Subtalar arthritis is inflammation and pain in the subtalar joint of the ankle, caused by wear and tear or a fracture. Treatment involves surgery to fuse the joint, but this reduces mobility. Nonsurgical methods include weight loss, comfortable footwear, and pain medication.
Subtalar arthritis is a condition in which the subtalar joint in the ankle becomes inflamed and painful. The subtalar joint is where the talus bone in the ankle joins the heel or calcaneus bone. Arthritis can occur there due to wear and tear on the bones in the subtalar joint that occurs over time or following a fracture of the talus. Subtalar arthritis is usually associated with pain, which occurs when the ankle is turned inward or outward. Treatment commonly involves surgery to fuse the joint and relieve pain, although this has the drawback that the foot becomes less mobile.
The anatomy of the foot is complex, with 28 bones forming more than 30 different joints to form a structure that not only supports the entire body’s weight, but also allows a person to leap into the air and land, usually without injury. The bones in the foot are held together by strong bands of tissue called ligaments and are shaped to form two arches, one along the length of the foot and one across the length of the foot. Because the foot is subjected to repeated impacts over time, the damage and wear and tear leading to arthritis occurs quite frequently, especially when extra force is placed on the joints in obese or athletic people, for example. At the ankle, the talus bone is important, as it connects the bones of the leg with those of the foot, allowing the ankle to move up, down, in, and out. The in-and-out motions enabled by the subtalar joint are essential for walking on uneven ground.
Probably the most common cause of subtalar arthritis is a fracture of the heel bone, although a broken talus can also lead to arthritis, especially if the blood supply to part of the bone is lost, causing it to die. The disease known as rheumatoid arthritis, in which the joints are attacked by the immune system and become inflamed, can also affect the subtalar joint. Having deformed feet can increase a person’s likelihood of developing subtalar arthritis, as stress can be unevenly distributed throughout the foot, putting extra force on the subtalar joint.
Ankle symptoms of pain, stiffness, and sometimes swelling may be experienced by a person with subtalar arthritis. X-rays are often used to diagnose the condition, and treatment usually begins with nonsurgical methods. Nonsurgical techniques, which can help protect the joint and relieve pain, include weight loss, swimming and biking rather than walking, and wearing comfortable footwear. Sometimes the ankle is tied or braced and ice may be applied. Pain medications are usually prescribed.
When nonsurgical treatment fails, subtalar arthritis pain can be treated with an operation to fuse the subtalar joint. Metal screws and pieces of bone graft material are used to secure the joint and help the bones heal together. The result is a stiff but relatively pain-free ankle joint.
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