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Find out the causes behind osteoarthritis of the ankle joint, and how it can be treated
The process of osteoarthritis involves wearing or thinning of the smooth cartilage joint surfaces as well as stiffening to the soft tissue surrounding the joint. Swelling, inflammation and pain are potential consequences.
Several factors normally combine to cause symptoms of osteoarthritis:
General exercise such as walking, cycling and playing sport does not increase the risk of developing or increase the rate of deterioration of ankle osteoarthritis.
Pain and stiffness on walking and ascending or descending stairs is often the main aggravating activity. If ankle osteoarthritis becomes more severe the ankle area may become increasingly swollen and the movements of the ankle may become increasingly stiff.
The main feature on examination is often a reduced range of movement.
X-rays are not routinely required but may be requested if symptoms are severe enough that ankle replacement surgery is being considered.
In the majority of cases, the symptoms of ankle osteoarthritis can be managed effectively by non-invasive measures as described below.
The two most important things you can do to improve your symptoms are:
These measures can have significant effects on your symptoms, with no side effects or complications. They have the added benefit of improving your general health.
Regular exercises to maintain flexibility and strength to the affected ankle joint.
Losing weight reduces the load which weighs down on your joints as you move about. Evidence shows that weight loss can result in significantly better mobility; there is also some evidence to suggest that weight loss alone may actually help to reduce pain. However, in combination with exercise, the results can be significant.
For many people, losing weight feels like an uphill struggle. However, there is lots of support and advice available. For example, you can find some excellent ideas, including recipes and advice on making healthy food choices, on the NHS “Change 4 Life” website (this also has a link where you can find out about healthy activities in your area).
You can read more in the NHS recommended guidelines on physical activity.
You can use a BMI calculator to tell you if it might be advisable for you to try to lose some weight.
Over-the-counter analgesia is available through pharmacies when needed. Paracetamol is most commonly prescribed. Anti-inflammatories, such as Ibuprofen, are also used, but as there is little or no inflammation involved in osteoarthritis these are best avoided without discussing with your GP. Side effects are even more common than with paracetamol, so please ensure to take appropriate medical advice There is a good booklet from Arthritis Research UK with information about the various drug options.
For individuals with ankle OA who continue to suffer disabling symptoms in spite of a course of non-surgical management (outlined above) or for patients who are unable to commence a supervised exercise program due to pain levels, a corticosteroid injection can be offered as the next line of treatment. You can read more about local corticosteroid injections here.
Ankle arthrodesis (fusion) and ankle replacement surgery outcomes are far less effective than those for hip replacement or knee replacement surgery. As such, this option is usually only considered for patients who…