The facts about Arthritis in the foot and ankle

12 Sep

Roughly 40 million people in the United States are suffering from arthritis symptoms at any given time. Most are over 50 years old, but arthritis can affect the joints in the foot or ankle at any age.

One-quarter of the bones in our body are in our feet and each foot has 33 joints. Any of these can be affected by arthritis.  Downward pressure from our body weight wears out the padding in our feet and wears out the cartilage in our joints until bone rubs on bone, inflaming the joints and causing pain. And it doesn’t help that we typically gain weight as we age.

One of the side effects of arthritis is the cascading effect. If you have pain in your ankle or foot, you change the way you walk. But when you change the way you use your feet, you also change the way you turn your ankles, knees, hips and spine. For instance, to reduce the pain in your foot, you might pronate (tilt your foot to the inside). This will cause cartilage in the ankle to degenerate, causing you to pronate more, further wearing out the cartilage. Weakness in the ankle will then cause stress on the knee joint, forcing the knee to turn in, resulting in a non-alignment of the knee, which can degenerate the outside of the knee joint. So when the foot isn’t aligned, it affects everything, and if you already have arthritis in these joints, it gets much worse.

To slow these additional issues, see a podiatrist at the earliest symptoms of arthritis, so they can establish a baseline and take pain management steps to avoid further damage to your body. The early signs of arthritis include pain or tenderness in the joint; stiffness or reduced motion; swelling; and difficulty walking due to joint pain.

The most common forms of arthritis in the foot and ankle are:

Post Traumatic Arthritis

ankle arthritisThis type of arthritis typically develops after an injury to the foot or ankle. Remember that day you fractured your foot when you were 25? You’ll feel that pain again when you’re about 50, especially if you fractured one of the joints. This type of arthritis is similar to osteoarthritis and may develop years after a fracture, sprain, or ligament injury. An injured joint is seven times as likely to develop arthritis, even if it’s properly treated.

Osteoarthritis (Degenerative arthritis)

osteoarthritis of foot

Joints are formed by two bones which are held close together by ligaments and an outer covering known as a joint capsule. In order for the joints to move freely and without pain, the ends of the bones are covered in a softer material called cartilage and the lining of the joint capsule produces a lubricating substance called synovial fluid.

In arthritis, the cartilage starts to crack and erode, resulting in bone rubbing on bone. The body responds by creating extra bone at the edges of the joint to try and stop movement and thus symptoms. This is why arthritic joints often become enlarged.

This degeneration of the joint results in inflammation, swelling, and pain. Osteoarthritis progresses slowly and the pain and stiffness it causes worsens over time. Because the ability of cartilage to heal itself decreases as we age, elderly people are most likely to suffer from osteoarthritis. Other contributing factors are obesity and a family history of the disease.

Rheumatoid Arthritis
rheumatoid arthritis feet

Severe rheumatoid arthritis

Rheumatoid arthritis is a systemic inflammatory disease where the patient’s own immune system attacks and destroys cartilage in many parts of the body. Unfortunately, the exact cause of rheumatoid arthritis is not known, but researchers believe that some people have genes that make them more susceptible. Women are three times as likely to suffer from RA than men are.

RA is much more erosive to the cartilage than Osteoarthritis, to the point that the bone is sometimes eroded completely, causing the joint to totally collapse. The disease typically begins with joints being swollen, warm, painful and stiff, particularly early in the morning on waking or following prolonged inactivity. Gentle movements may help to relieve symptoms. As the disease progresses the inflammatory activity leads to tendon tethering and erosion and destruction of the joint surface, which impairs range of movement and leads to deformity.

How your podiatrist relieves arthritis pain

Initial, non-surgical podiatric treatment may include

  • Pain relievers and anti-inflammatory medications to reduce swelling
  • Shoe inserts (orthotics), such as pads or arch supports
  • Custom-made shoe, such as a stiff-soled shoe with a rocker bottom
  • An ankle-foot orthosis
  • A brace or a cane
  • Forefoot supports such as gel toe caps, gel toe shields, and gel toe straighteners
  • Physical therapy and exercises
  • Weight control
  • Steroid medication injected into the joint
  • Footwear with a wider toe box

If pain persists, surgical management may be suggested.

More information on the symptoms and treatment of arthritis can be found at  the Mayo Clinic website and Arthritis.org.

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