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Ryan M. Putnam, MD
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Arthritis of the Foot and Ankle
The pain and stiffness you feel in your feet and ankles as you grow older could be arthritis. If left untreated, this nagging pain can grow worse, eventually becoming so excruciating that you can no longer walk even short distances. Severe arthritis can restrict your mobility and limit your quality of life, but with proper treatment, you can slow the development of arthritis and lead a more productive life.
What is Arthritis?
Arthritis is a broad term for a number of conditions that destroy the workings of a normal joint.
Arthritis may occur in your back, neck, hips, knees, shoulders or hands, but it also occurs in your feet and ankles. Almost half of people in their 60s and 70s have arthritis of the foot and/or ankle that may not cause symptoms.
There are many different types of arthritis. The most common type, osteoarthritis (OSS-tee-oh-ar-THRI-tiss), results from the "wear and tear" damage to joint cartilage (the soft tissue between joint bones) that comes with age. The result is inflammation, redness, swelling and pain in the joint.
Also, a sudden and traumatic injury such as a broken bone, torn ligament or moderate ankle sprain can cause the injured joint to become arthritic in the future. Sometimes a traumatic injury will result in arthritis in the injured joint even though the joint received proper medical care at the time of injury.
Another common type, rheumatoid arthritis, is an inflammatory condition caused by an irritation of the joint lining (the synovium). People with rheumatoid arthritis for at least 10 years almost always develop arthritis in some part of the foot or ankle.
Other types of inflammatory arthritis include gout, lupus, ankylosing spondylitis and psoriatic arthritis.
The foot has 26 bones and more than 30 joints. Tough bands of tissue called ligaments hold these together. The muscles, tendons and ligaments work together with the many joints of the foot to control motion. This smooth motion makes it possible for a person to walk well. When you get arthritis in the foot, you develop pain and limited motion so that you cannot walk as well.
Treatment of Arthritis of the Foot and Ankle
Proper treatment of foot and ankle arthritis addresses both pain and joint deformity. Pain develops when the joint is injured. Injury to the joint may result from swelling caused by inflammatory arthritis or from the loss of joint surface (cartilage), often caused by trauma. If left untreated, the foot and ankle may eventually become deformed.
If your doctor suspects you have arthritis of the foot and ankle, he/she will ask you to have a complete medical history and physical examination. X-rays and laboratory tests often can confirm the type and extent of the arthritis. Other tests such as a bone scan, computed tomography (CT) scan or magnetic resonance imaging (MRI) may be used to evaluate your condition.
Once your doctor confirms you have arthritis, he/she will recommend a treatment regimen which may include medications by mouth (anti-inflammatories), injections (steroids), physical therapy, weight loss, or orthotics such as pads in your shoes or custom-made braces. Surgery may be necessary. This may mean cleaning the arthritic joint, eliminating the painful motion of the joint, replacing the joint with an artificial joint or a combination of all these.
After surgery, you will require a period of rehabilitation when your foot might have to be in a cast and you might have to wear special shoes or braces for a while.
Who Will Care for You?
Orthopaedic surgeons, medical doctors who specialize in the nonsurgical and surgical care of foot and ankle problems, can diagnose and treat your arthritis. In addition to your orthopaedic surgeon, other health care professionals may care for you, including a rheumatologist (medical arthritis specialist), physiatrist (rehabilitation specialist), pedorthist (footwear specialist), physical therapist, orthotist (brace specialist), occupational therapist, nurse and/or clinical social worker.
Community resources also are available to people with arthritis. Local chapters of the Arthritis Foundation offer exercise programs, educational information and support groups.
You Are An Important Part of the Treatment
You are often told you must live with arthritis, but that does not mean that you have to stop living. You should take an active part in your treatment. Seek treatment for arthritis as early as possible to help control pain and reduce damage to joints. Take medications as directed, exercise, control your weight and participate in all aspects of your care.
Remember, if you have questions about the need for a test, or the risks or benefits of your treatment, ask your doctor. Even with the best of treatment, arthritis of the foot and ankle may continue to cause you pain or changes in your activities. However, proper diagnosis and treatment will help to minimize these limitations and allow you to lead a productive, active lifestyle.
The American Orthopaedic Foot & Ankle Society (AOFAS) , https://footcaremd.org/conditions-treatments#conditions
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