Subtalar Arthritis: Corticosteroid Injection, Bracing, and Subtalar Fusion

Medically reviewed by Dr. Tom Biernacki, DPM — Board-Certified Podiatric Surgeon — Balance Foot & Ankle, Howell & Bloomfield Hills, MI. Last updated April 2026.

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The subtalar joint — the talocalcaneal articulation comprising three joint facets that control hindfoot inversion and eversion — is the second most commonly fused joint in the foot and ankle after the ankle itself. Subtalar arthritis produces medial and posterior hindfoot pain with weight-bearing, stiffness on uneven ground (where subtalar motion is critical for accommodating terrain), and a characteristic antalgic gait pattern of walking on the lateral border of the foot. Understanding the treatment spectrum from conservative management through subtalar fusion helps patients navigate this common condition.

Conservative Management

Activity modification reducing walking on uneven terrain reduces subtalar loading. Hindfoot-controlling orthoses — specifically the UCBL (University of California Biomechanics Laboratory) orthosis, which provides rigid medial, lateral, and heel cup support to limit subtalar motion — provide significant pain reduction in moderate subtalar arthritis by unloading the arthritic joint surfaces. Arizona ankle-foot brace (custom leather and steel brace) provides the most effective non-surgical subtalar immobilization for advanced disease. Fluoroscopy- or ultrasound-guided corticosteroid injection into the posterior subtalar joint facet: provides 4–8 weeks of significant pain relief in the majority of patients and has diagnostic utility — if injection provides complete relief, it confirms the subtalar joint as the pain generator.

Subtalar Arthrodesis

Isolated subtalar fusion is indicated for end-stage subtalar arthritis failing conservative management. The standard technique: posterior approach with a 6.5–7.5mm large cancellous or cannulated screw placed retrograde from the plantar calcaneus into the talar body, providing compression across the posterior facet. One or two screws produce reliable fusion rates of 90–95%. The critical alignment principle: subtalar fusion in 5 degrees of hindfoot valgus — neutral valgus is associated with excessive forefoot supination and lateral column overload; excessive valgus produces medial forefoot overload and hindfoot pain. Recovery: 8–10 weeks non-weight-bearing, full weight-bearing by 12 weeks, full activity by 6 months. Adjacent ankle arthritis progression is a concern at 10-year follow-up, as isolated subtalar fusion eliminates the subtalar accommodation that protects the ankle from stress. Dr. Biernacki at Balance Foot & Ankle evaluates subtalar arthritis with weight-bearing X-rays and fluoroscopic injection for diagnosis and treatment. Call (810) 206-1402 at our Bloomfield Hills or Howell office.

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Frequently Asked Questions

When should I see a podiatrist?

See a podiatrist for any foot or ankle pain that persists more than 2 weeks, doesn’t improve with rest, limits your daily activities, or is accompanied by swelling, numbness, or skin changes. People with diabetes or circulation problems should see a podiatrist regularly even without symptoms.

What does a podiatrist treat?

Podiatrists diagnose and treat all conditions of the foot, ankle, and lower leg including plantar fasciitis, bunions, hammertoes, toenail problems, heel pain, nerve pain, diabetic foot care, sports injuries, fractures, and foot deformities — both surgically and non-surgically.

What can I expect at my first podiatry visit?

Your first visit includes a full medical history, physical examination of your feet and gait, and in-office diagnostic imaging if needed (X-rays, ultrasound). We’ll discuss your diagnosis and create a personalized treatment plan. Most visits take 30–45 minutes.

Need Treatment at Balance Foot & Ankle?

Dr. Tom Biernacki, Dr. Carl Jay, and Dr. Daria Gutkin see patients at our Howell and Bloomfield Township offices.

Book Online or call (810) 206-1402

Subtalar Arthritis Treatment: Injections vs Fusion in Michigan

Subtalar joint arthritis causes deep hindfoot pain that limits walking on uneven ground. Our podiatrists offer both conservative management with injections and bracing, and definitive surgical treatment with subtalar fusion when conservative measures fail.

Explore Hindfoot Treatment Options | Book Your Appointment | Call (810) 206-1402

Clinical References

1. Easley ME, Trnka HJ, Schon LC, Myerson MS. Isolated subtalar arthrodesis. J Bone Joint Surg Am. 2000;82(5):613-624.
2. Miehlke W, Gschwend N, Rippstein P, Simmen BR. Compression arthrodesis of the rheumatoid ankle and hindfoot. Clin Orthop Relat Res. 1997;(340):75-86.
3. Savory KM, Wulker N, Fakioglu O, Lohrer H. Biomechanics of the hindfoot joints in relation to degenerative hindfoot arthrodeses. Clin Biomech. 1998;13(1):62-70.

Your Board-Certified Podiatrists

Dr. Tom Biernacki, DPM

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Dr. Carl Jay, DPM

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Dr. Daria Gutkin, DPM

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Dr. Tom Biernacki, DPM

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Dr. Tom Biernacki, DPM is a double board-certified podiatrist and foot & ankle surgeon at Balance Foot & Ankle Specialists in Southeast Michigan. With over a decade of clinical experience, he specializes in heel pain, bunions, diabetic foot care, sports injuries, and minimally invasive surgery. Dr. Biernacki is a member of the APMA and ACFAS, and his patient education content on MichiganFootDoctors.com and YouTube has reached over one million views.