When you are experiencing pain in the ankle, it is often from a type of arthritis affecting this joint known as ankle osteoarthritis. This condition can cause loss of your joint’s cartilage, which in turn causes pain and swelling. When cartilage is lost or damaged, it not only causes pain in the ankle, but it may even lead to a deformity.

Symptoms of Ankle Osteoarthritis

Some of the primary symptoms of ankle osteoarthritis are:

  • ankle pain
  • swelling
  • Stiffness
  • decreased motion control of the joint

In addition, the ankle can appear deformed.  This occurs due to a bone spur, which causes pinching of the joint, further increasing the discomfort.

When you first develop ankle osteoarthritis, it is often mild and might simply affect your ankles when performing certain activities, such as walking or running. Over time, it can worsen and actually cause you to barely be able to put any weight on it.

Causes of Ankle Osteoarthritis

While there are a variety of things that can lead to ankle osteoarthritis, trauma is one of the bigger causes. You might have had multiple ankle sprains or a fracture of the ankle due to a sports injury or running accident.

You can also get osteoarthritis of the ankle if you perform the same daily activities frequently that put a lot of pressure on your ankle, such as if you have a job where you are on your feet all day or if you are a marathon runner. If you have high arches or flat feet, that can also increase your risk for ankle osteoarthritis.

The ankle is unique in that osteoarthritis doesn’t usually develop with no known cause, but more often has a very specific reason for its development.

Diagnosis of Ankle Osteoarthritis

When you think you have ankle osteoarthritis, your orthopedic specialist will perform a thorough examination of the ankle and find out more about your medical history and lifestyle. If your orthopedic specialist believes you might have osteoarthritis, he will then send you for X-rays. These X-rays are done while bearing weight on the ankle to see how the joint is affected. You may then need other imaging tests and examinations, such as an MRI or CT scan.

Treatment of Ankle Osteoarthritis

Treating ankle osteoarthritis is done through non-surgical or surgical treatment.

Non-Surgical Options. Your orthopedic doctor will likely recommend non-surgical options first, such as having you take anti-inflammatory pain relievers, wearing orthotics, or staying off the ankle as much as possible. While only providing temporary relief, injections may be given to you to lubricate your joint ankle or cortisone may be injected to reduce inflammation. Physical therapy might also be helpful in the beginning stages.

Surgical Treatment. If these conservative measures don’t help, surgery in the form of arthroscopic surgery can be performed. This keyhole surgery is minimally invasive and can be used to remove inflamed tissue, loose bone fragments, or bone and/or smooth the joint’s cartilage surface.  More advanced stages may require an ankle fusion or total ankle replacement.

Frequently Asked Questions

Q: Will an MRI show osteoarthritis?

Doctors may use an MRI test to determine if you have osteoarthritis and make a diagnosis. Once you’ve had an MRI, you’ll go back to your orthopedist’s office for a follow-up visit. During this visit, your doctor will go over your MRI results. If the MRI images show signs of osteoarthritis, they will give you a physical exam, go over your family history, review your symptoms and discuss treatment options.

Q: Will osteoarthritis spread?

Although OA affects a single joint, it involves other joints as it progresses. Sometimes, OA pain in one of your joints, such as your knee or ankle, can force changes in the way you stand, walk or move. It could even force your other joints like your spine or hip joints to become symptomatic.

Q: Why does osteoarthritis become worse over time and what causes that?

The release of degradative and debris enzymes can irritate your joints. The degradative enzymes produce more synovial fluid than normal to lubricate your damaged joint and dilute troublesome substances. When you have a flare-up of OA, lesions can get worse and persist if you don’t rest the joint and receive treatment.

The main symptom of osteoarthritis is joint pain. Joint pain occurs when your affected area cartilage wears away and exposes the ends of your bones leading them to rub against one another. Other reasons OA can become worse include:

  • Increased pain sensitivity and lack of sleep
  • Weak muscles
  • Lyme disease
  • Compensation pain
  • Feelings of helplessness
  • Dehydration

Q: Are osteoarthritis and rheumatoid arthritis the same?

They aren’t the same thing. Osteoarthritis is a degenerative disorder developing due to extreme cartilage wear between your joints. Rheumatoid arthritis is an autoimmune disorder causing your immune system to attack a healthy body. RA affects your whole body, while OA only affects your joints.

Q: Why does osteoarthritis cause fatigue?

When you have OA, you typically need to put in extra effort to perform your basic everyday activities, which can make you feel tired. Also, cytokines (chemical mediators) cause inflammation leading to fatigue.

Q: Will osteoarthritis go away or is there a cure?

Although your OA doesn’t go away, the pain associated with it can. You can treat the symptoms, but you should also realize that you don’t necessarily need to treat OA’s bony anatomy. If you treat the inflammation and your muscles are strengthened and stretched properly around your joints, your symptoms won’t come back despite your bony anatomy remaining unchanged.

The only real way to change OA’s bony anatomy is to change them surgically. This, however, will not provide a guarantee that future OA changes won’t impact your joints.

Q: Can osteoarthritis be reversed?

Research shows that combining standard OA therapies with a nutritional program just may reverse your OA. In fact, there is significant evidence around OA being completely reversible. There have been spontaneous human remissions reported. Long-term medications and intense physical therapy can stop juvenile chronic arthritis.

Q: Can osteoarthritis cripple you?

OA can limit joint motions and cause pain that’s so severe it can be disabling. You may not be able to carry out your routine daily living activities like bending over, getting dressed or walking. However, most OA patients don’t become disabled from the condition. And you can manage your OA and prevent future disability by exercising, losing weight and taking other steps.

Q: Why is osteoarthritis pain worse at night?

If you’re experiencing night pain, it usually indicates how severe your OA is and if you need more treatment like surgery, for instance. Your pain may get more noticeable when you’re not doing anything and you may have trouble getting to sleep. If pain wakes you up during the night, this could be an indication that your OA is at a stage that’s more advanced.


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