Most Americans are familiar with Arthritis, but what many do not know is that it is the primary source of disability in the nation. Of course, this is partially due to the fact that the term, “arthritis”, refers not to a specific illness but rather to a broad range joint pain conditions (the term itself actually means “pain within a joint”). Arthritis is found in people of all ages, and so far there is no cure.
But while no cure currently exists, there is still a wide variety of treatments to help ease its symptoms. The key here is seeking treatment as early as possible, preferably before symptoms become too debilitating. When keeping up with the proper treatments, it becomes possible for those afflicted to maintain active lives, control their pain levels and move better. Surgery is often not necessary.
When it comes to your feet and ankles, there are three main types of arthritis known to occur:
This is a particularly degenerative form of arthritis that most commonly affects people of middle age or older. Also called “wear and tear arthritis”, osteoarthritis is the result of cartilage between the bones gradually becoming worn down over time. This process takes years, but it eventually results in frayed cartilage and can cause inflammation and pain. Joints can also become stiff and immobile as a result.
This is a more severe form of arthritis that can affect other parts of the body instead of being centered only in certain joints. Rheumatoid arthritis involves a person’s immune system attacking and wearing down the cartilage in their body. It is an inflammatory condition, and the sooner a patient seeks treatment, the better.
As its name suggests, post-traumatic arthritis occurs after some kind of injury or trauma. For instance, a person can fracture or sprain (anything that injures the bone, cartilage, and/or ligaments) their ankle during a fall, and over time this can develop into a form of arthritis that resembles osteoarthritis. In fact, it may first be diagnosed as osteoarthritis before the injury is recognized.
Anatomy of the Foot
The human foot has over 30 joints and a total of 28 bones — all held together by strong fibrous tissue, otherwise known as “ligaments”. Joints in the foot affected by arthritis in turn take a toll on the person’s ability to walk and stay balanced.
Joints Most Commonly Affected by Foot and Ankle Arthritis
The Tibiotalar Joint
Better known as the “ankle”, the tibiotalar joint is where the tibia of the leg (the shinbone) meets the talus, or rather, the foot’s uppermost bone.
The Hindfoot joints
There are three of these joints:
- Talonavicular — where the talus (uppermost bone of the foot) meets the navicular, or the bone of the inner midfoot
- Calcaneocuboid — where the cuboid (the bone of the outer midfoot) connects with the heel
- Subtalar or “talocalcaneal” — where the heel meets the bottom of the talus
The Metatarsocunieform Joint
Known more simply as the “midfoot”, this joint is where the metatarsals (bones of the forefoot) connects with the cuneiforms (the notably smaller bones in the middle of the foot).
First Metatarsophalangeal Joint
Most people know this as their big toe, as well as the place on the foot most prone to bunions. This joint is where the big toe bone connects with the first metatarsal.
Symptoms of foot and ankle arthritis can be difficult to narrow down since they vary greatly, (largely depending on the affected joint). Generally speaking though, they include the following:
- Pain, soreness, or tenderness
- Reduced mobility or stiffness
- Finding walking or normal foot/ankle movement difficult
Depending on the form of arthritis and its severity, there are numerous non-surgical treatment options for foot and ankle arthritic conditions:
- Orthotics to wear in shoes for arch support and extra cushion
- Medications (both prescription and over-the-counter) to reduce pain and swelling
- Steroids and other such medications injected directly into the joint for relief
- Regular stretching and special exercises or physical therapy
- Custom-designed shoes for easier mobility
- A device to support the ankle and/or foot (Also known as Ankle Foot Orthosis or “AFO”)
- A cane or walking brace for more advanced conditions
- Healthy diet and weight control (weight loss reduces pressure on joints)
While it’s always best to try various non-surgical options first, surgery is of course another option. However, both the decision to do a surgical procedure and what kind will rely on the arthritis type, the severity of the condition and its precise location in the foot/ankle. If the condition cannot be improved with just one procedure, sometimes more will be necessary.
The types of surgery for arthritis of the ankle and/or foot are as follows:
Arthrodesis or Fusion
This procedure fuses the joint bones together so that they form one whole bone. Anything from plates, rods, pins, or screws is used to hold the joint bones together while they fuse. While this procedure has a high success rate, the risk remains that arthritis can sometimes develop next to the fused bones.
Best for early arthritic stages, this procedure involves an arthroscope (a small and flexible fiberoptic instrument) being put inside the joint so that a surgeon can see precisely what the problem is. The surgeon then watches the inside of the joint through a connected TV screen as they use additional instruments to clean the joint and make repairs.
Should there be bone loss as a result of arthritis, an arthroplasty can be done to replace it. In this procedure, a piece of healthy bone (usually taken from the patient’s leg bone or pelvis) is grafted on to the affected area. While a small percentage of people treated with arthroplasty experience healing issues, the procedure is, overall, very successful.
Depending on the type of procedure performed and the condition of the patient, complete recovery from surgery can take up to four or even nine months. While it should be considered a last resort, most patients who undergo surgery find that their arthritis becomes more manageable as a result. Pain is lessened, and it becomes easier to engage in everyday life.