How Osteoarthritis Hurts Ankles

Medically Reviewed by David Zelman, MD on June 30, 2023
Written by Amanda Gardner
2 min read

When you have ankle osteoarthritis, you might have inflammation or swelling of the joint that connects your foot with the lower part of your leg. Here is an overview of things you should know about how arthritis may affect your ankles.

Osteoarthritis of the ankle, unlike other parts of the body, isn't the "wear and tear" kind that goes along with aging. Instead, it's almost always due to an injury. You might hear your doctor call it "post-traumatic" arthritis.

You can get ankle osteoarthritis after one injury, like a fracture, or after many injuries over time, like repeated sprains.

If you're flat-footed, bow-legged, or knock-kneed or if you have high arches, you might also get ankle osteoarthritis, because these conditions put extra strain on your joints.

When you've got ankle osteoarthritis you might have:

  • Pain in the joint, which can get worse with activity and might not get better with aspirin or ibuprofen
  • Swelling and stiffness
  • Trouble walking and bending your ankle
  • Reduced motion, such as problems pushing the gas pedal in your car

The symptoms can develop months or even years after you were injured. They can get worse over time, but how fast or slowly varies.

You get pain and other problems because the cartilage in your joint thins or wears away.

Cartilage is the thick connective tissue at the end of bones. It protects them and allows them to move easily. If you don't have enough, your bones rub against each other, causing pain.

Because cartilage in the ankle is thicker than in other joints of the body, it takes longer to wear down. That may partially explain why this type of osteoarthritis doesn't happen as often as it does in other joints.

To diagnose your condition, your doctor will probably start by asking you questions such as:

  • What are your symptoms?
  • When did they start?
  • Does your pain get worse when you're walking or running?
  • Is the pain constant or does it come and go?
  • Have you had any injuries in the ankle such as sprains or a fracture?

Your doctor will examine your ankle for swelling and see how well it moves. They'll also check to see if you have any pain during motion.

You will get an X-ray of your ankle. If it shows that the space between your bones is narrow, it could indicate cartilage loss has occurred. It can also spot a bone spur, a clue that you might have arthritis.

Occasionally doctors use other imaging techniques, such as magnetic resonance imaging (MRI), which uses powerful magnets and radio waves to make pictures of the inside of your joint. You might also be asked to get a CT scan, which uses powerful X-rays to make detailed images of the ankle.