Arthritis of the foot is inflammation and swelling of the synovium, the soft tissue and lining of the joints in the foot. An increase in the fluid within the joints is usually present as well. One or both feet may be affected.
This condition can develop at any age, but is most common in people over the age of 50. Arthritis currently affects almost half of the adult population in the United States, and its prevalence is increasing:
Although arthritis is a well-known cause of joint pain, arthritis in the foot or feet may not cause symptoms. On the other hand, some people with arthritis in the feet become disabled and unable to walk.
Because the feet bear the weight of the body, it is impossible for arthritis sufferers to avoid the foot pain that accompanies load-bearing, and for this reason the feet seem more susceptible to arthritis than other parts of the body.
What Are Some Common Symptoms of Arthritis in Feet?
Common symptoms of arthritis in the feet include joint pain or tenderness, joint stiffness or reduced motion, joint swelling, and difficulty in walking.
There are 33 joints in each foot, any of which may be affected. The anatomic areas most commonly affected by arthritis are: the ankle (the tibiotalar joint), the hindfoot (including the subtalar or talocalcaneal joint, the talonavicular joint, and the calcaneocuboid joint), the midfoot (the metatarsocuneiform joint), and the great toe (in particular the first metatarsophalangeal joint, which is also where bunions usually develop).
What Causes Arthritis in Feet?
Arthritis may develop for a number of reasons and is associated with a variety of illnesses. The types of arthritis that most commonly affect the feet are:
- Osteoarthritis
- Rheumatoid arthritis
- Post-traumatic arthritis
- Gout
Osteoarthritis, the most common type of foot arthritis, is a condition in which joint cartilage is damaged as a result of wear and tear that occurs over time.
It is also known as degenerative arthritis because it progresses slowly and the associated pain and stiffness generally worsen.
Rheumatoid arthritis is an irritation of the joint lining (the synovium) that results when one’s own immune system attacks and destroys cartilage. This inflammatory disease usually affects multiple joints in the body.
Post-traumatic arthritis can develop after an injury to the foot, such as a broken bone, torn ligament, or moderate ankle sprain. It may not manifest until years after the injury, and may occur regardless of whether the joint injury was initially treated.
Diagnosing Arthritis in Feet — What to Expect at Your Doctor’s Office
To diagnosis arthritis, your doctor will ask you a series of questions about your symptoms, such as where and when the pain began, how often it occurs, and whether it is worse at night or when walking. Your doctor will also ask about past injuries to the foot, and what type of shoes you wear.
After a thorough medical history and physical examination, your doctor may perform a gait analysis, which evaluates how you walk, measures stride, and tests the strength of the ankles and feet. Additional tests may include:
- X-rays
- Bone scans
- Computed tomography (CT)
- Magnetic resonance imaging (MRI)
How is Arthritis in Feet Treated?
A diagnosis of arthritis does not necessarily mean that your quality of life will decrease. By seeking treatment early and taking an active role in the management of your arthritis, you can control the pain and limit damage to your joints.
Left untreated, however, arthritis can eventually lead to foot and ankle deformities.
A treatment regimen for arthritis in the foot or feet may include nonsurgical therapies and/or surgery. There are many nonsurgical treatment options, and they are often used in combination with one another. These can be divided into three categories:
Medical therapy
- Analgesics and nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce pain and swelling
- Nutritional supplements
- Corticosteroid injections into the joint
- Shoe inserts, such as pads or arch supports
- Custom-made shoe, such as a stiff-soled shoe with a rocker bottom
- An ankle-foot orthosis
- A brace or a cane
Physical and complementary medicine
- Physical therapy and gentle exercises
- Acupuncture or massage at and around affected joints
- Application of a heating pad or a damp, warm towel to affected joints
- Weight control
For many types of arthritis, aspirin is used as the first-line treatment, and its success or failure can help guide other therapeutic interventions. Treatment can control inflammation and preserve or restore joint function.
Surgical intervention may be considered as a last resort if the arthritis does not respond to nonsurgical interventions.
The choice of surgery depends on the type of arthritis you have, its impact on the joints, and its location. More than one surgery may be needed. Surgeries used to treat arthritis in the feet include:
- Arthroscopic debridement
- Arthrodesis or fusion
- Arthroplasty or joint replacement
After surgery there will be a period of rehabilitation, during which you may have a cast on your foot or have to wear an orthotic shoe or brace. It may be about three to four months before you are able to resume ordinary daily activities.
Arthritis Risks, and Complications That May Develop
In most cases, arthritis cannot be cured and the disease will continue to progress. Even with the best of treatment, arthritis of the foot and ankle may continue to cause you pain or require you to limit your activities.
Severe disability from arthritis is rare, however, and usually seen in persons with rheumatoid arthritis.
Frequent use of anti-inflammatory medications is known to cause gastrointestinal upset. People with rheumatoid arthritis are at higher risk for complications, such as peripheral neuropathy, infection, and skin or muscle problems.
How Can I Prevent Arthritis in My Feet?
Although it may be impossible to prevent arthritis from developing, the conditions that lead to it can be corrected. For instance, if you have osteoarthritis, correcting any faulty mechanics that lead to the joint not moving properly may prevent further joint damage.
Wearing proper footwear or custom orthotics prescribed by your podiatrist will ensure that the foot and ankle joints are properly aligned. If you have a rheumatic disease, such as gout, controlling your uric acid level can reduce the incidence of the associated arthritis.
Talking to Your Doctor
Here are some questions you may want to ask your doctor about arthritis in the foot:
- What can I do to slow progression of my arthritis?
- What other treatment options do I have?
- How will treating my arthritis limit my normal activities?
- What symptoms should I watch for that may indicate treatment is not working?
- How long should I wait to contact you again?
- What diagnostic testing should I expect during my follow-up visit?
