Foot Arthritis

Three types of arthritis affect the foot and the ankle. They are rheumatoid arthritis, post-traumatic arthritis, and osteoarthritis.

Rheumatoid arthritis: This disorder often begins in the ankle and the foot. Rheumatoid arthritis is a chronic disorder and many joints in the body are affected simultaneously. Rheumatoid arthritis is symmetrical – the implication being that it affects the same joint on both sides of the body.

Rheumatoid arthritis is also an auto-immune disorder, meaning the immune system attacks its own tissues. Rheumatoid arthritis occurs when the synovium (protective membrane) that covers the joints are attacked by our white blood cells. This causes the synovium to swell. With time, the cartilage and bone become damaged, as do tendons and ligaments. This results in deformity to the joints and ultimately, disability.

We still do not fully understand what causes rheumatoid arthritis. Studies have shown that rheumatoid arthritis is not inherited, but researchers are of the opinion that some people may have genes that make them more susceptible to the disorder. Studies have also shown Rheumatoid arthritis is dormant in the carrier's genes and certain environmental factors or infections are necessary activate the genes. Once an individual has been exposed to these factors the immune system will begin to attack the joints.

Post-traumatic arthritis: Post-traumatic arthritis occurs after the ankle or the foot has been injured. Examples of injuries that can lead to post-traumatic arthritis include fractures and dislocations – especially those that cause damage to the surface of the joint. Post-traumatic arthritis causes wearing away of the cartilage between the joints. One thing to note is that this condition can develop many years after the injury may have occurred.

Persons with injuries to the joint are at a higher risk of those joints becoming arthritic than those with uninjured joints because after sustaining an injury, the body begins to release hormones that trigger the death of cartilage cells.

Osteoarthritis: Also known as Wear-and-Tear arthritis, Osteoarthritis occurs mainly in middle age though younger people may also develop it.

Osteoarthritis is characterized by a gradual wearing away of the cartilage. As the cartilage wears down, it becomes rough and frayed. The protective space that lies between the bones begins to lessen causing friction and pain when they rub against each other.

Risk factors for osteoarthritis include age, family history, and obesity.

Osteoarthritis is not an acute process, meaning it develops slowly, and stiffness and pain become worse over time.

Arthritis is accompanied by several symptoms. Arthritic symptoms vary depending on the joint that is affected. Symptoms that signify the onset of arthritis include:

• Pain occurring during motion
• Pain that becomes very serious when the individual engages in strenuous and vigorous activity.
• Tenderness of the joints
• Redness, warmth, and swelling of the joint.
• Increased swelling and pain especially in the mornings, after resting or sitting.
• Difficulty in walking due to the above-mentioned symptoms.

There is no cure for arthritis. However, pain can be managed and disability prevented.

Non-surgical treatment: The first line of treatment is usually non-surgical. A foot and ankle specialist will recommend treatment based on the severity of the condition.

Lifestyle modifications: In some cases, the patient may have to adopt some lifestyle changes to help bring down the pain and also stop the disease from progressing. Such lifestyle modifications include:

• Disengaging oneself from activities that stress the joints, subsequently aggravating the condition.
• Taking part in less-stressful, low-impact activities like cycling or swimming, rather than strenuous activities like tennis or jogging. Doing so will reduce the stress on the ankle and the foot.
• For those who are obese, engage in weight loss programs. Losing weight will cause a drastic decrease in stress on the joints, thus reducing pain.

Physical therapy: Taking part in certain exercises can add more strength to your ankle and foot muscles. It also increases flexibility and range of motion. Family Foot and Ankle Specialist of Wyandotte and Southfield will create a personal exercise program for you, one that suits your lifestyle and needs.

Assistive devices: The purpose of using assistive devices is to improve mobility. Examples include cane or an ankle-foot orthosis. You can also wear shoe inserts or shoes that have rocker bottoms and stiff soles. These help to reduce the pressure on the foot and also reduce pain. If you have suffered some deformity, then the shoe insert will reduce the pain in the joint by tilting the foot to a straight position.

Medications: The Family Foot and Ankle Specialist of Wyandotte and Southfield will discuss the best arthritis pain treatment option for you.

Surgical Treatment: Surgery is recommended in the event of disability or when non-surgical treatment proves ineffective. There are many kinds of surgery. The kind recommended depends on the severity of the condition, and which joint(s) are affected. At times, there may be a need for more than one surgery.

Arthroscopic debridement: This type of surgery used during the early stage of the disorder. It is a very important arthritis pain treatment option. Debridement means cleansing. It involves removal of loose cartilage, synovial tissue that has been inflamed, and bone spurs from the joint region.

An arthroscopy procedure involves the insertion of an arthroscope into the joint of the foot or ankle. The arthroscope is a small camera. It displays images of the joint on a screen. With the help of these images, Arthritis of the foot and ankle doctor in Southfield will guide surgical instruments for the surgery. The surgical instruments used, and the arthroscope itself, is very thin. As such, your surgeon does not need to make a large incision.

Arthroscopic surgery becomes most effective when the pain is caused by the movement of bones spurs against each other. At this time, the joint has not widened significantly. Removing the bone spurs increases the range of motion, causing rapid wear of the cartilage.

Arthrodesis: Arthrodesis (fusion) is an important arthritis pain treatment option. It causes complete fusion of the bones. Pain is reduced by eliminating motion in the diseased joint.

Arthrodesis involves removal of the damaged cartilage. Screws, plates, and pins are then used to fix the joint permanently. Gradually, the bones grow and fuse together – the same thing that happens when both ends of a broken bone heal. Thus, removing the joint eliminates the pain.

Total ankle replacement: This procedure (arthroplasty) involves the removal of damaged bone and cartilage. Thereafter, new plastic or metal joint surfaces are positioned to restore joint function.

Total ankle replacement is not as common as total knee or hip replacement procedure but we have made it available. It is recommended for patients with:

• Ankle pain that disrupts daily activities
• Arthritis characterized by destruction of ankle surfaces
• Advanced ankle arthritis

Arthroplasty relieves pain and increases patient’s range of motion. Once the patient is able to move more freely, stress on the adjacent joint is drastically reduced. This reduces the risk of developing adjacent joint arthritis.