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Arthritis of the Rearfoot: Causes, Symptoms, and Effective Treatments

Rearfoot arthritis can quietly disrupt the way we walk, run, and stand until everyday tasks begin to feel like uphill battles. When our hindfoot joints are inflamed or worn down, they not only cause localized pain but also distort how weight is distributed throughout our body, leading to knee, hip, and even lower back issues.

Whether you’re an athlete, a busy parent, or someone dealing with aging bones, gaining clarity on this often-overlooked form of arthritis can empower informed care decisions. Let’s explore the ins and outs of arthritis in the rearfoot region and what we can do about it.


What is Rearfoot Arthritis?

Rearfoot arthritis refers to damage and inflammation of the joints in the back part of the foot, specifically the subtalar, talonavicular, and calcaneocuboid joints. These joints play a major role in absorbing shock and adapting to uneven surfaces. When arthritis takes hold, this natural adaptability is compromised.

Depending on the cause, arthritis here may be degenerative (like osteoarthritis), inflammatory (as in rheumatoid arthritis), or linked to past trauma.


Causes and Types of Rearfoot Arthritis

There’s no single culprit for rearfoot arthritis, it’s often the result of multiple overlapping factors.

Osteoarthritis (Degenerative Arthritis)

Osteoarthritis is the most common type we see in the rearfoot. It develops as cartilage wears down, often with age or after years of biomechanical stress. For example, someone who spent years working on hard floors or running long distances might develop localized wear and tear in one or more rearfoot joints.

Rheumatoid or Inflammatory Arthritis

These forms stem from the immune system mistakenly attacking joint tissues. Around 20–30% of individuals with rheumatoid arthritis report foot involvement, and the rearfoot, due to the complexity of its joints, is especially vulnerable.

Post-Traumatic Arthritis

Previous fractures, dislocations, or severe sprains in the rearfoot can alter joint alignment. Over time, this misalignment leads to increased wear on joint surfaces, eventually causing arthritis.


Who is at Risk for Rearfoot Arthritis?

Anyone can develop rearfoot arthritis, but certain factors increase the likelihood:

  • Age: Cartilage naturally wears down over time.
  • Foot injuries: Especially to the heel and hindfoot joints.
  • Genetic predisposition: A family history of arthritis can raise your risk.
  • Obesity: Extra weight intensifies pressure on foot joints.
  • Repetitive impact: Occupational or athletic activities that stress the foot.

We often see a combination of these risk factors in patients who seek our help for persistent foot pain.


Recognizing the Signs and Symptoms

Rearfoot arthritis doesn’t shout at first. It whispers through subtle but progressive discomfort. Common symptoms include:

  • Deep, aching pain in the back of the foot or ankle
  • Stiffness, especially in the morning or after long periods of rest
  • Swelling in and around hindfoot joints
  • Grinding or clicking during motion
  • Trouble walking on uneven ground
  • Loss of motion or flexibility in the foot

Left unaddressed, these issues can become debilitating, leading patients to limp or develop abnormal gait patterns.


How is Rearfoot Arthritis Diagnosed?

Diagnosis requires a combination of clinical evaluation and imaging.

We begin with a thorough history and physical exam to assess painful areas, range of motion, and signs of inflammation. We then use imaging like:

  • X-rays to visualize joint space narrowing or bone spurs
  • MRI to assess soft-tissue damage or early cartilage loss
  • CT scans to evaluate joint alignment and detailed bone architecture

These insights guide us in tailoring treatment plans specific to the patient’s condition and lifestyle.


Non-Surgical Treatment Options

Fortunately, many patients respond well to conservative management, especially in the early to moderate stages of arthritis.

Medication Management

NSAIDs (like ibuprofen or naproxen) help reduce inflammation and relieve pain. Corticosteroid injections into the joint can also offer temporary, targeted relief.

