| Tel. | : +65 6970 5905 |
| Fax | : +65 6970 5906 |
| Mobile | : +65 9898 7781 |
| : hello@bjc.sg, drkevinkoo@bjc.sg |
| Tel. | : +65 6970 5905 |
| Fax | : +65 6970 5906 |
| Mobile | : +65 9898 7781 |
| : hello@bjc.sg, drkevinkoo@bjc.sg |
| Monday to Friday | : 8:30am to 5:30pm |
| Saturday & Sunday | : Closed |
| Public Holiday | : Closed |
Understanding Foot and Ankle Arthritis in Singapore
Arthritis is a common condition that affects millions of people worldwide, often causing pain, swelling and stiffness in weight-bearing joints such as the foot and ankle. These areas contain multiple small joints that work together to support movement and carry body weight. When arthritis affects these joints, the protective cartilage can break down, leading to pain, reduced mobility and difficulty with everyday activities such as walking or standing.
What Are the Types of Foot and Ankle Arthritis?
While there are over 100 types of arthritis, the most common forms affecting the foot and ankle include:
Osteoarthritis
Osteoarthritis (OA) is a degenerative joint disease caused by the gradual wear and tear of the cartilage. It often affects weight-bearing joints like the ankle and foot. Over time, the cartilage becomes frayed and rough, leading to bone-to-bone contact and bone spurs (osteophytes). OA is more common in older individuals and those with a history of joint stress.
Rheumatoid Arthritis
Rheumatoid arthritis is an autoimmune condition where the body’s immune system attacks the joint lining (synovium), causing inflammation. It often starts at the ankle and foot and affects multiple joints symmetrically, leading to pain, swelling and deformities such as bunions and hammertoes.
Gout
Gout is a type of inflammatory arthritis that occurs when urate crystals accumulate in the joints. It commonly affects the joint at the base of the big toe, causing sudden and intense pain, swelling and tenderness. Gout attacks can be sporadic, but they may recur over time if uric acid levels are not controlled.
Psoriatic Arthritis
This type of arthritis is linked with a chronic skin condition, called psoriasis, which can affect the joints in the ankle and foot. It causes inflammation, stiffness and pain that typically begins at the end of the toes, leading to swelling (dactylitis) and or heel pain from the Achilles tendon. Symptoms may vary in intensity and can flare up alongside skin symptoms.
Post-Traumatic Arthritis
Post-traumatic arthritis develops after an injury to the foot or ankle, such as a fracture, dislocation or sprain. Similar to osteoarthritis, the trauma causes the cartilage between the joints to wear away and become inflamed over time. This type may appear after the initial injury and lead to chronic pain and stiffness.
What Causes Foot and Ankle Arthritis?
Foot and ankle arthritis typically occurs when the cartilage wears away due to trauma or underlying medical conditions. However, other factors may also increase one’s risk of developing the condition, including:
Advanced Age
The cartilage naturally wears down with age, which increases the risk of osteoarthritis in weight-bearing joints such as the ankle and foot.
Injury
Fractures, sprain or dislocations can damage cartilage or alter joint alignment, leading to post-traumatic arthritis.
Autoimmune Disorder
Conditions such as rheumatoid arthritis occur when the immune system mistakenly attacks joint cartilage, leading to chronic inflammation and joint damage.
Genetics
A family history of arthritis may increase susceptibility to the condition.
Metabolic Disorders
High uric acid levels, as seen in gout, can cause crystal deposits within joints, triggering inflammation.
Obesity
Having an excess body weight can place additional stress on the foot and ankle joint, which can further accelerate cartilage wear and exacerbate symptoms.
Repetitive Stress
Certain occupations or activities involving repetitive joint use (e.g., running or prolonged standing) can contribute to cartilage breakdown over time.
What Are the Symptoms of Foot and Ankle Arthritis?
Symptoms of foot and ankle arthritis vary depending on the joint involved and the severity of the condition. Common signs include:
- Pain that may be constant or come and go, often worsening with activity or weight-bearing.
- Swelling, warmth or redness around the affected joint, especially after prolonged use.
- Stiffness, particularly in the morning or after periods of rest.
- Tenderness when the joint is pressed or touched.
- Reduced mobility, making it difficult to walk, stand for long periods or climb stairs.
- Visible deformity in more advanced stages, such as bunions or hammertoes.
What Are the Stages of Foot and Ankle Arthritis?
Arthritis in the foot and ankle progresses through various stages. These stages describe the severity of cartilage damage and its impact on joint function:
Stage 1
The joint shows early signs of arthritis with minimal degenerative changes in the cartilage. Symptoms are mild, often limited to occasional stiffness or discomfort after activity.
Stage 2
In this stage, symptoms become more noticeable, such as pain during movement, swelling and stiffness. The joint space has also narrowed due to continued degeneration.
