The osteoarthritic foot
ARTHRITIS is a generic term for a group of more than 100 diseases that speak to joint inflammation.
The condition causes pain, swelling and stiffness in joints around the body. There can be instances where it can be a completely pain-free illness, but more commonly, it is a painful one resulting in limited motion, loss of joint function and deformity of the affected joints.
OSTEOARTHRITIS
Osteoarthritis is the most common type of arthritis. This is a ‘wear and tear’ degenerative condition that tends to occur as people get older.
Generally, people gain weight with age and therefore put pressure on joints. The muscles get weaker and the body loses its ability to heal itself.
Repetitive use of joints, inflammation and joint injury cause a breakdown in the cartilage that lines the joints and lead to the development of osteoarthritis. In most cases the process is slow, over a period of years, but there are exceptions. People who do a lot of sporting activities are particularly prone due to overuse.
Osteoarthritis may develop as a result of abnormal foot mechanics, such as a high arch or flat feet, which upset the correct movements of joints.
There are 28 bones in the foot and more than 30 joints. The most common joints affected are in the big toe, the mid-ankle or mid-tarsal joint, and the joint that forms where the ankle meets the shin bone.
SYMPTOMS AND DIAGNOSIS
The symptoms of osteoarthritis are: pain, swelling, stiffness in the joint. There is reduced movement in the joint, especially on weight-bearing. There is also increased pain in damp and cold weather.
Diagnosis for osteoarthritis is made on the medical history, clinical presentation, X-rays, and magnetic resonance imaging (MRI) scanning.
TREATMENT
1. Oral medication: Non-steroidal anti-inflammatory drugs, for example ibuprofen, can help reduce pain. Prescription steroids are occasionally prescribed in severe cases.
2. Steroid injections: These can be directed to the affected joint.
3. Anti-inflammatory gels and creams, for example Voltaren.
4. Orthotics: Foot-support devices can be placed in shoes to realign the foot and reduce pain.
5. Weight loss where indicated.
6. Canes, braces and elastic strapping for support.
7. Immobilisation: Wearing a removable cast may allow inflammation to resolve.
8. Surgery: In extreme cases, where non-surgical intervention has not worked, joint fusion may be suggested by your doctor. Joint replacement in the foot is rare but can be carried out.
MANAGING THE OSTEOARTHRITIC FOOT
Wear supportive shoes with cushioning soles. Make sure they are the shape of your foot and roomy.
Exercising and stretching can help to strengthen your feet and maintain flexibility. Swimming is a great form of exercise as it reduces pressure on your joints. Yoga is another good way of exercising and stretching the joints.
Maintain a healthy diet rich in antioxidants, fruits, vegetables, and water.
Angela Davis BSc (Hons) DPodM MChS is a podiatrist with offices in Montego Bay (293-7119), Mandeville (962-2100), Ocho Rios (974-6339), Kingston (978-8392), and Savanna-la-Mar (955-3154). She is a member of the Health and Care Professions Council in the United Kingdom.