What symptoms might I have? Is it really ankle arthritis? If I have been diagnosed with ankle arthritis how can I arthritis ankle swelling my symptoms? Compare to the normal ankle x-ray.
These are common features of all arthritic joints and are not specific to ankle arthritis. The inside of a normal ankle joint is lined completely by smooth cartilage which looks very like the covering of the joint one sees with a chicken drum stick for example. The arthritic ankle loses this smooth cartilage lining which normally allows for low friction and pain free weight bearing. Once lost, the underlying bone is exposed in ankle arthritis. This is not a comfortable surface for weight bearing and pain is generated from inside the joint. As the cartilage is being «worn away» in ankle arthritis loose flaps of cartilage can become partially detached from the arthritic joint and these can also produce pain and also sometimes a sensation of locking from the arthritic ankle joint.
What symptoms might I have with ankle arthritis? It is possible that in the early stages or even in the «late» stages of ankle arthritis that one may experience little in the way of symptoms. Most commonly pain is the presenting symptom and in ankle arthritis this is usually well localised to the level of the ankle joint. It can be felt anywhere circumventially around the ankle joint but usually it is felt deep within the joint. The intensity and duration of pain from an arthritic ankle varies significantly person to person and at different times. Generally, early symptoms in ankle arthritis are pain and perhaps swelling, after prolonged weight bearing or high impact type activities. If the ankle arthritis progresses then pain can become a more frequent occurrence and provoked by progressively less and less activity.
Eventually pain can become present most of the time, even when non-weight bearing or at night in bed. Other structures around the ankle can also produce pain. There are also other joints in the immediate vicinity of the ankle joint which if they are arthritic can produce pain in a similar location to ankle arthritis. Deformity can also be an occurrence in ankle arthritis. There is a great deal of individual variability in the level of symptoms from ankle arthritis and also the rate at which it progresses. Generally, one should base one’s treatment upon the level of symptoms that the ankle arthritis is currently giving as opposed to any extrapolation of how severe the symptoms from ankle arthritis might be in the future.
Ankle arthritis is commonly the result of either a direct injury into the joint such as an ankle fracture or the result of a longstanding and symptomatic ankle instability. Occasionally it may occur secondary to chronic and recurrent inflammation such as with rheumatoid arthritis, gout or the recurrent bleeding of haemophilia. Rarer causes of arthritis may be secondary to a neurological condition such as polio or hereditary sensory and motor neuropathy. The resulting ankle arthritis is treated in the same fashion, whatever the underlying immediate cause. There are a large number of other causes of pain from the ankle joint which are separate entities from ankle arthritis. It is also important to bear in mind that the more superficial tissues around the ankle joint, in particular the tendons such as the Achilles and flexor hallucis longus may also produce pain in the vicinity of the ankle joint.
The ankle joint sits very close in particular to the sub-talar joint. It can sometimes be difficult by examination and plain x-ray to tell which the relevant joint is. Under these circumstances it can be useful to inject local anaesthetic and dye into the joint under question to see whether this produces temporary relief and therefore identifies the joint directly as being the relevant one which is producing pain. The general things which one can do which are helpful for arthritis in all limb joints is to ensure one is not carrying excess weight, reduce heavy impact activities on the joint, use occasional non-steroidal anti-inflammatory tablets as required. A lightweight and stiff soled walking boot can also be useful in relieving symptoms of ankle arthritis.
The sole itself should be too stiff to flex and run with a gentle curve from heel through to the toe, a rocker type sole. Our advice before going down the route of expensive, customised shoewear would be simply to try a stiff soled hiking boot, such as those that are manufactured by Meindl, Scarpa, Brasher or Merrill. Another key feature if using the boot to alleviate ankle arthritis is that the upper should be stiff and sit well above the ankle. Physiotherapy can help by strengthening some of the muscles around the joint but generally ankle arthritis is a difficult condition to treat successfully with physiotherapy. The problem with treating the arthritic ankle with physiotherapy is that the joint is often stiff and painful and the muscles around the joint relatively wasted. All of these factors make improving the situation with physiotherapy difficult.