Joint pain

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There are 26 bones in the foot, more than 30 small joints and multiple ligaments, tendons, muscles and nerves. The arch in the foot helps to spread the body’s weight evenly across the many bones and joints. If you have high or low arches you may be more prone to developing other foot problems.

Pain in the feet and ankle joints is often caused by arthritis, which produces inflammation and swelling in the body’s joints and the surrounding soft tissues. There are many different types of arthritis but the most common is osteoarthritis. Arthritis is a degenerative disease which leads to progressive deterioration of the joints. As cartilage is lost, the bones begin to rub and wear against each other.

Causes of foot and ankle joint pain

Common causes of pain in the feet and ankle joints include:

  • Osteoarthritis – this can affect any joint in the foot, but it most often affects the big toe joint which can become stiff and inflexible. It may become larger and knobbly due to the overgrowth of bone and you may develop a bunion or a lump on the side of the little toe. The condition can also affect:
    • The arch of the foot or the ankle, particularly after injury or damage to the ankle from inflammatory arthritis.
    • The joint where the ankle and shinbone meet.
    • The heel, inner and outer foot.
  • Rheumatoid arthritis – this is an autoimmune condition that can affect many joints in the feet.
  • Gout most often affects the big toe joint. It causes severe inflammation which can make the joint feel hot, swollen and very painful. It is the result of urate crystals in the joint and repeated attacks can lead to osteoarthritis.
  • Ankylosing spondylitis can affect the heels
  • Other types of arthritis such as reactive arthritis and psoriatic arthritis can also affect the feet and ankles.

Symptoms of foot and ankle joint pain

Symptoms vary depending on the cause of foot and ankle pain and the severity of the condition.

Common symptoms include pain in the joint (which can range from mild to severe), swelling and inflammation, loss of movement, reduced ability to walk or bear weight and deformity.

Diagnosis of foot and ankle joint pain

Most conditions that cause joint pain in the feet and ankles can be diagnosed during a clinical examination which will check for signs of swelling, pain and loss of movement. You may be asked to walk up and down to assess its impact on everyday activities.

In some cases you may be given a blood test, ultrasound, MRI or X-ray to confirm the diagnosis or rule out other conditions.

Treatment of foot and ankle joint pain

Treatment will depend on the type and severity of the condition. Among the common treatments for foot and ankle joint pain are:

  • Anti-inflammatories and pain killing medication to reduce swelling and relieve pain.
  • Injections of corticosteroids to relieve tendon inflammation.
  • Orthotics to relieve pain in the foot arch.
  • Braces or walking aids to support the joints.
  • Losing weight to relieve pressure on the joints.
  • Exercises to relieve pain and improve flexibility in the feet and ankles.
  • Disease-modifying anti-rheumatic drugs for some types of inflammatory arthritis.
  • Biologics, which are drugs that suppress the immune system. They can be effective for some types of inflammatory arthritis.
  • Surgery to correct the positioning of the joint or fuse the joint (arthrodesis) into the correct position may be offered in some cases. You may also be offered surgical treatment to remove the bone from a bunion or to reshape the toes. Currently, joint replacement surgery for the ankle and foot joint is not as successful as hip and knee implants and is rarely used.

Consultants

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