Finding the Best Treatment Option for Arthritis Pain in Feet and Ankles

Health Minute     Winter 2019

With 26 bones and 33 joints, the foot plays an important role in a person’s overall health. If one of those joints is affected by arthritis and is undergoing unneeded stress and pain, it can affect the way you walk and feel, said Michael Barnett, MD, an orthopedic surgeon with Premier Orthopedics who is fellowship-trained in foot and ankle surgery.

Foot arthritis can develop gradually; at first, you might not even notice it. Pain may be felt every now and then, or come and go. The pain is usually associated with activity level – the higher the activity level, the more pain. Swelling then develops around the areas of the joints – whether it’s the big toe, the mid foot, hind foot or ankle – once the arthritis becomes more advanced.

The best way to diagnose foot and ankle arthritis is through an X-ray. There are classic signs on an X-ray that indicate whether you’re developing arthritis. These include loss of joint space.

“Cartilage doesn’t show up well on an X-ray like bones, so if the spaces between the bones become smaller, we know a person is developing thinning of the cartilage, which is arthritis,” said Dr. Barnett, who practices with Premier Physician Network. “We may also see the development of bone spurs through imaging. These develop as the body senses the loss of cartilage and the joints become unstable.”

Dr. Barnett said X-rays are invaluable, but in his practice he also takes it one step further.

“Patients who come to see me will likely undergo weight-bearing films, which is even better because it loads the joints,” he said. “If you don’t put weight on your joint, you’re not going to have decreased cartilage space like you would if weight was applied. This gives us a good indication of how advanced the arthritic process has become.”

There are multiple treatment options if you are found to have arthritis in your foot or ankle. Dr. Barnett works with his patients to determine which of the following may be best for their situation.

  • Temporary stabilization – Conservative measures of treatment are usually the first step, and one of the most common practices is placing the foot in a boot. This helps stabilize the arthritic foot to provide temporary relief and to take pressure off the joints.
  • Orthotic management – The cause for a good number of arthritic cases in the foot can be traced back to malalignment of joints, such as flat foot or a high arch. Those with an alignment issue are referred to a specialist to have orthotics made for their shoes. 
  • Cortisone injections – The next step of treatment may include the use of cortisone injections into the joint that is causing the problem. These injections help minimize inflammation in the joint anywhere from six weeks to six months. Minimizing inflammation usually helps reduce pain in the joint.
  • Physical therapy – Some arthritis cases benefit from physical therapy, which is aimed at strengthening muscles in the body that help support the joint that is causing pain, as well as stretching out muscles that may be too tight.
  • Joint replacement or fusion – The most common type of arthritis in the foot is big toe arthritis. There are two main surgical options that can treat this. One fuses the bones in the big toe together, alleviating pain over time. The other is an implant called Cartiva, which is made of a substance that mimics real cartilage. It alleviates pain and allows a person to still flex their big toe.

For more information on foot arthritis or to find a Premier Physician Network physician near you, visit us online.