Arthritis, in general terms, means inflammation and swelling of a joint. This term encompasses the inflammation and swelling of the cartilage and lining of the joints, generally accompanied by an increase in the fluid in the joints. Arthritis may impact any joints in the body which includes the joints in the foot and the ankle. There are many different causes why a patient may suffer from arthritis in the foot and ankle. More than often, Arthritis is a manifestation a complex disease. The human foot has thirty three (33) joints which be affected by arthritis. Due to the weight bearing nature of our feet, arthritis can immediately turn into a debilitating and crippling disease. While the prevalence of arthritis increases with age, all people from infancy to middle age are potential victims. People over 50 are most prone to arthritis. Millions of Americans suffer from arthritis each year.
Arthritis in our feet and ankle leads to pain, swelling, loss of function and mobility therefore early diagnosis and treatment is of paramount importance.
What Causes Arthritis
Besides heredity, arthritic symptoms may arise in a number of ways:
- Post-traumatic arthritis: after a joint has been traumatized. Trauma (blunt force) to a joint, depending on the severity of it, may cause damage to a joint that isn’t reversible.
- Bacterial and viral infections can attack our joints and cause destruction to the joints. Some examples include pneumonia, gonorrhea, staph infections, and Lyme disease.
- You can suffer from arthritis in conjunction with bowel disorders such as colitis and ileitis, frequently resulting in arthritic conditions in the joints of the ankles and toes. Such inflammatory bowel diseases seem distant from arthritis, but treating them can relieve arthritic pain.
- Using drugs, both prescription drugs and illegal street drugs, can induce arthritis.
- As part of a congenital autoimmune disease syndrome of undetermined origin.
Types and Symptoms of Arthritis
Osteoarthritis: Osteoarthritis is the most common form of arthritis. It is frequently called degenerative joint disease or “wear and tear” arthritis. Although it can be brought on suddenly by an injury, its onset is generally gradual; aging brings on a breakdown in cartilage, and pain gets progressively more severe, although it can be relieved with rest. Dull, throbbing nighttime pain is characteristic, and it may be accompanied by muscle weakness or deterioration. Walking may become erratic. It is a particular problem for the feet when people are overweight, simply because there are so many joints in each foot. The additional weight contributes to the deterioration of cartilage and the development of bone spurs.
Rheumatoid arthritis (RA): RA is a major crippling disorder and perhaps the most serious form of arthritis. It is a complex, chronic inflammatory system of diseases, often affecting more than a dozen smaller joints during the course of the disease, frequently in a symmetrical pattern—both ankles, or the index fingers of both hands, for example. It is often accompanied by signs and symptoms—lengthy morning stiffness, fatigue, and weight loss—and it may affect various systems of the body, such as the eyes, lungs, heart, and nervous system. Women are three or four times more likely than men to suffer RA.
RA has a much more acute onset than osteoarthritis. It is characterized by alternating periods of remission, during which symptoms disappear, and exacerbation, marked by the return of inflammation, stiffness, and pain. Serious joint deformity and loss of motion frequently result from acute RA. However, the disease system has been known to be active for months, or years, then abate, sometimes permanently.
Gout (gouty arthritis): Gout is a condition caused by a buildup of uric acid—a normal byproduct of the diet—in the joints. A single big toe joint is commonly the affected area, since it is farthest from the heart, and therefore the coldest; attacks of gouty arthritis are extremely painful, perhaps more so than any other form of arthritis. Men are much more likely to be afflicted than women, an indication that heredity may play a role in the disease. While a rich diet that contains lots of red meat, rich sauces, shellfish, red wine, and brandy is popularly associated with gout, there are other protein compounds in foods such as lentils and beans that may play a role.
Psoriatic arthritis: Psoriasis is often thought of as a skin disorder, but it can affect the joints as well. On the skin, psoriasis appears as dry, scaly patches. Not all people with psoriasis of the skin will develop joint symptoms—about one in twenty people with psoriasis will develop associated arthritis. The arthritis may be mild and involve only a few joints, particularly those at the ends of the fingers or toes. People who also have arthritis usually have the skin and nail changes of psoriasis. Often, the skin gets worse at the same time as the arthritis.
Traumatic arthritis: Traumatic arthritis is a form of arthritis that is caused by blunt, penetrating, or repeated trauma or from forced inappropriate motion of a joint or ligament. Injury to a joint, such as a bad sprain or fracture, can cause damage to the articular cartilage. This damage to the cartilage eventually leads to arthritic changes in the joint.
When to Visit a Podiatrist
It is important to visit a doctor of pediatric medicine if any of the following symptoms occur in your feet. Prompt diagnosis and treatment prevent further damage to the affected joint and start the healing process.
- Swelling in one or more joints
- Recurring pain or tenderness in any joint
- Redness or heat in a joint
- Limitation in motion of joint
- Early morning stiffness
- Skin changes, including rashes and growths
Diagnosis and Treatment of Arthritis
The Foot is commonly affected by different forms of arthritis and ignoring arthritis may lead to irreversible damage to the joint and altered normal biomechanics/motion of the foot. It is important to see your podiatrist who can evaluate and treat you immediately. Thorough History of the illness, meticulous clinical examination and radiographic studies are very important in the treatment. There is a variety of different modalities available to treat arthritis. Some of these treatment modalities include but not limited to: Non-steroid anti-inflammatory, steroid injection, physical therapy, icing, elevation, compression, Bracing and orthotics. Orthotics , otherwise commonly referred to shoe inserts, can be a very powerful treatment to altered or faulty biomechanics of the foot. depending on the severity and the type of arthritis that you are experiencing, we will tailor our treatment to increase your chances of success. However, sometime the patient doesn’t respond to conservative therapy then surgical intervention should be discussed with the patient. I believe in patient education as being very important part of the treatment. The advent of modern technology, has increased the surgical options at our disposal in the treatment of your arthritis. Joint-replacement and joint sparing procedures in the foot and ankle have gained momentum, as the drive toward preservation of motion in the foot and ankle has only increased. However, at times fusion of a joint is more appropriate and this will be discussed with you in detail in the consultation.
How to Prevent Arthritis
It is very important in the foot and ankle as arthritis can be debilitating to the patient. Some forms of arthritis such as osteoarthritis secondary to faulty mechanics of the foot and ankle may be preventable by custom molded orthotics. Proper alignment of the joints of the foot and ankle reduce the chances of damage and erosions to the cartilage and therefore prevent destructive changes to the joint which are at times painful. Another example is arthritis secondary to gout. This may be remedied by controlling the Uric acid level in people whoa re prone to gouty attacks.