Ocean Grove Podiatrist, Max Stebnyckyj talks Arthritis and how our Ocean Grove clinic can help…

Understanding Arthritis in the Foot and Ankle

By Ocean Grove Podiatrist, Max Stebnyckyj, Senior Podiatrist

As a podiatrist, one of the most common concerns I see in the clinic is arthritis affecting the

foot and ankle. Many people don’t realise just how much strain our feet endure every

day—and how arthritis in these small, hardworking joints can have such a profound effect on

our mobility and overall quality of life.

In this blog, I’ll walk you through the different types of arthritis that can impact the foot and

ankle, how we typically diagnose them, and the treatment options available. Whether you're

dealing with a long-standing issue or starting to notice early signs, understanding what’s

going on is the first step to managing your condition effectively.

1. Osteoarthritis: The Degenerative Kind

Osteoarthritis (OA) is what most people think of when they hear the word “arthritis.” It’s a

wear-and-tear condition that develops over time, especially in joints that have been overused

or previously injured

Where it shows up:

• Big toe joint (1st MTP joint)

• Midfoot joints

• Ankle joint (especially in those with a history of injury)

What patients typically report:

• Gradual onset of pain and stiffness

• Discomfort with prolonged walking or standing

• A sensation of grinding or limited range of motion

In the clinic, I often use a combination of gait analysis, palpation, and X-rays to assess the

extent of joint degeneration.

2. Rheumatoid Arthritis: An Autoimmune Offender

Rheumatoid arthritis (RA) is an inflammatory, autoimmune disease that can cause

widespread joint destruction if not managed early. I often see patients presenting with

forefoot pain and deformities before they’re even aware they have RA.

Where it tends to strike:

- Multiple joints in the forefoot

- Subtalar and ankle joints

Common symptoms:

- Persistent, symmetrical joint swelling

- Redness and warmth

- Early morning stiffness lasting more than 30 minutes

For patients with suspected RA, I usually refer for blood tests and coordinate care with a

rheumatologist for diagnosis and long-term management.

3. Post-Traumatic Arthritis: Injury-Related Degeneration

When a patient comes in years after a sprain or fracture with persistent joint pain, post-

traumatic arthritis is high on my differential. Even well-healed injuries can lead to joint

surface damage and, eventually, arthritis.

Common sites:

- Ankle joint

- Midfoot joints

What patients tell me:

- Pain worsens with activity

- Occasional swelling and stiffness

- History of trauma to the area

I often review old imaging alongside new X-rays to track changes over time and determine

the best course of action.

4. Gout: The Classic “Hot, Red Toe”

I can’t count how many times a patient has walked (or limped) in with a painfully swollen big

toe, convinced they’ve broken it, only for it to turn out to be a gout flare. Gout is a type of

inflammatory arthritis caused by uric acid crystal build-up.

Classic presentation:

- Sudden, severe pain in the big toe

- Swelling, redness, and warmth

- Often occurs at night or after dietary triggers (e.g., alcohol, red meat)

If gout is suspected, I usually recommend a uric acid blood test and work closely with the

patient’s GP to manage flare-ups and prevent future attacks.

5. Psoriatic Arthritis: Not Just a Skin Condition

Psoriatic arthritis (PsA) often affects the feet before patients realise what’s happening. If a

patient with a history of psoriasis presents with foot pain and swollen digits, PsA is on my

radar.

Tell-tale signs:

- Swollen, “sausage-like” toes (dactylitis)

- Pain at tendon insertion points (enthesitis), like the Achilles

- Nail changes or skin lesions associated with psoriasis

Diagnosis often involves a combination of clinical history, imaging, and referral to a

rheumatologist.

How We Manage Arthritis in the Foot and Ankle

The good news? You don’t have to suffer through arthritis pain. As a podiatrist, I take a

comprehensive approach to managing these conditions:

Non-surgical options:

- Custom orthotics to offload painful joints

- Footwear advice and modifications

- Exercise programs and physical therapy

- Anti-inflammatory medications or topical treatments

- Cortisone injections in selected cases

When surgery is needed:

For severe cases, I’ll discuss referral options for surgical intervention, such as joint fusion,

debridement, or replacement, depending on the joint and overall function.

Arthritis in the foot and ankle is more than just a nuisance—it can dramatically affect how

you move through life. The earlier we catch it, the more options we have to keep you active,

mobile, and doing what you love.