Ankle Osteoarthritis

What is Ankle Osteoarthritis?

Often resulting from an underlying medical condition or injury, ankle osteoarthritis (OA) is characterized by inflammation and pain associated with movement. While ankle pain resulting from an injury can heal in time, some injuries may cause changes to joints, which may hasten degeneration and trigger pain experienced years or even decades after the initial injury.


Stiffness from ankle OA is caused by inflammation and bone friction. Damage to articular cartilage from a strain, sprain, or fracture can also result in OA. If not treated surgically, such damage will not heal on its own. By the time OA has developed, it’s likely that there has been some wear and tear on supporting bones.

What are the Symptoms of Ankle Osteoarthritis?

Joint pain from ankle osteoarthritis can be felt in other parts of the foot or in the tibia (lower shin). The most noticeable symptom is a decreased range of motion that can sometimes include difficulty flexing toes or moving the affected ankle without pain.

Other symptoms

  • Ankle swelling
  • Ankle “popping” or crunching (crepitus)
  • Pain associated with certain movements (i.e., walking up stairs, jogging)

Ankle Osteoarthritis Causes

The main causes of ankle osteoarthritis are previous injury or trauma to the ankle. People who have had sprains, fractures, and similar injuries are seven times more likely to develop arthritis in the ankle. This is because the injury can cause changes in the joint even after full healing has occurred and normal ankle function has returned.

Sometimes, the arthritis doesn’t occur for many years or even decades after the initial injury. In other instances, the arthritis begins almost immediately after the injury and this is often known as “post-traumatic arthritis”.

In other instances, ankle osteoarthritis may be caused by another underlying condition. Rheumatoid arthritis and reactive arthritis can both cause osteoarthritic damage over a long period of time, leading to osteoarthritis in the ankle and other joints.

Around 10% of ankle osteoarthritis cases are “primary”, which means they are not caused by previous joint trauma or other medical conditions.

Primary arthritis may be caused by:

  • Repetitive stress on the joint, perhaps as a result of a sporting activity
  • Getting older when general wear and tear makes the joint prone to arthritis
  • Obesity which puts added pressure on the ankles
  • A family history of ankle osteoarthritis.

How is Ankle Osteoarthritis Treated?

X-rays and other image tests are performed to identify damage to tissues and bones. A needle may be inserted into the ankle to remove fluid to check for signs of infection.

Non-surgical treatment includes

  • Application of ice or heat
  • Periods of rest after activities
  • Medication (glucosamine and chondroitin sulfate are commonly prescribed)
  • Injectable medications to lubricate the joint
  • Temporary bracing to reduce movement

Surgical treatment includes

Surgical options for ankle OA include arthroscopic debridement to remove loose pieces of cartilage in the joint, ankle fusion, or artificial ankle replacement. An ankle that has been previously injured is seven-times more likely to be affected by OA. Delaying treatment can worsen symptoms and increase the risk of experiencing increased joint stiffness and pain.

Ankle Osteoarthritis Prevention

Those who have experienced trauma or injury to an ankle, or who are at an increased risk of the osteoarthritis due to underlying health conditions or lifestyle factors, can take steps to minimize their risk of developing the condition.

They could work on conditioning their ankles by strengthening the peroneal muscles which, located in the shin, help to support the joint. Strengthening muscles in the foot might also be beneficial. Physiotherapy may help with this process for individuals who are recovering from an ankle injury.

Those who are overweight or obese could prevent ankle osteoarthritis by losing weight. Regular exercise will help with this process, but it will also help to keep ankles strong and flexible.

High impact sports such as running, tennis, soccer, and basketball can all put pressure on the ankles. Those with historical ankle injuries may wish to avoid these activities. If not, they should take extra care to condition their ankles and undergo frequent physiotherapy to maintain strong ankles.

Some simple changes which might also help prevent ankle osteoarthritis include:

  • Avoid very high heels or very flat shoes
  • Use shock-absorbing shoe inserts
  • Avoid sitting with feet crossed behind the body.
Last Reviewed:
September 30, 2016
Last Updated:
November 08, 2017