When lifestyle changes are not enough, non-surgical medical interventions can help ease the symptoms of ankle arthritis. In general, people are advised to try medical treatments in consultation with a doctor.
Shoe Inserts and Rocker Shoes
Cushioning shoe inserts can reduce the pressure put on the ankle joint when walking. They can also discourage ankle rolling. A doctor can recommend appropriate pre-made inserts or custom inserts.
A doctor may also recommend “rocker” shoes, which have soles rounded from front to back. The rounded soles require less flexion of the ankle while walking; however, some people find rocker soles difficult to get used to and are less stable wearing them. 1 Albright BC, Woodhull-Smith WM. Rocker bottom soles alter the postural response to backward translation during stance. Gait Posture. 2009 Jul;30(1):45-9. doi: 10.1016/j.gaitpost.2009.02.012. Epub 2009 Mar 28. PubMed PMID: 19329317.
Orthopedic Supportive Devices (Orthotic Devices)
Certain orthopedic products may be used to help stabilize or take pressure off the ankle.
- Elastic braces wrap around the ankle and foot, providing more ankle support.
- A hard plastic brace that wraps around the back of the ankle and bottom of the foot can limit ankle mobility and reduce pain.
- A cane (used on the opposite side of the affected ankle) can absorb 25% of a person’s bodyweight, taking pressure off the ankle.
If a person has problems with balance, a walker may be considered.
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Physical therapy exercises can stretch the ankle joint’s soft-tissues and build surrounding muscles. These changes may make the ankle less prone to further cartilage loss. A physical therapy program to treat ankle arthritis should progress gradually and take into account the patient’s specific needs and co-existing conditions.
There is not a lot of research regarding physical therapy for ankle arthritis. The recommendation for physical therapy is mostly derived from research about knee and hip osteoarthritis. 2 Paterson KL, Gates L. Clinical Assessment and Management of Foot and Ankle Osteoarthritis: A Review of Current Evidence and Focus on Pharmacological Treatment. Drugs Aging. 2019 Mar;36(3):203-211. doi: 10.1007/s40266-019-00639-y. Review. PubMed PMID: 30680680.
Certain medications can be used to alleviate ankle osteoarthritis symptoms. A doctors and patient should discuss medication in the context of the patient’s lifestyle, severity of pain, and medical history. Potential side effects and interaction with other medications, vitamins, and supplements should also be considered.
- Oral over-the-counter pain relievers, such as acetaminophen (e.g., the active ingredient in Tylenol) have relatively few side effects and relieve pain. Non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen (e.g., Advil), naproxen (e.g., Aleve) may reduce pain, swelling, and inflammation caused by ankle osteoarthritis, but may also cause gastrointestinal problems, especially if used on a daily basis for more than a couple of weeks.
- Prescription oral pain relievers typically recommended for ankle arthritis include higher doses of traditional over-the-counter drugs, such as ibuprofen, and a type of NSAID called cox-2 inhibitors (Celebrex). Cox-2 inhibitors carry less risk of gastrointestinal side effects than other NSAIDS. Opioid pain relievers are not recommended.
- Topical medications come in the form of creams, sprays, gels and patches and are applied directly to the skin over the painful joint. Most topical medications either contain ingredients that either reduce inflammation or cause a warming or cooling sensation that distracts the brain from pain.
All medications carry the potential risk of side effects.
For some patients, lifestyle changes and medical treatments listed above may not be enough, and injections may be considered.
- 1 Albright BC, Woodhull-Smith WM. Rocker bottom soles alter the postural response to backward translation during stance. Gait Posture. 2009 Jul;30(1):45-9. doi: 10.1016/j.gaitpost.2009.02.012. Epub 2009 Mar 28. PubMed PMID: 19329317.
- 2 Paterson KL, Gates L. Clinical Assessment and Management of Foot and Ankle Osteoarthritis: A Review of Current Evidence and Focus on Pharmacological Treatment. Drugs Aging. 2019 Mar;36(3):203-211. doi: 10.1007/s40266-019-00639-y. Review. PubMed PMID: 30680680.