Arthritis Doesn’t Ignore Feet
When you think about arthritis, what parts of the body pop into your mind? I’d venture to say that you didn’t think of your feet. The truth is, feet are very much affected by arthritis. That’s really not surprising, since the disease mostly targets your joints, and your foot has over 30 of them! So, if you’re experiencing foot pain, you shouldn’t rule out arthritis as the cause.
So, what about arthritis and your feet? Well, there are different types of this condition to consider. Osteoarthritis is the most common and indeed, I find it in the feet of many patients over the age of 50. It usually effects the joint that connects your big toe to your foot, but you’ll also find it in the midfoot and ankle.
Then there’s rheumatoid arthritis. Folks suffering with it are 90% likely to experience symptoms in the foot and ankle. If fact, those symptoms are often the first signs of the disease. It usually pops up in both feet and affects the same joints in each foot. That contrasts with osteoarthritis, which typically affects only one joint.
Have you heard of psoriatic arthritis? If there’s a swelling in your toes that makes them look like sausages, it might be the culprit. Psoriatic arthritis also causes inflammation right where tendons and ligaments attach to bones. If you’re experiencing plantar fasciitis – an inflammation of the thick tissue that connects the heel bone to the toes – as well as bone spurs – then psoriatic arthritis is something you should consider as the source.
In the world of arthritis, honorable – or dishonorable – mention must go to gout, which occurs when crystals of uric acid deposit in a joint. The big toe is often the victim here. Another mention goes to ankylosing spondylitis, a type of arthritis which can cause plantar fasciitis.
You’re probably thinking, “This is a great lesson on arthritis, doc, but how can you help relieve my pain?” Well, I’d first do a thorough examination to be sure we know we’re talking arthritis, and what form of it might be affecting your feet. This may include imaging, such as x-rays. Once we establish that arthritis is causing your feet to hurt, I’d consider several strategies for treating your pain, stiffness and swelling.
I might want to begin with either over-the-counter or prescription versions of non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen, and naproxen to reduce the symptoms. Now, these drugs can increase the risk or cardiovascular and GI problems, so you might want to consult with your physician first. If he or she says no go, then we can prescribe a topical anti-inflammatory, like Voltaran Gel. Depending on your type of arthritis, I’d also want you to either apply ice or heat to your feet on a regular basis.
In addition, I would discuss the possibility of prescribing custom-made orthotics which can greatly help reduce your arthritic foot pain. Because they’re made-to-order, we can target the areas of your feet that are most troublesome and divert pressure away from them. In addition, your orthotics can be customized to be different for each foot, depending on your arthritis condition.
In certain cases, I would consider using steroid injections like cortisone to help reduce inflammation and swelling. I might also want to prescribe physical therapy, which has been very successful in decreasing inflammation as well. The therapist might use massage, ultrasound and lasers, depending on your case.
Now, there are some common-sense practices that I would highly recommend as well. For instance, invest in the shoes that fit properly. Most comfort brands offer very stylish selections for you. If you’re overweight, it would be a great idea to set in place a weight loss program that’s right for you. Remember, feet are weight-bearing, and when they’re arthritic, every pound matters. Also be sure to exercise, which will not only shed some pounds but will also help maintain joint function and relieve stiffness.
If conservative measures haven’t relieved your pain sufficiently, I would then discuss your surgery options. For instance, we might talk about fusion of the big toe joint, which would limit its range of motion and help eliminate pain. Another option would be joint replacement surgery. First things first, though. Let’s take a look and determine the best course of action to getting you pain-free and back on your feet again.
Salvatore Guadino, DPM
DeLoor Podiatry Associates