Arthritis is a common inflammatory condition that affects bony joints. The most common type of arthritis is Osteoarthritis (OA). It occurs when the cartilage, which acts as a cushion between the bones of the lower limb wears down over time. As the cartilage deteriorates, the bones begin to rub against each other causing pain and inflammation. While it is most common in older adults, osteoarthritis can occur in at a younger age. Other types of arthritis include psoriatic arthritis, rheumatoid arthritis and gout.
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Symptoms
The most common symptom of foot arthritis is pain, which can range from mild to severe. Depending on the affected joint, pain can be felt throughout the foot. Psoriatic and rheumatoid arthritis primarily affect the toes and cause changes in shape, alignment, and may cause swelling. Along with pain, people with foot arthritis may also experience stiffness, as well as decreased range of motion. These symptoms may be worse after sitting or standing for long periods of time, or with physical activity. Gout can be acute or chronic, but when it first presents, pain, swelling and redness of the joint are the primary indicators.
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Causes
Osteoarthritis is caused by a combination of genetic and environmental factors. With age comes the natural breakdown of the cartilage. The most common joint in the foot to be affected by OA is the big toe joint. Biomechanics plays a significant role in the development of osteoarthritis because the position of our foot joints and how they move can cause increased pressure throughout the area affected. Previous foot injuries or surgeries can cause damage to overall joint structure/cartilage, which can be another factor. Overuse of certain joints is another cause of foot osteoarthritis as the more we work our foot joints, the faster cartilage breaks down. This is why jobs that involve a lot of walking and kneeling will have higher rates of workers with foot osteoarthritis. Psoriatic and Rheumatoid arthritis are a by-product of the disease processes, and have genetic and auto-immune causal factors. Gout is primarily precipitated by diet but ultimately, is a by-product of faulty handling or producing of uric acid by the body. These crystals build up within a joint and are very painful.
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Treatment
Treatment for foot arthritis begins with non-surgical approaches, such as medication, physical therapy, weight loss, bracing/splinting, orthotics and well-fitted shoes. Physical therapy can help to reduce pain and improve function by strengthening the muscles around the joints. Weight loss is also an important aspect of treatment as it can help to reduce the pressure on the foot joints. Often a brace, splint, orthotic or shoe with a forefoot rocker may be recommended to offer support and aid in pain reduction.
