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Arthritis of the foot

What is arthritis of the foot?

There are multiple types of arthritis that might affect your feet. The most common type of arthritis is osteoarthritis, which is often described as “wear and tear” arthritis. This can affect anyone at any age, but it’s most common in people over 45. Osteoarthritis can affect any joint throughout the body, but more commonly it is the larger joints such as your shoulders, hips and knees that are affected. This is due to the increased amount of stress which is applied through these joints during day-to-day life.

The same applies to the joints in your feet, which carry the weight of your body every day. Osteoarthritis can occur in one or multiple joints in the foot and ankle, and gradually develops as the cartilage at the joint begins to degenerate (wear and tear) and the joint space becomes narrowed. This causes the pain and stiffness we associate with osteoarthritis.

What causes arthritis in feet?

Osteoarthritis develops as a result of gradual wear and tear of the protective cartilage that surrounds the end of a bone where it forms a joint. As the cartilage wears away, the joint space becomes narrowed, which causes the joint to become restricted and painful. Some reasons you may develop osteoarthritis include:

  • Secondary arthritis – from a previous injury or medical conditions that affect the joints e.g., fractures, joint injuries, gout, rheumatoid arthritis.
  • Foot anatomy or altered foot mechanics – varying anatomical alignment or how your feet move and functions can increase your risk of developing OA.
  • Being overweight or obese – this will increase strain on your joints
  • Genetics – you may inherit a predisposition towards developing osteoarthritis, but this doesn’t mean you’ll definitely get it. It also doesn’t guarantee that those who aren’t genetically predisposed towards osteoarthritis won’t develop the condition.
  • Lifestyle – if you lead a highly active lifestyle or work in a demanding job which means you are on your feet for long hours every day, you may be at greater risk of arthritis.
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What are the symptoms of arthritis of the foot?

Symptoms of osteoarthritis gradually develop over time as the condition advances. Symptoms can include:

  • Pain and stiffness in the joint – for some people this may feel worse first thing in the morning (up to 30 minutes) or in cold, damp weather conditions.
  • Heat, redness or swelling around the joint – this may be worse at the end of the day or after excessive use of the feet.
  • The affected joints may appear more prominent or enlarged.
  • Bone protrusions or growths which may form on top of the affected joints.
  • Difficulty or altered walking due to pain and/or stiffness in the affected joints.

What are the arthritis of the foot treatment options?

There are multiple treatment options for osteoarthritis. Conservative (non-surgical) treatment is usually advised first but if this fails to alleviate your pain then surgery may be the next suggestion. 

Conservative treatment:

There are many steps you can take to help manage the symptoms of osteoarthritis:

Do ✓

  • Make footwear changes: switching to a sturdy, supportive shoe with secure fastenings, such as a firm running style trainer or walking shoes/boots will help to reduce movement and stresses throughout the foot, which in turn will help to reduce pain.
  • Use over the counter painkillers, such as paracetamol or ibuprofen, to help relieve pain and inflammation.
  • Trial hot and cold therapies: heat can help to alleviate stiffness and cold can help to alleviate swelling.
  • Wear compression garments such as foot or ankle supports which can help to restrict excess movement through the painful joints and support the feet.
  • Wear supportive insoles: adding a supportive insole into your shoes, such as ZeroSole Contour, can help further reduce stress (and pain) at the arthritic joint(s).
  • Strengthen and stretch the muscles in your feet and ankles to help support and stabilise the arthritic joint(s) in your feet. Your GP or a podiatrist can guide you on what exercises are best suited for you.

 

Don’t X

  • Avoid use of soft, flexible shoes or high heels as this will increase stress and pain through the joints in the midfoot and forefoot. 
  • Where possible, try to avoid especially cold or damp weather conditions. 
  • Try to avoid activities or exercise which aggravate your pain – instead try low impact alternatives such as swimming or cycling.

Other types of arthritis of the foot treatment?

Steroid injection

Cortical steroid injection (CSI) therapy would be one of the first options if pain persists following the above treatment. A steroid is injected around the arthritic joint to help reduce inflammation. Pain relief is generally temporary and the duration of relief can vary significantly from person to person. General risks include infection, bleeding, losing the colour in that area of skin, damage to the skin, post injection flare-up and a weaker immune system up to one month following the injection. 

Surgery

There are different types of procedures that can be performed depending on your condition. This usually involves (1) removing any bony growths/protrusions extending from the arthritic joint or (2) fusing the joint with plates and screws. There are multiple risks associated with surgery including infection, scar sensitivity, ongoing or worsening of pain and other general risks which will be discussed with you by your surgeon. 

When to see your GP

Organise a visit to see your GP or podiatrist if your foot pain persists for more than 3 weeks after following the above steps. They can advise of further steps you can take to manage the condition, or refer you to a specialist podiatrist for further management. 

Other types of arthritis

In addition to “wear and tear” osteoarthritis, which affects most of us as we get older, there are many other types of arthritis which can affect the feet, such as rheumatoid arthritis, psoriatic arthritis, and other inflammatory arthropathies.

Rheumatoid arthritis and inflammatory arthropathies are completely different to osteoarthritis. These are autoimmune conditions whereby the immune system, which usually protects us from infections, starts to attack the joints and cause pain, stiffness and swelling.

Rheumatoid arthritis tends to affect the smaller joints, such as in your fingers and toes, which may make gripping objects more difficult. Symptoms may be worse in the morning and improve throughout the day, and the condition may develop from a younger age compared to osteoarthritis. In some cases, you may feel more tired than usual or suffer from a low mood.

If left untreated, rheumatoid arthritis and other inflammatory arthropathies may cause significant joint damage, deformity and long-term pain and disability. Flare ups of the condition can be managed by certain medications which suppress the body’s immune system, reducing the immune system’s ability to attack the joints. 

If you suspect that you may be experiencing any of the signs and symptoms of rheumatoid or inflammatory arthritis, it is important that you discuss this with your GP as soon as possible, as early diagnosis and treatment is important to prevent joint damage and disability. The GP may organise specific blood tests and refer you to a Consultant Rheumatologist who will be able to monitor your condition and devise a long-term treatment plan for you.

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