Orthotics and Footwear Modifications

Custom orthotic devices can redistribute pressure and support arch alignment. We’ve seen dramatic improvements in patients who pair orthotics with wide, cushioned footwear designed to minimize pressure on arthritic joints.

Physical Therapy

Structured exercise programs focusing on ankle mobility, calf flexibility, and core strength can reduce stress on the rearfoot. Therapists may also use ultrasound or manual techniques for symptom relief.

Activity Modification

Avoiding high-impact exercises and opting for low-resistance activities (like swimming or cycling) allows patients to stay active while minimizing joint stress.


When is Surgery Recommended?

While most cases improve with conservative management, some situations call for surgical intervention, especially when pain severely limits function.

Subtalar or Triple Arthrodesis (Joint Fusion)

In severe arthritis involving multiple hindfoot joints, fusion procedures stabilize the foot and eliminate the pain source by uniting bones into a single, solid block. While this reduces flexibility, it often greatly improves stability and walking comfort.

Joint-Sparing Techniques

If arthritis is limited to one area, we may use procedures to realign bones or smooth joint surfaces with less invasion. In rare instances, partial joint replacements may be considered.

Our surgical decisions always weigh benefits, risks, personal goals, and overall foot structure.


The Role of Physical Therapy and Orthotics

Think of physical therapy and orthotics as long-term tools rather than temporary fixes.

  • Orthotics control motion and improve alignment, crucial for preventing progression.
  • Physical therapy helps maintain as much ankle and foot flexibility as possible.
  • Together, they reduce compensatory movement patterns that often lead to new problems in the knees, hips, or spine.

Lifestyle Modifications for Managing Pain

How we live can make or break our treatment success. We recommend:

  • Weight management: Even modest weight loss lessens joint stress significantly.
  • Supportive shoes: Select stability-focused shoes with rocker soles if needed.
  • Anti-inflammatory nutrition: Diets rich in omega-3s and antioxidants can help.
  • Low-impact movement: Stay mobile while protecting your joints.
  • Avoiding barefoot walking: Especially on hard surfaces.

Prognosis and Long-Term Management Strategies

Rearfoot arthritis isn’t a short-term hurdle, it requires long-term planning. The good news is, with a comprehensive strategy, most patients can maintain a high quality of life.

We’ve seen patients transition from chronic limping to enjoying long walks again, all through smart planning, early intervention, and consistent follow-up.


If you’re experiencing persistent foot or ankle pain, swelling, or difficulty walking, don’t wait. Our team at South Florida Multispecialty Hospital is here to provide expert diagnosis, cutting-edge treatments, and compassionate care. Reach out today to schedule an appointment and take the first step toward pain-free movement.


Frequently Asked Questions

Arthritis of the rearfoot affects the joints in the hindfoot, such as the subtalar and talonavicular joints. Unlike arthritis in larger joints (like knees or hips), rearfoot arthritis disrupts weight bearing and walking mechanics due to the foot’s role in balance and mobility.

Osteoarthritis (wear and tear), rheumatoid arthritis (autoimmune), and past injuries (post-traumatic) are leading causes, often stemming from aging, biomechanical stress, or systemic inflammation.

Symptoms include deep foot pain, stiffness, swelling, clicking sounds in joints, and difficulty walking, particularly on uneven surfaces or after activity.

We often begin with X-rays and may follow with MRI or CT scans for a more detailed evaluation of cartilage, joint alignment, and surrounding tissues.

Treatment includes NSAIDs, orthotics, corticosteroid injections, physical therapy, and activity modifications to relieve pressure and improve function.

Surgery is considered when conservative strategies fail. Options include joint fusion for stability or joint-preserving procedures based on the location and severity of arthritis.

It alters how weight is distributed across the foot, leading to compensatory changes up the kinetic chain—affecting knees, hips, and spine over time.

Maintaining a healthy weight, choosing supportive footwear, staying active with low-impact exercise, and embracing a joint-friendly diet all support joint longevity.

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