Arthritis
Joints are formed by two bones which are held close together by
ligaments and an outer covering known as the joint capsule. In
order for the joints to move freely and without pain, the ends of
the bones are covered in a softer material called cartilage and the
lining of the joint capsule produces an oily fluid called synovial
fluid.
In arthritis, the cartilage starts to crack and erode, resulting
in bone rubbing on bone. As this is painful, extra bone is laid
down at the edges of the joint to try and stop movement and thus
symptoms. This is why arthritic joints are often enlarged.
Arthritis can affect any of the joints in the foot although some
more commonly (e.g. big toe joint, ankle joint).
What causes arthritis?
Generally this is due to trauma/injury. Whilst this can be one
single event, it can occur over time with low-grade irritation.
Most people develop a degree of arthritis at some stage in their
life.
There are some conditions (e.g. rheumatoid arthritis, gout)
which predispose to arthritis in the joints. These diseases have
genetic and inflammatory components and often have specific
patterns of arthritis.
Will it get worse?
Arthritis is a progressive condition and will get worse with
time. As a result, the joints will become stiffer and more
prominent / enlarged. Although the degree of pain is generally
related to the extent of arthritis, it does not always get more
painful with time.
What are the common symptoms?
- Stiffness in the joint
- Pain
- Redness around the joint
- Swelling around the joint
- Difficulty in shoes
- Difficulty in walking
- Associated deformity
How is it recognised?
Clinical examination and a detailed history allow diagnosis.
X-rays help to evaluate the degree or type of arthritis within the
joint. Sometimes, more sophisticated scans are required.
What can I do to reduce the pain?
There are several things that you can do to try and relieve your
symptoms:
- Perform exercises to keep the joint mobile
- Rest the joint when if it becomes more painful
- Wear good fitting shoes
- Avoid high heels
- Wear protective pads
- Pain killers can help to relieve discomfort but should not be
taken long term without
seeking professional advice
What will a podiatrist do?
If simple measures do not reduce your symptoms, there are other
options:
- Advise appropriate shoes
- Advise exercises
- Consider prescribing orthotics /splints
- Administer a cortisone injection when appropriate
- Administer a hyaluronic acid injection when appropriate
- Recommend physiotherapy when appropriate
- Advise on surgery
Will this cure the problem?
No. Arthritis is a progressive condition and whilst treatment
and surgery may help to relieve symptoms and slow progression, the
damage that is already done cannot be reversed.
What will happen if I leave this alone?
The arthritis will progress and your symptoms may get worse.
However, the degree of discomfort can settle with time although it
is likely that you will have periods when the discomfort is
worse.
How can I cure any associated deformity?
Surgery is required to correct any associated deformity and
reduce stress to the arthritic joints. The nature of the surgery is
dependent upon the deformity and is described in the related
conditions.