Foot and Ankle Arthritis Missoula, Montana

Osteoarthritis is the most common form of foot and ankle arthritis, occurring when cartilage wears down naturally over time due to age-related degeneration. This “wear and tear” arthritis typically affects weight-bearing joints where cartilage cells break down faster than the body can repair them, leading to bone spurs, stiffness, and chronic joint pain. The condition often develops in the ankle, subtalar, and metatarsophalangeal (MTP) joints at the base of the big toe, causing increased pain during activity and after periods of rest. As osteoarthritis progresses through its early stages to severe cases, patients experience reduced range of motion, difficulty walking on uneven ground, and increasing foot pain that impacts daily activities.

Rheumatoid arthritis is an autoimmune condition in which the immune system mistakenly attacks the body’s own tissues, particularly the soft tissues lining the small joints of the foot and ankle. This inflammatory arthritis typically affects the same joint on both sides of the body, causing symmetrical pain, swelling, and morning stiffness that improves with movement.
Unlike osteoarthritis, rheumatoid arthritis can rapidly damage cartilage and bones, even in younger patients, often affecting three joints in the foot simultaneously. Blood tests can confirm this systemic condition, which requires specialized treatment to reduce inflammation and prevent progressive joint deformities.

Psoriatic arthritis develops in some people with psoriasis, a skin condition, and causes inflammatory arthritis that commonly affects the toes, ankles, and other foot joints. This autoimmune condition causes swelling, pain, and stiffness in the affected joints, often resulting in a characteristic “sausage-like” appearance of the toes. The condition can cause nail changes, tendon inflammation, and bone damage if left untreated, making early diagnosis crucial for preserving joint function. Like rheumatoid arthritis, psoriatic arthritis requires medical management to reduce inflammation and prevent the immune system from causing more pain and joint destruction.

Post-traumatic arthritis develops after an injury, such as a fracture, dislocation, or ligament tear, that damages the cartilage inside the ankle or foot joints. Previous injuries or fractures to the ankle joint or foot bones disrupt the smooth cartilage surface, accelerating wear and causing arthritis to develop years after the initial trauma. Athletes and individuals who play sports face higher risk factors for this condition due to repetitive stress and acute injuries that compromise joint health. Even with proper initial treatment, damaged cartilage from significant injuries increases the likelihood that patients will develop arthritis in the affected area over time.

Big toe arthritis, medically known as hallux rigidus, affects the MTP joint where the big toe connects to the foot bone, limiting the toe’s upward motion needed for normal walking. This condition develops from osteoarthritis, repetitive stress from activities, or previous injuries, leading to bone spurs forming around the joint that restrict movement and cause pain. Patients experience foot pain when walking, especially when pushing off the ground, and may notice swelling, stiffness, and difficulty wearing certain shoes. As cartilage wears away in this critical joint, the big toe becomes increasingly rigid, altering gait and potentially causing more pain in other parts of the foot, ankle, and even the knees and hips.

Midfoot arthritis affects the arch area, where the inner and outer midfoot bones articulate through multiple small joints that provide flexibility and shock absorption during walking. This form of foot arthritis commonly develops from post-traumatic arthritis following a Lisfranc injury, from osteoarthritis due to repetitive stress, or from inflammatory conditions like rheumatoid arthritis. The midfoot bone joints bear significant body weight with each step, so when cartilage wears in this region, patients experience pain in the arch that worsens with activity and standing. Swelling, difficulty walking on uneven surfaces, and a flattened arch appearance often accompany midfoot arthritis as the condition progresses.

Hindfoot arthritis involves the subtalar joint beneath the ankle joint and other articulations at the back of the foot where the three bones of the hindfoot connect. This condition limits the side-to-side motion of the foot needed for walking on uneven ground and can result from previous injuries, inflammatory arthritis, or degenerative changes over time. Patients with hindfoot arthritis experience ankle pain and stiffness below the ankle joint, often describing a deep, aching sensation that worsens with activity and improves with rest. The condition frequently coexists with ankle arthritis, and gait analysis often reveals compensatory walking patterns that may cause additional stress on other joints.