Arthritis In Feet:
Treatment is Available

But it's precisely because of the job the feet must handle that makes them susceptible to arthritis in feet.

The joints that can experience arthritis include the ankle, three joints in the hindfoot, the joints in the midfoot where the hindfoot connects to the toe forefront bones, and the big toe joint. Just the list of joints tells you how complicated the foot design is, and it is understandable why so many people have problems with their feet.

Whatever type of arthritis develops in any of the joints, the pain that ensues can make you try to compensate by changing your walk or how you balance on your foot. Sometimes this attempt to relieve the pain can lead to other joint problems because of the weight shifting. It's important to pursue treatments for the pain to relieve as much of it as possible so normal walking can be resumed.

Some arthritis in feet can occur at the ankle joint, however this is much less often than other joints in the body. When patients have ankle arthritis, they have worn out the joint between the shin bone (tibia) and ankle bone (talus), also called the tibiotalar joint.

What causes ankle arthritis?

Common factors that lead to arthritis in feet include:

• Previous ankle injury
  Ankle arthritis is most commonly the result of a prior injury to the ankle joint. In patients who sustain an injury such as an ankle fracture, the cartilage may be damaged and lead to accelerated arthritis.

When the ankle is injured, it is also susceptible to an injury called osteonecrosis. When osteonecrosis occurs as the result of an ankle injury, a portion of the bone has damage to its blood flow. Osteonecrosis can also lead to ankle arthritis.

• Rheumatoid arthritis
  Patients with rheumatoid disease can have ankle arthritis. Rheumatoid disease causes joint inflammation and damage to the cartilage. Over time, this can lead to significant problems, necessitating treatment.

• Infection
  Infections of a joint can lead to damage of the cartilage cells. Because cartilage cells cannot regrow, the damage from an infection can last permanently.

• Genetics
  The effect of genetics on the development of arthritis is not well understood, but we do know that some people have a genetic tendency to wear out joints faster than others.

• Body weight
  Patients who are overweight place a larger burden on their hips, knees, ankles, and feet. These patients have more of a tendency to develop some form of arthritis in feet, and often have more accelerated damage to the joint cartilage.

There are many treatment options for painful arthritis found in the foot or feet. The symptoms of the arthritis in feet may include stiffness and swelling in addition to the pain. Treatments focus on reducing the swelling, which can relieve the stiffness while also reducing pain.

Arthritis treatments can vary from taking pain relievers, purchased at the local drugstore, to surgery when the arthritis is advanced.

Nonsurgical treatments include the following:

• Anti-inflammatory medication
• Pain relieving medication
• Physical therapy
• Exercises
• Weight loss (if overweight or obese)
• Steroid injection

If you have arthritis in your foot and are experiencing pain, walking can be difficult so using a brace or cane may help relieve some of the pressure in the joints. You will notice that weight loss is on the list because being overweight creates a lot of joint stress in the feet.

Ankle arthritis can usually be easily diagnosed with an examination and X-ray. Once patients are diagnosed with ankle arthritis, nonoperative treatments should be attempted. Most patients can find relief through steps including activity modification and changes in their footwear.

What treatments are available for ankle arthritis?
Treatment of ankle arthritis should always begin with simple steps including:

• Footwear Changes
  One of the simplest steps to take is to try some shoe modifications. Cushioned inserts can help alleviate symptoms. Another helpful step is to have a shoe repair specialist add a 'rocker-bottom' to the sole of the shoe.
• Activity Modifications
  Activity modification is an important part of treatment, and patients unwilling to change their lifestyle generally should not consider surgical treatments for ankle arthritis. Patients should try to limit impact activities including running and jumping.
• Braces
  A brace can be fabricated to help hold the ankle joint in position. These braces, called ankle-foot-orthoses or AFOs, will support the joint and prevent excessive motion.
• Anti-Inflammatory Medications
  Anti-inflammatory medications can be helpful in patients with moderate symptoms of ankle arthritis. Patients should use anti-inflammatory medications carefully as there are possible side effects, especially with longer-term use of these medications.
• Cortisone Injections
  Cortisone injections can be extremely helpful in the management of ankle arthritis, especially in an acute flare up of pain. While cortisone injections cannot be performed regularly, the occasional cortisone shot is helpful in most patients with ankle arthritis.

If these treatments can't alleviate ankle arthritis pain, then more invasive treatments may be considered.

Surgical treatments are as follows:

• Arthroscopy debridement
• Joint fusion
• Arthroplasty (joint replacement)

Arthroscopy
often works well when arthritis in feet is discovered in the early stages. This is a procedure where a tiny camera is inserted through an incision a surgeon makes. The doctor trims bone spurs or inflamed tissue to relieve inflammation and pain.

Joint Fusion Surgery
Ankle fusion surgery is the standard treatment for advanced ankle arthritis. This surgery removes the worn out portion of the joint, and then permanently holds the bones in a solid position.

Ankle Replacement Surgery
Replacement surgery is a more controversial treatment for ankle arthritis. The success of fusion surgery is under debate, and there is not too much experience with replacement surgery for ankle arthritis. As more of these procedures are being performed, the implant design is being improved. This will likely lead to better results.

So arthritis in feet can be either rheumatoid arthritis or osteoarthritis. Both are painful and both can limit your activities. Fortunately there are many ways to treat the arthritis so you can resume your lifestyle.









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