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Living With Arthritis in Your Feet

Many of you have heard the term or know someone diagnosed with Rheumatoid arthritis (RA) or Osteoarthritis (OA). Could you be suffering one of these forms of arthritis as well?

Rheumatoid arthritis is an autoimmune disease in which the lining of the joints becomes irritated and inflammed because it is being attacked by the body’s own inflammatory cells. The irritation of the joint lining causes the fluid within the joint to thicken, which in turn results in swelling, stiffness, increased warmth and pain. Over time, this process can actually cause damage to the cartilage protecting the joint as well and give you arthritis. While the incidence of this disease is seen with increasing age, it can affect any age.

Osteoarthritis, while not caused by an attack on the joints by your own body, can be as debilitating as Rheumatoid arthritis. Osteoarthritis is much more common and is what most people are referring to when they say they "suffer from arthritis." This is the normal wear and tear on our joints seen over the course of many years. Just like putting miles on your car tires cause wear and tear on the treads, the many miles we put on our "tires" cause wear and tear on our joints. And just as our car tires can eventually go bald, the joints in our feet and ankles can also go bald of their protective cartilage. Once they do, we end up with stiff, painful joints and well, Osteoarthritis.
Osteoarthritis can affect any joint, is usually asymmetrical, and can also be precipitated and sped up by any traumatic event. From the seemingly meaningless jamming of your big toe to the more severe spraining of your ankle or dropping that frozen Thanksgiving turkey on your foot; almost everyone at some point has started this joint damaging process.

The arthritis seen in Rheumatoid arthritis is usually symmetrical (in both extremities) and unrelated to trauma. While podiatrists cannot help treat the disease process itself, we are an important part of the multi-disciplinary team that can help to reduce some of the painful symptoms.

Where to begin treatment for Rheumatoid and Osteoarthritis? Well, first and foremost a thorough clinical exam and evaluation of your symptoms is needed. X-rays will need to be taken to determine how much if any joint damage is present in the foot and ankle. Based on these factors, we will be able to put you on the right course of conservative treatment.

This can include:
1. Functional orthotics. These come into play by at the very least slowing down the damage by helping to eliminate some if not all the strain of abnormal pressure from abnormal biomechanics (what the foot does when it walks). By realigning your foot to the best of its ability, the joints come into alignment better, reducing pressure points on the cartilage surfaces.
2. Anti-inflammatories. This is, after all, Rheumatoid arthritis is one big inflammatory process gone awry. Anti-inflammatories can help to calm the joints down in both Osteoarthritis and Rheumatoid arthritis and can be given orally or actually injected into the joint in the form of cortisone injections for more immediate relief.
3. Accomodative shoe gear. If you already have deformity of one or more joints in the foot and ankle then choosing an appropriate shoe can play a big role in providing comfort to those aching joints. Our Healthy Steps DFW offers a full array of shoes to help accommodate your feet and your orthotics with a Certified Pedorthist focusing on the proper shoe and orthotic fit for your feet.
4. Physical Therapy. Strengthening exercises, manipulation, active and range of motion, ultrasound, are some of the many modalities physical therapists use to reduce stiffness and discomfort.

In the most extreme cases, when conservative therapies fail, surgical intervention may be warranted. Your best chances in avoiding this is to seek treatment at the onset of symptoms.