Osteoarthritis, or OA, is arthritis caused by the normal wear and tear of our joints. Unlike other forms of arthritis, which can develop even when we take excellent care of our bodies, osteoarthritis slowly develops in everyone, but the severity of condition is dictated by our activities and our age. Most people that suffer from OA begin to notice symptoms during middle age and most adults will have at least one affected joint by the age of 70.
The causes of OA are related to how much physical activity we partake in and what type of demands are placed on the joints. People who are very active in sports are more prone to this condition due to the excessive demand placed on the joints. Occupations that require bending, kneeling, squatting, or strenuous labor also have a higher incidence of OA. One of the most common factors that increase joint wear is excess body weight, which places tremendous pressure on the joint.
The wear and tear that causes this condition involves the cartilage that lines our joints. The cartilage functions as a buffer between the bones on opposing edges of our joints. When cartilage is damaged either from injury or excessive activity, the bones are allowed to rub together leading to the painful symptoms of arthritis.
Symptoms are usually pain, swelling, and stiffness in joints. Stiffness occurs after long periods of rest and pain can also worsen after long periods of activity. Common foot conditions which can lead to arthritis include chronic ankle sprains, bunions, hammertoes, and foot and ankle fractures.
Diagnosis of OA is based upon patient history of stiffness, pain, and swelling as well as the character of joint motion. You shouldn’t hear or feel cracking with movement. The presence of deformities like hammertoes and bunions can also lead to arthritis if left untreated. OA typically affects only a few joints, while pain from other arthritides usually affects multiple joints. X-rays will also be taken to evaluate the extent of joint damage.
Initial treatment for mild arthritis of the foot and ankle includes oral anti-inflammatories like Ibuprofen and Naproxen. Over-the-counter supplements like chondroitin and glucosamine can help lubricate larger joints and improve cartilage function. Appropriate shoe gear and over the counter inserts can help reduce painful motion. In more severe cases of arthritis, physical therapy may be required to loosen stiff joints and reduce pain.
Sometimes, when anti-inflammatories are not helpful, custom orthotics that control painful motion may be recommended. Acute flare-ups of arthritis can occur and sometimes an injection into the joint with a steroid (cortisone) is indicated to reduce swelling, pain, and inflammation. In severe cases special shoes or braces may be needed. When conservative measures are not helpful, sometimes surgery is indicated.
Surgery for arthrities in the foot can include:
- Arthroplasties – most common for arthritis in hammered toes. Involves removing a portion of the joint to eliminate bone on bone wear.
- Arthroplasty with implantation – implants in the foot are most commonly used at the great toe joint. This involved removing one or both sides of damaged joint and replacing with a metal or synthetic polymer to reduce pain and return to normal joint motion.
- Arthrodesis – Common for hammertoes and severe great toe joint pain. Involves fusing the affected joint to eliminate pain from motion. Saved for severe arthritis.
- Arthroscopy- Utilized primarily in the ankle. Allows surgeon to remove spurring of joints, dead devitalized cartilage, and inflamed tissue. Areas of cartilage damage can also be stimulated to begin repair by removing nonviable tissue.
- Exostectomy – literally means removal of spur. Sometimes arthritis stimulates excessive bone formation which can lead to pain if pressure occurs from toes or shoe gear.
As much as you want to say "not me!", when it comes to OA almost all of us will develop some form of this condition somewhere in our bodies if we live long enough. The painful symptoms of OA can be treated. Come see us at FAANT for an evaluation if you suffer from painful, stiff, and achy feet.