The main symptom of RA in the ankle joint is inflammation, making the joint swollen, painful, and stiff. This can restrict the joint’s mobility, and impair a person’s ability to walk and stand.
In the early stages, symptoms may be mild and infrequent. For example, people may begin to feel discomfort when walking up a hill, as this places the ankle joints under extra pressure.
Over time, inflammation can become worse, causing damage to the joints and their surrounding tissues. Symptoms then become more pronounced. The ankles may frequently become painful and stiff, particularly when walking or standing.
In longstanding disease, the ankle joint can become fused and range of motion lost, which impacts gait significantly because the foot cannot flex to allow the necessary push off. However, due to developments in treatments, this is now rare.
When chronic RA causes changes to the structure of the foot, it can lead to callouses, bunions, nodules, and corns.
Exercising the ankle joints
For a person with RA in the ankles, a physical therapist can create an exercise plan. Keeping the ankle joints mobile throughout the day can improve flexibility and range of motion in the area.
Exercises can be designed to ensure the ankles stay mobile but without adding too much strain and causing further damage.
Strengthening the muscles around the joints can also reduce further damage by providing extra support.
People can try specific exercises that stretch and strengthen the ankle joints to reduce pain, stiffness, and swelling, including:
- exercises to strengthen the foot and ankle muscles to relieve pressure on the joints
- stretches to alleviate stiffness in the tissue surrounding the ankles
Physical therapists can create exercises plans that they tailor for the individual. People will need to find out what exercises are best for their needs.
People may need to stop or limit activities that put too much strain on the ankles in some cases.
When walking, a person may need to use equipment that offers support, such as a cane or walking frame, to limit the impact on the ankles. Orthopedic shoes may also be beneficial.
Maintaining a healthy weight can help reduce discomfort. Being overweight can put additional strain on the ankle joints. A doctor may encourage a healthful, anti-inflammatory diet, or a new exercise routine.
Reducing inflammation is critical to enable a person to limit swelling in their ankles and manage their pain.
The following medications can help with the symptoms of RA and may reduce long-term damage in the joints:
- painkillers to manage uncomfortable symptoms
- nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce inflammation
- disease-modifying anti-rheumatic drugs (DMARDs)
Managing inflammation can help restore mobility in the ankle and other joints. If RA has caused permanent damage to the ankle joint, medication will not reverse this but may assist with pain, preventing further damage, and improving quality of life.
Doctors can also use corticosteroid injections into the ankle to quickly reduce severe inflammation to prevent damage or reduce pain.
People should be aware that they may be more likely to get infections if they take DMARDs and biologics, as these can suppress the immune system.
People who have advanced forms of RA or do not respond sufficiently to treatment may require surgery.
What surgery doctors offer will depend on the type of arthritis and extent of the damage. Some surgeries involve fusing parts of bones in the ankle to prevent them from rubbing and causing inflammation and pain.
Ankle replacement surgery may be an option to reduce someone’s pain and restore their joint mobility in more severe cases, such as if fusion has not been effective.