of your foot and ankle and check for swelling and areas of tenderness. Range of motion will be assessed as well as muscle strength and reflexes.

It’s common for your clinician to perform a gait evaluation during your examination. This simply means they will watch you walk. By analyzing how you walk, your clinician can see where your weight shifts on your foot. Sometimes, people alter their gait to avoid arthritis pain, which can cause other joints to be overloaded. Your walking pattern may factor into your treatment plan.

For example, you may be prescribed orthotics, footwear modifications, or physical therapy to correct your gait.

Imaging Studies and Radiographic Evaluation

It’s likely your clinician will order some imaging studies to confirm your diagnosis. Most patients receive weight-bearing X-rays as part of their initial evaluation.

Weight-bearing refers to X-rays that are taken while you’re standing. These images help your clinician see how your joints line up when weight is applied to them.

Advanced imaging, like MRI or CT scans, may be ordered if your clinician needs more information about the soft tissues in your foot and ankle. MRI scans provide details about cartilage, tendons, and inflammation in your joints. CT scans show more information about bone.

X-rays, MRIs, and CT scans are only pieces of the puzzle. Your clinician will correlate your imaging studies with your symptoms to make sure they’re treating your actual source of pain.

Conservative Non-Surgical Treatment

Many patients are able to find relief with non-surgical treatment options alone. These treatments focus on relieving pain and improving mobility while minimizing stress on your arthritic joints.

Examples of conservative care include:

• Avoid activities that cause joint overload

• Wear shoes with good shock absorption properties

• Try physical therapy to strengthen supportive musculature

• Manage your weight to reduce load on weight-bearing joints

• Orthotics or braces that provide stability to the foot and ankle

Often times a combination of these treatments provides the best result.

Medications for Pain and Inflammation

Your clinician may recommend medications to help decrease inflammation and relieve your day-to-day pain. Options include:

• Anti-inflammatory medication, such as ibuprofen or naproxen

• Topical anti-inflammatory creams

• Acetaminophen for pain control

• Oral corticosteroids when needed

Orthotics and Bracing

Orthotics and bracing are used to help support your foot and ankle during weight-bearing activities. These treatments work by shifting pressure away from your arthritic joint.

Orthotics are inserts that are placed inside your shoes. Custom orthotics are molded to the shape of your foot and can include features like arch supports, metatarsal pads, or heel lifts.

Bracing can provide additional support to the ankle or midfoot. Some people with arthritis benefit from bracing if the arthritis affects joint stability.

Physical Therapy

Physical therapy is almost always recommended for people with foot and ankle arthritis. A physical therapist can help improve joint range of motion while strengthening muscles that support the joints.

During physical therapy you may:

• Have your joint mobilized

• Perform stretching exercises

• Strengthen muscles of the foot and ankle

• Work on balance and proprioception

• Retrain your walking pattern

Once your pain begins to subside, your physical therapist will focus on building strength and endurance.

Injections and Minimally Invasive Treatments

If conservative treatment options fail to provide relief, your clinician may recommend injections. Injections can help decrease inflammation in your joints and provide temporary pain relief.

Corticosteroid injections are commonly used to alleviate arthritis pain. Some patients receive several weeks of benefit while others may last a few months.

In certain cases, clinicians may also utilize biologics like platelet-rich plasma (PRP) to try and decrease inflammation. As with steroid injections, results vary.

Surgical Treatment Options

Surgery is typically recommended when non-surgical treatment options have failed and your arthritis significantly impacts your mobility or quality of life.

Different types of surgery can help patients overcome pain from arthritis. The following procedures are common treatment options for arthritis of the foot and ankle:

• Joint fusion (arthrodesis). Bone fusion surgery permanently connects your bones to prevent painful motion.

• Total ankle replacement. An artificial joint is used to replace your damaged ankle joint.

• Bone realignment. Surgery to shift weight bearing pressures off of a damaged joint.

• Arthroscopic surgery. Used to clean out the joint in certain situations.

Keep in mind that there are many other procedures that can help people with arthritis. The type of procedure will depend on factors like alignment of the joint, severity of arthritis, overall health, and activity level.

Recovery From Treatment for Foot and Ankle Arthritis

As you can see, treatment for foot and ankle arthritis begins with conservative options and slowly progresses if your symptoms persist. Therefore, recovery time is different for everyone.

Conservative treatment may take weeks to months to notice an improvement. If you undergo surgery, you can expect an initial recovery phase where you will limit weight bearing. Once you’re able to walk, you’ll progress through physical therapy.

Strengthening exercises and balance training are important for recovery regardless of the treatment you receive. These exercises help you regain mobility and restore function to your legs.

Frequently Asked Questions

What will happen at my first appointment for arthritis of the foot and ankle?

During your first appointment, your clinician will discuss your symptoms and medical history. They will perform a physical exam and evaluate your walking pattern. Finally, they will typically order weight-bearing X-rays of your foot and ankle.

Which treatments are tried before surgery?

Doctors always try conservative treatment options first. This includes things like physical therapy, shoe modifications, orthotics, activity modification, and medications.

When do you need surgery for arthritis?

Surgery for arthritis is considered when conservative treatments fail to provide relief. Arthritis needs to interfere with your mobility or quality of life before surgeons typically recommend surgery.

How long does recovery usually take?

Treatment recovery time can vary depending on what treatment you receive. Conservative nonsurgical treatment can take weeks to months to work. Surgical rehabilitation usually takes several months.

What can patients expect after treatment for foot and ankle arthritis?

Patients can expect to experience less pain with activity after treatment for arthritis. With proper treatment and joint care, many people are able to regain function in their feet and ankles.