Arthritis of the Foot
The word arthritis, when broken down, simply means "inflammed or painful joint" ("arthro"= pain, "itis"= inflammation). There are 33 joints in each foot, and some are more likely to develop arthritis than others. There are multiple stages of arthritis, and multiple treatment options depending on the location and stage of your arthritis. Here, we will cover some the basics about arthritis of the foot. Please, follow the links throughout the page to learn more about each specific arthritic condition, and the treatment options that are available.
Stages of Arthritis:
- Mild - Isolated Inflammation and Pain. No Cartilage damage. Pain improves with rest.
- Moderate - Cartilage damage begins and worsens. Pain is more consistent and intense. Stiffness increases. Bone Spurs start to form.
- Severe (End-Stage) - Cartilage is destroyed. "Bone-On-Bone." Bone Spurs increase in attempt to limit, and eventually stop, joint motion. Pain is unbearable, leading to marked decrease in activity level.
One of the major goals of the evaluation is to identify which joints are involved and to classify the arthritis into the stage of severity. This involves identifying pain level and activity limitations, in addition to assessing range of motion. It is important to evaluate for any instability or deformity of the foot, or lower leg, that may be a cause of increased strain on the joint. Diagnostic/Therapeutic Injection can help predict the success of certain treatment options and provide temporary pain relief, that sometimes lasts for months. X-ray evaluations are routine. CT scan or MRI can be useful in staging the arthritis, and it is helpful in pre-operative planning.
Common Foot Joints That Develop Arthritis:
- Ankle Joint
- Great Toe Joint (Hallux Rigidus)
- Interphalangeal Joints
- Common in Hammertoes
- Subtalar Joint
- Talo-Navicular Joint
- Tarso-metatarsal Joints (Midfoot Arthritis)
Conditions That Can Lead To Arthritis:
- Flat Feet
- Deformities of the Foot or Ankle
- Degenerative Arthritis ("wear & tear")
- Hammertoes or Claw Toes
- History of Trauma or Fracture
- Osteochondral Defect (OCD) of Talus
- Rheumatoid Arthritis or Other Systemic Arthritis
The available treatments depend greatly on what stage of arthritis you have. It is important to remember that arthritis will get progressively worse with time, and treatment is centered around managing the symptoms and trying to prevent major activity limitations, until you reach the point where surgery is necessary.
- Mild arthritis can generally be managed with oral or topical anti-inflammatory medication, and periodic steroid injections may be beneficial. Physical therapy may also be indicated.
- Moderate arthritis usually requires periodic steroid injections for pain relief, with use of daily anti-inflammatory medication. Bracing or Ankle-Foot-Orthosis (AFO) options may be considered at this stage.
- End Stage Arthritis often requires reconstructive surgery. Surgical options include joint fusion and joint replacement. Custom AFOs can be used as a non-surgical option, but required a lifelong commitment to wearing the brace, and can be limiting to shoe options. Oral, topical, and injectable medications are used as needed to manage pain.
There are many different surgical options, many of them depend of the stage and location of arthritis you have. Desired activity level also plays a critical role in procedure selection.
Surgical Options Include:
- Bone Spur Removal (Joint "Clean-Up")
- Cartilage Repair
- Joint Fusion
- Joint Replacement (Implant)
Fusion procedures have been the "Gold Standard" treatment for many decades, when treating end-stage arthritis. These procedures have a high level of predictablity, and pain relief is quite significant. For some joints, there are options for joint replacement, or implant procedures. While not every person is a candidate for joint replacement, it can be an option that allows for elimination of pain, while maintaining some level of motion.
If you are suffering from Foot Arthritis, Call us at 512-593-2949 or CLICK HERE to Schedule an Appointment.