Is It Arthritis or Something Else? Why Foot/Ankle Pain Often Gets Misdiagnosed
Foot pain is frequently attributed to arthritis, particularly in older adults. At the same time, true arthritic conditions in the foot are often overlooked or mistaken for soft tissue injuries. This overlap can delay appropriate treatment and prolong symptoms.
The foot and ankle form a complex system consisting of 28 bones, 33 joints, and more than 100 ligaments, all controlled by both extrinsic and intrinsic muscles. This intricate structure makes the foot particularly susceptible to degenerative and inflammatory conditions.
Arthritis in the foot and ankle commonly presents as stiffness after periods of rest, pain that worsens with activity, swelling around joints, and reduced range of motion. These symptoms differ from conditions such as plantar fasciitis or tendonitis, which typically present with more localized soft tissue pain.
Certain joints are more commonly affected, including the first metatarsophalangeal joint (hallux rigidus), the midfoot, and the ankle—especially following prior injury. Because symptoms can overlap, clinical evaluation often requires imaging and a detailed biomechanical assessment to establish an accurate diagnosis.
Accurate diagnosis is essential. Treating joint disease as a soft tissue condition—or the reverse—can prolong symptoms and lead to unnecessary frustration. Management varies depending on severity and may include mechanical offloading, targeted injections, footwear modification, or surgical intervention when appropriate.
Persistent, activity-related pain accompanied by stiffness should not be dismissed as a routine part of aging but instead evaluated within the context of joint health and function. If you are experiencing these symptoms, please call our office—we are here to help!
William E. Donahue, DPM, FACFAS
