Arthritis in the Foot

Arthritis is a general term for inflammation around a joint resulting from any cause. Rheumatoid arthritis, gout and osteoarthritis are more commonly known types of arthritis, however there are many other types of arthritis. The bones in the joint along with the soft tissues around the joints such as cartilage, joint capsule, ligaments and tendons become inflamed and painful. The cause of this joint inflammation can be due to injury, the ageing process, or overuse trauma from occupational or sporting activities. Certain types of arthritis are caused by abnormal metabolic processes in the body. You can inherit certain types of arthritis from one your parents or grandparents. Whatever the cause of your arthritis it can be disfiguring, degenerative, painful and inflammatory.

Osteoarthritis

Osteoarthritis (OA) is caused by wear and tear over a life time. This is a progressive degenerative disease. Women are affected more than men. OA is caused by a thinning of the cartilage covering the bone ends in the joint. This is an on going process until you start to notice the feeling of your bones rubbing together. This causes stiffness and pain.

Osteopathic foot manipulations are useful in freeing up motion in a stiff osteoarthritic joint. The mid-foot joints control the motion of the joints in the front of the foot. When the stiffness is released in the mid-foot joints there is a noticeable difference in the ability to bend the toes in the ball of the foot and walk more freely. Exercises that promote muscle flexibility will help to keep joints from becoming stiff. Gentle passive range of motion exercises will help to keep your foot joints free of stiffness. Custom foot orthotics can help to prevent joints from being stressed due to excessive motion.

Rheumatoid Arthritis

Rheumatoid arthritis (RA) is a common type of arthritis that occurs more frequently in women as compared to men. The cause of RA is thought to be auto- immune. This disease process causes the body’s own immune system to attack the soft tissues around the joint. The synovial tissues around the joint are attacked resulting in bone destruction and a loss of joint lubrication. The synovial tissues produce lubrication for the joint. The result is the joint becomes stiff and very painful and inflamed. This creates limited mobility and movement especially if this occurs in the foot joints.

The medical goal of RA treatment is to minimize the disease process and reduce the inflammation in and around the joint. Your family physician may prescribe either oral medications that modify the disease process, or oral corticosteroids and most likely oral anti inflammatories. Physical therapy is indicated to keep joints moving as well as protected from abnormal stresses. Surgery in the foot is sometimes required to realign disfigured painful feet.
Your chiropodist/podiatrist will discuss preventive measures such as accommodative custom foot orthotics and orthopedic footwear that will help to keep the foot stable and reduce the stresses applied to the foot joints. The goal of a custom foot orthotic is to position the foot to create less stress and reduce pain. Footwear needs to address the hypersensitivity of the rheumatoid foot. Painful and sensitive toes need soft leather shoe uppers and extra depth to accommodate crooked toes. The shoe must have extra cushioning to accommodate the loss of fibro fatty padding under the foot. The loss of fibro fatty padding under the ball of the foot feels like you are walking on your bones. If you have arthritis in your hands it may be more convenient if the your footwear has Velcro® straps instead of laces and a wide opening to easily get you foot in and out of the shoe.

Gout

Gout is a frequently mentioned disease in historical texts including the bible. Gouty arthritis is caused by a build up of uric acid crystals in the fluid of the joint spaces and tissues throughout the body. Uric acid is a breakdown product that forms after the body digests and metabolizes the food s we eat. Some people inherit an abnormality in the body’s ability to process uric acid. The inability by the body to handle uric acid will lead to painful gouty attacks in the joints and elsewhere in the body.

Gouty arthritis results in an extremely painful attack with a rapid onset of joint inflammation. The joint becomes very hot, very red and very painful to any pressure including light touch. The big toe joint is one of the most common areas in the foot affected by gouty arthritis. Over time, the attacks of gout typically occur more frequently. Therefore, gout can become a chronic recurrent problem. Chronic gout can also cause hard lumps of uric acid deposits in the tissues. This can cause joint destruction to occur.
Gout can also be a cause of heel pain.