Arthritis is musculoskeletal disorder, which affects the joints, resulting in pain, stiffness and inflammation of the joints. Arthritis is a major cause of foot pain because each foot has 33 joints that can become affected by the disease. The condition does not only affect the elderly, it can affect people of all ages. Arthritis will affect the joint by damaging the bones and cartilage, this in turn can lead to muscle weakness, therefore leading to joint instability. Patient suffering from arthritis may notice gradual change in the shape of the joint and this can lead to deformities.
Arthritis is not a single disease there are many different forms of the condition, however the two most common forms of arthritis are osteoarthritis and rheumatoid arthritis.
The most common type is called osteoarthritis and it develops gradually over time. It occurs when the cartilage between bones has become worn and is no longer cushioning the joint. Movement then becomes very difficult and painful. The pain and swelling is worse while standing or walking and stiffness in joints occur after a period of rest.
Osteoarthritis affects the joints that have been under pressure and is common in the feet. Any of the joints in the feet can be affected but the big toe joint is most commonly affected. Osteoarthritis is less common in the ankle. Many people notice changes in the shape of the arch of their feet as they get older and mild arthritis in the arch area is common.
Some people are genetically predisposed to developing arthritis. Other factors that can increase the risk of developing arthritis include being overweight, which puts extra strain on the joints of the foot, activities that involve repetitive movements of a certain joint, and previous damage to the joint, such as an injury.
Podiatry treatment – Patients who have been diagnosed with osteoarthritis and are receiving medical care may also benefit from podiatry treatment if it is appropriate. A podiatrist can treat any corns or callous formation that develop over bony prominences. Orthoses can be provided which can help the foot to function more efficiently and reduce pressure over certain ‘at risk’ areas. Cushioning insoles can provide comfort for the affected joints. Advice regarding the most suitable footwear can also be suggested and referral for specialized footwear may be appropriate in some cases.
Gout is another form of arthritis that also leads to foot pain. It is a metabolic disorder and results in the formation of Uric Acid crystals within joints.
It is often larger joints that are affected, and in the foot the big toe joint is most affected. This is due to the stress and pressure it experiences during walking and other weight bearing activities.
A flare up of gout is extremely painful and the affected joint will often be red and swollen. Medications from GP’s include anti-inflammatories and/or longer term medication to prevent gout. Gout can often create deposits called ‘Tophus’ – whereby a chalky white substance can be seen.
Podiatry treatment – Podiatrists can help by protecting and padding affected joints, and providing wound-care to areas where tophus has led to the skin breaking down. Recurrent bouts of gout may cause arthritic change within a joint and podiatry treatment can help to manage this by using orthoses or advising on appropriate footwear.