Stage 3
This stage is marked by significant cartilage loss, resulting in frequent pain, swelling and reduced mobility. Bone spurs may also become more prominent and joint deformities begin to develop.
Stage 4
This is the most advanced stage, characterised by severe cartilage loss, bone-on-bone contact and joint deformity. Pain and inflammation are persistent, even at rest and joint movement is severely limited.
How Is Foot and Ankle Arthritis Diagnosed?
Diagnosing arthritis of the foot and ankle begins with a review of the patient’s medical history and a physical examination. The doctor assesses swelling, tenderness and joint movement and may observe the patient’s gait to evaluate how the condition affects mobility.
If a specific type of arthritis is suspected, further tests may be ordered to confirm the diagnosis and assess the extent of joint damage. These may include:
Blood Test
This test detects markers of inflammation or autoimmune disorders present in the blood, such as rheumatic factor or uric acid levels, which can help determine the type of arthritis.
Imaging Tests
X-rays can reveal joint space narrowing, bone spurs or deformities indicative of arthritis. In some cases, MRI and CT scans are used to provide detailed images of soft tissues and cartilage and assess joint damage.
Joint Aspiration
In this procedure, a sample of joint fluid (arthrocentesis) is extracted and analysed to check for infection, gout crystals or signs of inflammation.
What Are the Treatments for Foot and Ankle Arthritis?
Managing foot and ankle arthritis involves a combination of non-surgical and surgical treatments tailored to the individual's needs and the severity of the condition.
Non-Surgical Treatments
Early-stage arthritis is typically managed conservatively with:
- Medications – Non-steroidal anti-inflammatory drugs (NSAIDs) and corticosteroids can help reduce pain and inflammation. Disease-modifying antirheumatic drugs (DMARDs) may be prescribed for rheumatoid arthritis.
- Physiotherapy – Targeted exercises and modalities can improve joint mobility, strengthen supporting muscles and reduce stiffness.
- Orthotics and Braces – Custom shoe insoles or ankle braces can provide additional support and minimise strain on the affected joints.
- Lifestyle Changes – Weight loss, low-impact activities and proper footwear can minimise joint strain and alleviate mild symptoms.
Ankle Surgery
If nonsurgical treatments no longer provide adequate relief from symptoms or if joint damage is extensive, the doctor may consider surgical options, such as:
- Arthroscopy – This minimally invasive procedure uses a specialised instrument (arthroscope) to remove loose cartilage, bone spurs or inflamed tissue around the joint.
- Joint Fusion (Arthrodesis) – In this procedure, bones are fused together using rods, pins, screws or plates to reduce pain by eliminating motion in the arthritic joint.
- Total Joint Replacement (Arthroplasty) – This procedure involves removing the damaged cartilage and bone and then placing a new metal or plastic implant in the joint surface to relieve pain and restore function, particularly for advanced arthritis.
Can Foot and Ankle Arthritis Be Prevented?
While not all types of arthritis can be prevented, certain steps may help reduce the risk or slow its progression:
- Maintain a healthy weight to reduce stress on the foot and ankle joints.
- Wear supportive footwear with proper arch support and cushioning.
- Stay physically active with low-impact exercises such as swimming or cycling to maintain flexibility and muscle strength.
- Adopt a balanced diet, including anti-inflammatory foods and limiting purine-rich foods if you are prone to gout.
- Protect your joints by using proper techniques during sports and avoiding injuries.
- Attend regular medical check-ups to detect and manage underlying autoimmune or metabolic conditions early.
Our Foot and Ankle Surgeon in Singapore
FRCSEd (Orth), FAMS
Dr Kevin Koo is a foot and ankle surgeon with over 20 years of experience in orthopaedic surgery. He completed a fellowship at Imperial College Healthcare in London, where he worked with elite athletes and professional dancers, honing his expertise in managing sports injuries.
Dr Koo's dedication to the field is evident in his numerous accolades and his former role as Director of Foot and Ankle Service at Singapore General Hospital. He also actively contributes to advancements in foot and ankle surgery through his published research in numerous peer-reviewed medical journals.
| Tel. | : +65 6970 5905 |
| Fax | : +65 6970 5906 |
| Mobile | : +65 9898 7781 |
| : hello@bjc.sg , drkevinkoo@bjc.sg |
| Mon - FriMonday to Friday | :8:30am to 5:30pm |
| Sat, Sun and PHSaturday, Sunday & PH | :Closed |
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get in touch as soon as possible.
| Tel. | : +65 6970 5905 |
| Fax | : +65 6970 5906 |
| Mobile | : +65 9898 7781 |
| : hello@bjc.sg , drkevinkoo@bjc.sg |
| Mon - FriMonday to Friday | :8:30am to 5:30pm |
| Sat, Sun and PHSaturday, Sunday & PH | :Closed |