Subtalar Arthritis: Symptoms, Diagnosis & Treatment Options

What Is the Subtalar Joint?

The subtalar joint sits directly below the ankle joint, between the talus (ankle bone) and the calcaneus (heel bone). While the ankle joint provides up-and-down (plantarflexion/dorsiflexion) motion, the subtalar joint provides side-to-side motion (inversion/eversion) — the rocking motion essential for walking on uneven terrain. Subtalar arthritis severely limits this motion, causing pain with any activity involving irregular surfaces.

Causes and Symptoms

Post-traumatic arthritis is the most common cause — occurring years after calcaneal fractures, severe ankle sprains, or talar fractures. Other causes include: primary osteoarthritis (less common than in hip/knee), rheumatoid arthritis, inflammatory arthritis, and tarsal coalition (abnormal bone connection) that increases stress on the joint. Symptoms: deep, diffuse rearfoot pain difficult to localize precisely; pain worse on uneven ground (hiking, grass, gravel); limited ankle inversion/eversion; stiffness in the morning; antalgic (pain-avoiding) gait.

Diagnosis

Weight-bearing X-rays of the foot and ankle show joint space narrowing, subchondral sclerosis, and osteophytes in advanced subtalar arthritis. CT scan provides superior detail of subtalar joint anatomy and is preferred for surgical planning. MRI is used for early arthritis where X-rays may still appear normal. A diagnostic injection of local anesthetic into the subtalar joint under fluoroscopic guidance is the most reliable test — pain relief from the injection confirms the subtalar joint as the pain source.

Treatment

Conservative treatment: custom orthotics with medial/lateral posting to restrict subtalar motion; stiff-soled shoes; ankle-foot orthosis (AFO) for severe cases; corticosteroid injection for acute flares. Subtalar joint fusion (arthrodesis) is the definitive surgical treatment for end-stage subtalar arthritis — it eliminates the painful joint by fusing the talus and calcaneus, trading motion for pain relief. Outcomes are generally excellent, with high patient satisfaction at 5-year follow-up.

Frequently Asked Questions

Is subtalar arthritis the same as ankle arthritis? No. The subtalar joint and the tibiotalar (ankle) joint are anatomically separate, though both can be affected simultaneously. Subtalar arthritis restricts side-to-side motion; ankle arthritis restricts up-and-down motion. Both can occur together after calcaneal fractures.

Can subtalar arthritis be treated without surgery? Yes. Many patients with subtalar arthritis achieve adequate pain control with conservative measures (orthotics, injections, activity modification) for years. Surgery is reserved for cases where conservative measures have failed and quality of life is significantly impacted.

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Affiliate Disclosure: This page contains affiliate links to products we recommend. If you purchase through these links, Balance Foot & Ankle may earn a small commission at no additional cost to you. We only recommend products we use with our patients.

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.

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Frequently Asked Questions

Can a podiatrist treat arthritis in the foot?

Yes. Podiatrists diagnose and treat all types of foot and ankle arthritis including osteoarthritis, rheumatoid arthritis, and gout. Treatments include custom orthotics, joint injections, physical therapy, and surgical options when conservative care is insufficient.

How much does a podiatrist visit cost without insurance?

Self-pay podiatrist visits typically range from 100 to 250 dollars for an initial consultation. Contact Balance Foot & Ankle Specialists at (810) 206-1402 for current self-pay pricing and payment plan options.

Medical References

1. Diagnosis and Treatment of Plantar Fasciitis (PubMed / AAFP)
2. Heel Pain (APMA)
3. Hallux Valgus (Bunions): Evaluation and Management (PubMed)
4. Bunions (Mayo Clinic)

This article has been reviewed for medical accuracy by Dr. Tom Biernacki, DPM. References are provided for informational purposes.

Related Treatments at Balance Foot & Ankle

• MLS Laser Therapy
• Custom 3D Orthotics

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• Best Pain Relief Gel for Foot Pain