Foot Health

Arthritis and the feet

Today, complaints of joint pain seem common place and is even expected as people get into their golden years. Arthritis is the leading cause of disability in the United States affecting more than 40 million people. It is more common as you get older, however it can occur at any age, and the word literally means pain within a joint. Arthritis describes the inflammation and swelling of the cartilage and lining of the joints, along with increased fluid in the joints.

Arthritis and the feet

The feet seem more susceptible to arthritis than other parts of the body because the feet have 52 bones and 33 joints that can be affected and they bear the brunt of walking and standing. Arthritis in the feet can cause loss of motion in the joints and independence, but that may be avoided with early diagnosis and proper medical care.

Causes

There are three main types of arthritis that may affect your foot and ankle.

Osteoarthritis is “wear and tear” arthritis, and is common in many people after they reach middle age. Over the years, the smooth cartilage at the ends of the bone wear down causing inflammation, swelling, and pain in the joint as the bone edges rub together. It progresses slowly and the pain and stiffness worsen over time. Arthritis can develop after an injury to the foot or ankle especially if the injuries were ignored and not treated. This type of arthritis is similar to osteoarthritis and may develop years after a fracture or severe sprain.

Rheumatoid arthritis is an inflammatory disease seen in joints all over the body caused by the person’s own immune system attacking and destroying the cartilage.

Gout is a form of arthritis caused by a buildup of the salts of uric acid – a normal byproduct of protein in the diet. The big toe joint is the most commonly affected area. Avoiding proteins such as shellfish, red meat, cold cuts and cheese can prevent or delay the attack of arthritis. There are other causes of arthritis including bacterial and viral infections to the joint, bowel disorders, and even some drugs.


Symptoms

Different forms of arthritis affect the body in different ways. Once cartilage is damaged it cannot be reversed. Signs and symptoms of arthritis of the foot vary, depending on which joint is affected. Common symptoms include joint pain or tenderness, early morning stiffness or reduced motion, swelling and difficulty walking.


Diagnosis

Early diagnosis is important for effective treatment of all types of arthritis. Your podiatrist will diagnose arthritis by using medical history, a physical examination and other tests. Additional tests may include an exam of the way you walk (gait analysis). This shows how the bones in the leg and foot affects walking. X-rays can show changes in the joint space between the bones or in the shape of the bones themselves. A bone scan, computed tomographic (CT) scan, or magnetic resonance image (MRI) may also be ordered for more evaluation.


Treatment

The objectives for treatment of arthritis are controlling inflammation, preserving or restoring joint function and curing the disease if possible. Depending on the type, location, and severity of the arthritis, there are many types of treatment available.

Education is important. Physical therapy and exercise are important to make sure the joint continues to move. It is best to exercise in the sea or pool or perform other non-weight bearing exercises to prevent pain and further damage to the joint.

Other non-surgical treatment options include:

• Pain relievers and anti-inflammatory medications to reduce swelling, shoe inserts (orthotics).

• Custom-made shoes, such as a stiff-soled shoe with a rocker bottom, a brace or a cane.

• Weight loss and control or nutritional supplements such as chondroitin and glucosamine. People can also use turmeric, ginger, fever grass and other natural herbs and spices that have anti-inflammatory properties to help control the pain and inflammation.

• Medications, such as a steroids, anesthetics or joint filler fluid can be injected into the joint.

If arthritis doesn’t respond to non-surgical treatment, surgical treatment might be considered. The choice of surgery will depend on the type of arthritis, the severity of the disease, the impact of the disease on the joints, and the location of the arthritis. Sometimes more than one type of surgery will be needed. Surgery performed for arthritis of the foot and ankle may include arthroscopic debridement to clean out the joint, arthrodesis or fusing the joints together permanent, and arthroplasty a joint replacement.

Remember, arthritis is a chronic, long term condition that will require long term treatment. If you have symptoms of arthritis in your feet and ankle, you don’t have to suffer in silence – there is relief available if you see your podiatrist.

 
 • For more information, email us at foothealth242@gmail.com or visit www.apma.org. To see a podiatrist, telephone 325-2996 for an appointment, visit Bahamas Foot Centre on Rosetta Street, or call 394-5824 for an appointment; or visit Bahamas Surgical Associates Centre on Hilltop Medical Centre off 4th Terrace Collins Avenue. In Grand Bahama, call Lucayan Medical Centre at 373-7400 for an appointment. 

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