What is foot arthritis?
Three types of arthritis affect the feet – osteoarthritis, rheumatoid arthritis (RA) and post-traumatic arthritis. Foot and ankle physicians at Midwest Orthopaedics at Rush treat patients with conditions caused by all types of arthritis.
Doctors often call osteoarthritis the "wear-and-tear arthritis." The cartilage and lining of the joints become worn and frayed, which triggers inflammation, swelling, pain and eventually stiffness in the joint. It is no wonder the foot is one of the first places osteoarthritis strikes, because the foot has so many joints. Osteoarthritis is as common as gray hair among seniors. It progresses at a slow pace and worsens over time.
Rheumatoid arthritis is an autoimmune disease and more serious than osteoarthritis. It can strike at any age and is called "juvenile arthritis" when it strikes children. The immune system attacks the synovia, which is the lining of the membranes that surround the joints. In addition to inflammation and pain, it causes destruction of the joint.
Post-trauma arthritis is the result of an injury that leads to arthritis. Typically this would be a dislocation or fracture. An injured joint is about seven times more likely to become arthritic, even if the injury is properly treated. That's because after an injury the body may secrete hormones that stimulate the death of cartilage cells used to cushion the joints.
What are the symptoms of arthritis?
Symptoms include pain, swelling and stiffness of the joints. With rheumatoid arthritis, the pain can be severe and debilitating. Over time, this can distort the joints. The toes can curl, the big toe can bend inward and the middle toes can become hammer-like.
Who is likely to get foot arthritis?
Although osteoarthritis is "in the cards" for most people as they age, an injury can progress the onset and severity of the condition. If a patient breaks a foot while playing soccer in high school, for example, he may succumb to foot osteoarthritis before his peers do when they are middle-aged.
A patient is more likely to get rheumatoid arthritis if there are autoimmune diseases in the family. It is more common among women, people ages 40 and older and people who smoke.
What causes arthritis of the foot?
Years of using feet and ankles for everyday activities can result in osteoarthritis when a patient is older.
The origins of rheumatoid arthritis, though, are uncertain. Having rheumatoid arthritis in the patient's genes does not "cause" it, but does make the patient more susceptible to environmental factors that can trigger this disease.
How is arthritis of the foot diagnosed?
In addition to a physical examination, the foot and ankle physicians at Midwest Orthopaedics at Rush may order an X-ray, computerized tomography (CT) scan or magnetic resonance imaging (MRI) to help determine the extent of the patient's arthritis.
To diagnose and treat rheumatoid arthritis, the orthopedic surgeon works in conjunction with a rheumatologist because this disease affects the whole body. The patient's work-up includes a blood test, too.
What are the treatments for foot arthritis?
Non-surgical Treatment Options
For osteoarthritis, the foot and ankle doctors at Midwest Orthopaedics at Rush may prescribe non-steroidal, anti-inflammatory drugs (NSAIDs) to relieve pain and reduce inflammation.
A greater range of drugs is available now for rheumatoid arthritis, while many others are in trial stages. They include steroids, painkillers, disease-modifying anti-rheumatic drugs (DMARDs), immunosuppressant and TNF-alpha inhibitors. Many have side effects, so the physician can help the patient wade through this alphabet soup to determine the drug that is best for him/her.
Patients with both types of arthritis can benefit from:
- Physical and occupational therapy
- Wearing orthopedic shoes, protective shields or shoe insoles
- Wearing braces to support and protect the arthritic joints
- Soaking feet in hot water
- Switching from high-impact exercise to low-impact exercise – from running to brisk walking, for example
- Keeping the patient's weight down to reduce the stress on his foot joints
- Ice or heat
Surgical Treatment Options
If the patient has joint damage from arthritis, the physicians at Midwest Orthopaedics at Rush, with clinics in Chicago, Westchester, Oak Park, Winfield and affiliations with Elmhurst Hospital, may employ one of these types of surgeries for joint repair:
- Joint debridement. If the arthritis is in the early stages, the physician can remove damaged tissue through a small incision or arthroscopically. This is not an option, though, for advanced osteoarthritis or for rheumatoid arthritis.
- Joint fusion. For more advanced cases, the physician can eliminate pain by removing a joint and fusing the bones together with metal screws and plates.
- Joint replacement. The physician replaces the damaged joint with an implant made of metal and plastic or with bone and cartilage from a donor. Ankle replacement is an excellent option for many patients today who have severe arthritis in the ankle and are unable to walk. The doctors at Midwest Orthopaedics at Rush are highly skilled in performing ankle replacement surgery and do more ankle replacements than most other orthopedic practices in Illinois.