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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

• See a podiatrist

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.