Foot & ankle arthritis and gout

What is it?

Arthritis means wear or swelling in a joint. Over time, the smooth padding on the ends of the bones (cartilage) can wear thin. The joint may get stiff, swollen, and sore, and bone spurs can form.

In the big toe, this is called hallux rigidus. The toe gets stiff and hurts when you push off to walk. Arthritis can also affect the middle of the foot (midfoot) and the ankle, often after an old injury.

Gout is a type of arthritis caused by a buildup of uric acid that forms crystals in a joint. It often strikes the big toe joint.

Signs to watch for

• Pain and stiffness, often worse in the morning or after activity
• A big toe that does not bend well, or a bump on top of the joint
• Swelling or aching in the top of the foot or the ankle
• Gout attack: sudden pain in a joint, often the big toe, that is red, hot, swollen, and very painful to touch

Care at home

• Wear supportive shoes with a roomy toe area
• Choose stiff-soled shoes or shoes with a curved, rocker-style sole
• Try lower-impact activities, like biking or swimming
• Ice a sore joint for short periods

Treatment options

Dr. Nafal will examine your foot and may order X-rays. He explains each option in plain words, starting with the simplest ones.

• Shoe changes and stiff-sole or rocker-bottom shoes
• Shoe inserts (orthotics) or braces he may recommend
• Medicines for pain, swelling, or gout, working with your other doctors
• Injections into the joint to calm pain and swelling
• Surgery when other options have not helped enough, such as cleaning up bone spurs in the joint or joining the bones together (fusion)

Common questions

Can gout come back?

Yes, gout attacks can return. Your doctors may suggest diet changes or medicine to help lower uric acid and reduce future attacks.

Will I need surgery for arthritis?

Many people do well with shoes, inserts, and other non-surgical care. Surgery is an option when pain still limits your daily life.