The ankle is a complicated area, and one that we often take for granted. Composed of three primary bones and two separate joints, a problem with any part of the ankle can greatly limit one’s mobility. And while not life-threatening, a diagnosis of ankle arthritis can significantly limit an individual's ability to participate in recreational activities, workplace activities, and even the most basic activities of daily living.
Established in 2004, Pittsburgh Foot and Hand Center is a local resource and care center for those affected by ankle arthritis. Since 1987, Dr. Bowman has provided the latest in both nonsurgical and surgical orthopaedic treatment to those affected by joint disorders. From our cutting-edge electronic medical records to our use of the latest in imaging technology, our staff process and training puts the focus on providing consistent care to you that is 100% based on your symptoms and needs.
"Arthritis" is a singular term used to refer to more than 100 different types of joint pain and joint disease, each with different causes and approaches to treatment. No matter the type of arthritis, however, the condition is marked by inflammation in at least one joint (although multiple joints can be affected at once). The result of arthritis is pain and stiffness, which often worsens with age.
According to the Arthritis Foundation, people of all ages, sexes, and races can and do have arthritis, and it is the leading cause of disability in America. More than 50 million adults and 300,000 children have some type of arthritis.
Common arthritis joint symptoms include swelling, pain, stiffness and decreased range of motion. Symptoms can range from mild to severe, and may also come and go. In more severe cases, the disease can lead to chronic pain, making it difficult to move or engage in daily activities.
Symptoms specific to ankle arthritis include the following:
Patients with ankle arthritis have received damage to part of the joint between their shin bone (tibia) and ankle bone (talus), also called the tibiotalar joint. While anyone can potentially develop this condition, you are at a greater risk of doing so if you have a medical history that includes an ankle injury, a rheumatoid disease, or a higher weight than recommended based on your age and height.
The good news is that ankle arthritis is less common than other types of the disease. When it develops, however, it’s just as painful and debilitating. There are several types of ankle arthritis:
In osteoarthritis, the cartilage (i.e. a connective tissue that reduces friction between joints) of the joint is gradually worn away. Without this protective substance between them, the bones of the joint begin to rub together, leading to pain and bone spurs.
In rheumatoid arthritis - an autoimmune disease - the immune system begins attacking the synovium (a thin joint lining). Swelling from these attacks then damages the other areas of the joint.
Posttraumatic arthritis may develop after an injury to the foot or ankle, as injuries can lead to a faster loss of cartilage.
Ankle arthritis is diagnosed with an initial examination, followed by an x-ray to confirm the doctor’s findings and to provide a closer look at the ankle. During an exam, you should be ready to answer questions about your pain (i.e. when did it start, how frequently does it occur, when and where does it occur, etc.). You will likely also be asked to walk around the exam room so the doctor can examine your gait.
If additional imaging or lab testing is needed, these can be ordered by your doctor. These tests may help your doctor further evaluate your bones and tissues, as well as determine the type of arthritis you're suffering from.
While this condition cannot be cured, it can be treated in a way that provides relief and slows the progress of the disease.
Following diagnosis, treatment begins with noninvasive lifestyle adjustments. This includes changes in footwear, which can provide additional support to the ankle. Patients will also be advised to change their activity and habits to reduce the impact and stress movements may put on their joints (i.e. minimal running and jumping, more swimming and cycling). Further support can be provided via a brace that holds the ankle joint in place. Weight loss may also be prescribed to relieve pressure on the afflicted joints.
In addition to these changes, medical relief is also available to patients. For example, anti-inflammatory medications can be helpful in patients with moderate symptoms of ankle arthritis. Cortisone injections - used to deliver medication directly to an arthritic joint - can also be very helpful in managing ankle arthritis. And if needed, patients may also be prescribed physical therapy, which can strengthen the ankle. However, physical therapy may be canceled if it’s found to worsen arthritic pain.
When lifestyle adjustments and pain management methods do not provide relief to a patient, surgical options can be considered. Depending on the exact location and nature of an arthritis diagnosis, a doctor may prescribe surgery to remove loose cartilage, inflamed synovial tissue, and bone spurs; to fuse the bones of the joint to eliminate painful rubbing between them; or to replace damaged cartilage and bone with metal or plastic joint surfaces.
The Pittsburgh Foot and Hand Center will initially provide an exam and prescribe any immediate lifestyle changes that may provide relief from the pain in your afflicted ankle(s). Where necessary, we can also prepare patients for ankle replacement surgery and fusion surgery. Dr. Bowman also offers specialized cartilage repair surgeries, which were pioneered under his hand through his years of practice and experience. We invite you to ask about this care option during your visits!
In addition to Dr. Bowman’s expertise, our practice’s partnerships provide patients with the access they may need to other medical professionals, including physical therapists, occupational therapists, and orthotists. Dr. Bowman - and, when needed, these partners - will constantly strive to provide a consistent and high level of nonoperative and post-operative care.
Because every patient is different, specific questions about any diagnosis or surgery should always be discussed in-depth with your medical and/or surgical teams. That’s why we invite you to bring all of your questions to us during your visits, as well as by phone afterward if needed. We will gladly provide the information you need to make the right decision for your health needs.