Hi, I’m Dr. Michael Zimmerman, foot and ankle specialist, here to talk to you about ankle pain today.

Ankle pain itself can be dealing with arthritis, ligament pain, tendon pain.

What is arthritis of the ankle?
First I’m going to start talking to you more about what is arthritis of the ankle and what does that mean to you. Arthritis can mean more like a wear and tear or overuse of your ankle and it’s where the cartilage, or the lining inside the ankle starts to get thin, and as that thinning happens you can start to get bone-on-bone contact. That pain or contact can cause a deep throbbing type ache inside of your ankle. As that goes on, it can worsen and then you can start to develop bone spurs and further pain in your ankle where it actually limits the range of motion of your ankle.

How is ankle arthritis treated?
Typically when someone comes in with this type of pain in the ankle are we taking x-ray. At times, an x-ray may show that the joint itself is actually getting closer together; we don't see that spacing because we're losing some of that cartilage or that lining in the ankle. If we start to see that, we talk to the patient about what things can be done. Things that can be done are always conservative versus surgical management.

What are conservative treatment options?
With these things we always start with conservative management and that can range from bracing, certain anti-inflammatories, potentially an injection with a steroid medication, or physical therapy. All those modalities are done to try to help protect the ankle and at the same time decrease some of the inflammation or swelling or pain inside that ankle. If we attempt these things and they're not helping or they're not getting the patient to the level that they want to be, then we consider surgical options.

What are surgical treatment options?
Any time when you're dealing with an arthritis or wear and tear of the ankle joint, surgical options can consist of an ankle arthroscopy, where we actually take two small incisions and put a camera inside of the ankle and clean the ankle up. We start to clean some of the bone spurs up or some of the wear and tear as to help alleviate some of that pain. In more severe cases, we consider a little bit more involved surgery, which can consist of either an ankle arthrodesis, or a fusion, where we actually take these two bones and we use plates and screws and fuse them together so the joint no longer moves. When the joint no longer moves, that helps eliminate pain. Another procedure is ankle arthroplasty. Arthroplasty is actually an ankle replacement, very similar to your knees, hips and shoulder replacements where we actually go in and we place a device in here to replace the ankle. That's usually done with a component or a piece that’s on the talus, the underneath ankle joint bone and the top bone, your tibia. And then usually a type of spacer in there is one way to do that. That helps keep the motion as well as decrease pain.

If this is something you’ve been experiencing, I’d recommend seeing a foot and ankle specialist.

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