Arthritis

Arthritis is inflammation of a joint and is very common in the small joints of the ankle and foot, especially in the big toe and midfoot.
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Arthritis

Arthritis

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Table of Contents

What Is Arthritis?

Arthritis can cause pain in your feet as well as your knees, fingers and wrists. Arthritis is inflammation of a joint and is very common in the small joints of the ankle and foot, especially in the big toe and midfoot.

Degenerative arthritis is a condition that slowly wears away joints (the link where bones meet and move). In the beginning, you may notice that the affected joint seems stiff. It may even ache. As the joint lining (cartilage) breaks down, the bones rub against each other, causing pain and swelling. Over time, bone spurs (small pieces of rough or splintered bone) develop, and the joint’s range of motion becomes limited. But movement doesn’t have to cause pain. The effects of arthritis can be reduced. Talk with your doctor about developing a treatment plan to meet your needs.

Which Joints Are Affected?

Your feet pound the pavement every day. They support and propel your body as you move through life. Such constant use takes a toll. Aging, the wear and tear of daily use, and injury—these are the common causes of arthritis. Many people eventually develop some arthritis in their feet.

The Big-Toe Joint

When arthritis affects your big toe, your foot hurts when it pushes off the ground. Arthritis often appears in the big-toe joint along with a bunion (a bony bump at the side of the joint).

Rear or Midfoot Joints

When arthritis affects the rear or midfoot joints, you feel pain when you put weight on your foot. Arthritis may affect the joint where the ankle and foot meet. It may also affect other joints nearby.

Types of Arthritis

Several types of arthritis can affect the foot and ankle:

Osteoarthritis

Osteoarthritis or “wear and tear” arthritis can occur with younger individuals but most often affects those during and after middle age. When the cartilage that protects the joint bones wears away, the bones rub against each other causing pain and stiffness. Other risk factors are family history and obesity.

Rheumatoid arthritis

Rheumatoid arthritis is a chronic autoimmune disease where the immune system attacks the tissue covering the joint causing damage to the cartilage and bone. Joint deformity and disability are often the results.

Gout

Gout is a type of arthritis caused by a build-up of uric acid crystals in the big toe and other joints. Some risk factors include heavy alcohol intake, obesity and high blood pressure.

Arthritis from Trauma

Arthritis can result from trauma to the foot or ankle such as fractures and dislocations.

Arthritis Symptoms

  • Pain with motion
  • Tenderness
  • Joint swelling
  • Joint warmth
  • Difficulty walking

Treating Arthritis

If your symptoms are mild, medications may be enough to reduce pain and swelling. For more severe arthritis, surgery may be needed to improve the condition of the joint.

Physical Exam

To learn the cause of your joint problem, your doctor asks about your medical history. He or she also examines your feet for skin changes and swelling. The range of motion in any joint affected by arthritis may be tested as well. With a simple hands-on test, your doctor can find out how far a joint moves before pain occurs.

Imaging Tests

You may have an imaging test to check the condition of a joint. X-rays show damage to bone, and magnetic resonance imaging (MRI) can show damage to the joint lining. To evaluate how smoothly a joint works, your doctor may move the joint back and forth.

Medications

Your doctor may prescribe medications—pills or injections—to limit pain and swelling. Ice, aspirin, or ibuprofen may help relieve mild symptoms that occur after activity.

Surgery

To ease movement and reduce pain, your doctor may trim damaged bone. If arthritis is severe, the joint may be fused or removed.

If the bone is not damaged too badly, your doctor may simply shave away bone spurs. Any excess growth related to a bunion may also be trimmed.

Fusing Joints

If damage is more severe, your doctor may fuse the joint to prevent the bones from rubbing. Afterward, staples or screws may hold the bones in place so they heal properly. In some cases, the joint may be removed and replaced with an implant.

After Surgery

During the early stages of recovery, your foot is likely to be bandaged and immobilized for a while. For best results, follow up with your doctor as scheduled. These visits help ensure that your foot heals properly.

As You Heal

After surgery, you’ll be told how to care for your incision and how soon to begin walking on the foot. Until the foot can bear weight, you may need to walk with crutches or a cane.

For surgery on the big toe, your foot may be splinted to limit movement for several weeks. Despite this, you should be able to walk soon after surgery.

For surgery on rear or mid-foot joints, you may need to wear a cast or surgical shoe. These joints are fairly large, so full recovery may take a few months. Once the bone has healed, any staples or screws may be removed.

Conclusion

There is no cure for arthritis, but once we have confirmed our diagnosis we can help you manage your arthritis to relieve your discomfort.
  • Custom-fitted orthotics can ease pain and minimize pressure on the foot.
  • Reduce excess weight to relieve joint stress.
  • Switch to low-impact exercise like swimming or biking.
  • Physical therapy can increase range of motion, flexibility and muscle strength.
  • Take anti-inflammatory medication to relieve inflammation.
If these conservative measures do not help, we will discuss surgery on the joint with you.

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