Pain is the main problem with osteoarthritis of any joint. At first, the ankle joint pain occurs only related to activity. Once the activity gets underway there is not usually much pain, but after resting for several minutes the ankle pain and stiffness increase. Later, when the condition worsens, pain may be present even at rest. The pain may interfere with sleep. There may be a swelling around the ankle joint and it may fill with fluid and feel tight, especially following increased activity. When all the articular cartilage is worn off the joint surface there may be a squeaking sound when the ankle joint moves. Doctors refer to this sound as crepitance. Osteoarthritis will eventually affect the motion of the ankle joint and it will become stiff and lose the ability to move.
Certain motions can become painful, and it may become difficult to trust the ankle joint to hold your weight in certain positions. The body has a pain reflex to ensure that, when a joint is put into a position that causes pain, the muscles around the joint may stop working without warning. This reflex can lead to falls when arthritis affects the leg joints. When osteoarthritis has reached a very severe stage, the bone under the articular cartilage may become worn away. This can lead to increasing deformities around the ankle joint. In the final stages, the alignment of the joints can begin to form odd angles where they meet to form the joint.