Ankle arthritis is a degenerative disease, but with the right treatment the degenerative process can usually be slowed down and pain can be controlled.
The sooner treatment begins, the better the odds of conserving joint integrity and function for years—or even a lifetime—thereby staving off debilitating pain and the possible need for surgery.
Recommended treatments typically include lifestyle changes, medical interventions, injections, and surgery. Few people ever need surgery.
Lifestyle Changes for Ankle Arthritis
Making changes to daily habits can significantly reduce ankle arthritis pain. These changes can be made at home and do not necessarily require a consultation with a doctor. Lifestyle changes include:
- Activity modification involves identifying and avoiding activities and exercises that make ankle pain worse.
- Supportive footwear that is comfortable and discourages ankle “rolling” can help minimize ankle pain and stress on the ankle joint.
- Periodic rest may be necessary when ankle pain is moderate to severe.
- Warm or cold compress may temporarily improve ankle stiffness or ankle pain.
- Weight loss can reduce pressure and strain on the ankle joint.
- Coping techniques, such as meditation and biofeedback, have been shown to effectively reduce chronic pain.
Lifestyle changes may reduce ankle pain enough that no other treatments are needed.
Medical interventions for ankle arthritis refer to nonsurgical treatments that are done in consultation with a licensed health care provider. Medical interventions include:
- Shoe inserts recommended by a doctor can reduce the pressure on the ankle joint when walking as well as discourage ankle rolling.
- Rocker shoes with rounded soles require less flexion of the ankle while walking
- Orthopedic supportive devices (orthotic devices), such as braces and canes, can help stabilize or take pressure off the ankle.
- Physical therapy can strengthen the ankle’s soft-tissues and surrounding muscles, potentially taking pressure off the ankle and increasing its range of motion.
- Medications, including over the counter oral medications, topical medications, and prescription medications are available to treat arthritis pain.
A doctor and patient should discuss medications in the context of the patient’s lifestyle, severity of pain, and potential side effects and interaction with other drugs and supplements.
Therapeutic injections may provide relief from ankle osteoarthritis pain. Several different types of injections are available, including:
- Steroid injections reduce inflammation
- Hyaluronic acid (hyaluronate) injections lubricate the ankle joint
- Platelet rich plasma (PRP) injections and stem cell injections may encourage new cartilage cell growth and repair
- Stem cell injections, which like PRP injections, are meant to trigger new cell growth and repair
Steroid injections and hyaluronic acid injections are the most common and most researched types of injections. While injections work for many people, they do not work for everyone.
Read more about Ankle Osteoarthritis Injections
If ankle arthritis symptoms are severe enough to interfere with daily activity and other treatments do not succeed, surgery may provide relief. Several types of surgeries are available:
- Ankle debridement, which is typically requires only small incisions
- Ankle arthrodiastasis, which involves a procedure to affix a temporary device to the ankle
- Ankle arthrodesis (tibiotalar arthrodesis or ankle fusion), which fuses bones together
- Ankle replacement (ankle arthroplasty), which replaces the ankle joint with artificial parts
What type of surgery is recommended will depend on the surgeon and the patient’s circumstances. The majority of people with ankle osteoarthritis will never need surgery.