Your Feet and Arthritis

We have all heard about arthritis. Even when you are just watching TV you can hear about medicines for it.
Before we talk about arthritis, let’s go through a quick anatomy lesson. Your feet are made up of 28 bones which have more than 30 joints. These joints allow for flexible movement in your foot and ankle. The ends of the majority of these joints are covered in cartilage. This cartilage is called articular cartilage because it has a slippery substance which helps your bones move easily. (Sort of like the grease between bearings.) And then the joints themselves are covered by a thin layer that is called the synovium. The synovium produces a fluid that also helps lubricate and ease motion of the joints. On top of the joints, there are ligaments to help keep them in place. Then there are tendons and muscles on top of that provide support and the strength to help with movement.
There are several different forms of arthritis that can affect your foot. We are going to specifically talk about three of them today. A fourth form of arthritis, gout will not be discussed in this post but we have talked about it in the past. (See post on gout)
Types of foot and ankle arthritis
The first and probably the kind of arthritis that your parents and grandparents talked about is osteoarthritis. This type of arthritis is due to the wear and tear on the joints. This generally will start during middle age when the cartilage in the joint will start to wear away. This diminishment of the cartilage makes the ends of the bones uneven. The space between the joint will also close with this change. When that happens, you have the two ends of the bones rubbing against each other. That sounds like it would hurt, right?  But that is not the entire problem. This rubbing can cause bone spurs to form. A bone spur is a boney growth that forms in response to the pain and swelling from the rubbing of the bones.
Rheumatoid arthritis is a chronic autoimmune disease. When you have an autoimmune disease, it means that your body attacks its own tissues. With rheumatoid arthritis, the immune cells attack the synovial cells causing them to swell. Overtime, the attack will damage the bone, cartilage, ligaments and tendons. The cause of rheumatoid arthritis is not known. It is not strictly an inherited disease but a person’s genes may be susceptible to the disease. The disease usually has an environmental factor or infection that serves to “wake up” the disease.
The third type of arthritis is post-traumatic arthritis. This is arthritis that is the result of an injury to the foot or ankle. The type of injuries that can damage the bones like dislocations or fractures can lead to post traumatic arthritis. This type of arthritis can develop many years after the initial injury. Even property treated injuries can result in arthritis developing. Statistically, an injured joint is about seven times more likely to develop arthritis.
How can I tell if I have arthritis?
Pain is usually the first indicator. If you experience pain when you are in motion or if you see that there is an area of your foot that is tender when you apply pressure to it, you may have an arthritic joint. If your joints are swelling, red, and warm to the touch, you could have arthritis. Another key indicator is if you have pain when you get up in the morning or after you have been sitting for a while. If you feel pain either when you are moving or sometimes even when you aren’t, you should go see your friendly local podiatrist and have the doctor check your foot. In many cases, the doctor will have an x ray taken of your foot so that the joints in your feet will be visible.
What can be done?
There are several non-surgical treatments that your doctor can discuss with you. They might begin with lifestyle changes like avoiding the exercises that aggravate the joints. The doctor might also suggest that you go to physical therapy to help strengthen the muscles to improve your range of motion and flexibility. An individualized exercise plan can be developed.
Depending upon where the joint is, it may be that an orthotic device for your shoes could help ease the stress on the joint. Or perhaps using a cane or a brace would help you.
Also taking NSAIDS (ibuprofen or naproxen), if you can tolerate them, and help some people. Shots of cortisone are also temporary but effective at reducing the inflammation and pain.
If those changes and treatments are not effective for you then your doctor may discuss surgical intervention. Surgeries for the treatment of arthritis are varied and depend upon the patient.
While arthritis is a common disease, the arthritis you have is personal to you. You need relief. Going to the doctor sooner rather than later will not only save your some pain but it may help you maintain your current lifestyle longer.
Your Pal,
The Foot Blogger Chick


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