Medical Treatment for Foot & Ankle Arthritis
If you are diagnosed with arthritis in the foot or ankle, NYU Langone doctors often recommend a combination of treatments to lessen discomfort and prevent further joint damage. These may include modifying activities that put stress on the affected joints, using orthotic inserts and braces, taking medication, or receiving corticosteroid injections that provide longer-term pain relief. People diagnosed with rheumatoid arthritis may require medications to control the body’s immune response, in addition to some of the following therapies.
In the early stages of arthritis, limiting the amount of force being placed on the foot and ankle may relieve pain. For example, low-impact activities such as swimming and yoga can provide cardiovascular benefits without putting stress on the foot or ankle.
In addition, losing weight may decrease pressure on the joints. The foot and ankle support the entire body every time you stand and move, and being overweight increases this pressure and may cause arthritis to progress more quickly. Our doctors understand that losing weight isn’t easy and are here to help you make positive changes in your diet and exercise routine. Learn more about our Weight Management Program.
Non-steroidal Anti-inflammatory Drugs
Our doctors often recommend nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce swelling and relieve pain in foot and ankle joints affected by arthritis. NSAIDs are taken by mouth, and many, including ibuprofen and naproxen, are available over the counter. If these medications aren’t working to ease your arthritis-related pain, your doctor may recommend a prescription medication.
Whether your doctor recommends prescription or nonprescription NSAIDs, he or she can advise you on the right dosage for you, including how long to continue treatment. NSAIDs may cause side effects including nausea, diarrhea, and headache, and prolonged use should be monitored by a doctor.
Orthotic Inserts and Braces
Some people find that wearing an orthotic insert, which fits into the shoe, or a foot or ankle brace helps to ease arthritis symptoms. By limiting the movement of the foot or ankle joint, an insert or brace may relieve pain and stiffness, making it more comfortable to walk.
Orthotic inserts are available in different sizes and levels of stiffness. They can be placed in the shoe to support different parts of the feet, depending on the location of your arthritis pain. Orthotic inserts help reduce the amount of stress put on arthritic areas of the foot by redistributing the weight of the body to other parts of the foot, providing pain relief.
Braces also come in different sizes and levels of support. Some are flexible and worn in addition to regular shoes, and others resemble a cast that covers part of the foot and ankle. NYU Langone doctors can advise you on the type of brace that best suits your lifestyle and the severity of your symptoms. If you’re planning to spend the day in an environment that requires very little walking, for instance, a light brace may be all you need. If your job requires you to be on your feet all day, a brace with more support might be a better choice.
Some of the time, inserts and braces available at drugstores work well. If your doctor suggests that a brace or orthotic insert designed to fit the shape of your foot may be more effective, NYU Langone specialists can customize a brace or orthotic insert to ensure it provides the support you need.
Corticosteroids are anti-inflammatory medications that, when injected directly into arthritic joints, may reduce swelling and alleviate pain for three to six months.
Doctors use a needle to inject steroid medication into the joint space. Usually, the steroid solution also contains a small amount of anesthetic. If arthritis affects joints that are very small, such as those located in the front of the foot, doctors may use live X-ray or ultrasound guidance during the procedure for increased precision.
Corticosteroid injections are outpatient procedures, meaning that you can go home almost immediately after a treatment. The injected anesthetic numbs the foot or ankle for 30 to 60 minutes, at which time pain may return. The pain-relieving effect of the corticosteroids begins after two to three days.
Steroids may produce side effects, including nausea or discoloration at the site of injection. Most doctors recommend limiting steroid injections to two per year.