Many people struggle with the everyday aches and pains associated with arthritis of their feet and ankles. The feet are more susceptible to arthritis than other parts of the body because each foot has 33 joints that are subjected to the body’s weight-bearing load. Arthritic feet can be painful and result in a loss of mobility, independence, and poorer quality of life. In some instances it can be crippling. Although there is no cure for arthritis, there are many treatment options to bring it under control or remission. Early detection and treatment can help to slow its progression. If you are suffering from this condition, it may be time to step ahead of arthritis by pursuing treatment.
There are several different types of arthritis, and while not all affect only the geriatric population, the symptoms are often remarkably similar. Arthritis most often results from a breakdown or degeneration of cartilage within a joint that causes inflammation and pain, and eventually the formation of exostoses (ex•os•to•sis) or bone spurs that the body produces in order to restrict the joint from moving. This often is counterproductive as the spurring becomes a source of pain in its own right, often compressing on nearby bursal sacs or nerves. Clinically, this commonly presents with stiffness and pain that is immediately painful during the initiation of weight bearing, and improves after the patient has walked a while. It can also flare during the night, or during changes in barometric pressure, such as weather fronts. While all forms of arthritis have similar clinical manifestations, a specific diagnosis is important in order to formulate an optimal management plan.
Primary osteoarthritis, also known as normal “wear and tear” or degenerative arthritis, is the most common type that affects the joints of the foot. This is termed primary osteoarthritis if it is not a result of trauma or manifestation of a different systemic disease. This condition involves different areas depending on each person’s foot structure.
A high-arched foot structure places a great deal of stress right in the center of one’s foot, and these patients very often present with midfoot arthritis. The extensor tendons that function on the top of the foot and ankle are very active, and often cause contracture, or hammering, of the toes. The small joints of the toe can also become arthritic and painful.
Those people with a low-arched foot type more often get arthritis in the rearfoot joints, as the sagging of the arch places abnormal stress on the joints, causing them to wear out more quickly. This overpronation often causes elevation of the first metatarsal bone that makes up part of the big toe joint. This elevation often leads to a jamming of this big toe joint and can create a painful arthritic condition often referred to as hallux limitis or rigidus.
Primary osteoarthritis treatment involves supporting the involved joint with braces and orthotics that help limit pathologic motion, which can decrease degeneration and pain. Treating the painful inflammation with a combination of steroids and NSAIDS such as Advil or Aleve can further reduce painful symptoms.
Post-traumatic arthritis is a secondary type of arthritis that occurs when the joint itself is influenced by trauma, most often times in the form of a fracture. This can lead to direct injury to a joint’s cartilage, or can cause angular deformity that places abnormal stress on the involved joint, causing it to wear out at an incredibly accelerated rate. Trauma is the most common cause of arthritis and degeneration of the ankle joint, although this can affect any joint that is subject to fracture.
The best form of treatment is prevention, which is why the majority of unstable, malaligned fractures in the foot and ankle are surgically corrected very soon after the original injury occurs. Often, however, direct damage to the joint cartilage cannot be prevented, and post-traumatic arthritis can become painful at any time after the original injury. Bracing and anti-inflammatories are used as indicated to control symptoms, and surgical intervention is warranted if relief is not sufficient with conservative measures.
Systemic arthritis can produce pain in the foot and ankle joints, the most common of which is known as Rheumatoid arthritis. There are several systemic inflammatory arthritic conditions.
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Rheumatoid arthritis is an auto-immune process of unknown origin that often affects the hands, spine, as well as the lower extremities. This presents as stiffness, tenderness, swelling, pain with joint motion and progressive deformity.
Soft tissues masses known as rheumatoid nodules are another common finding that can also be a source of pain. The deformity in the hands and feet generally is symmetric and affects the smaller joints (toes and fingers), resulting in subluxation and progressive pain.
Early diagnosis and treatment of the inflammation and auto-immune response is crucial to long-term management of this condition, and timely referral to a rheumatologist will optimize the prognosis.
Bracing is generally not well tolerated, and surgery can be therapeutic when deformity limits mobility. There are several other types of inflammatory arthritis that can affect several joints throughout the body, and treatment is based on the specific diagnosis.
Surgical treatment is a viable option for end-stage arthritis when nonsurgical treatments have not worked. Your foot and ankle surgeon will select the type of surgery that is best for you. The types of surgery performed include arthroscopic debridement, fusion, joint replacement, and external fixator to maintain joint motion, correct alignment, and preserve toe length.
Many sources of foot and ankle pain are a result of arthritis. Determining what specific type of arthritis is the root of the problem and a crucial component for treatment and establishing a favorable long-term result. An experienced foot and ankle surgeon can quickly determine the specific cause of your arthritis, and formulate a treatment plan that can minimize its effect on your activity, and get you back to walking pain free.
If you want to learn about nonsurgical and surgical treatment options that are best for you, call the Foot & Ankle Center of Illinois at (217) 787-2700 to schedule a consultation.
The Foot & Ankle Center of Illinois is located in Springfield, Decatur and Carlinville. Also, visit www.myfootandanklecenter.com for additional information, videos, and articles on foot care.