What Should I Know About Arthritis of the Feet?
Did you know that your feet can be very much affected by arthritis?
Podiatric surgeon, Dr. Salvatore Guadino talks about the arthritis of the feet.
Did you know there’s over 100 different types of arthritis that affect the foot?
The most common types of arthritis that affect the feet are osteoarthritis. Osteoarthritis usually affects patients over the age of 50. Osteoarthritis is a degenerative joint disease, which attacks the patient’s joint, causing the joint space to be narrow. Osteoarthritis can also affect the mid foot and ankle joints, it causes decreased range of motion in the joints, the patient has pain when he ambulates.
Daria N.: Are there other types of foot arthritis?
Dr. Guadino: We also have rheumatoid arthritis. The interesting thing about rheumatoid arthritis, 90% of the time rheumatoid arthritis starts with symptoms in the foot. Rheumatoid arthritis affects the small joints and usually the same joints on both sides of the body.
Dr. Guadino: Psoriatic arthritis. Psoriatic arthritis is kind of interesting because it affects the areas where the tendon and ligaments attach to bone. Most commonly we see psoriatic arthritis in patients with plantar fasciitis.
Dr. Guadino: There’s ankylosing spondylitis which also attacks the areas where the tendon and ligaments attach to bone, causing plantar fasciitis.
Dr. Guadino: In addition, we see a lot of gout. Gout is an increase levels of uric acid, which deposit into the joints. Most commonly affecting the big toe.
Daria N.: So, how can you help patients with arthritic pain?
Dr. Guadino: We often start with conservative treatments. The first conservative therapy would be non-steroidal medication, either prescription or over the counter. This would help reduce inflammation. We often advise a patient before taking the medication to check with their doctors if they have cardiovascular problems or gastrointestinal problems, because it can make it worse.
Daria N.: What if a patient cannot take these drugs?
Dr. Guadino: If the patient is unable to take oral medication, we could start the patient on topical medication. Topical anti-inflammatory medication such as Voltaren. And it has the same effect on reducing pain as the oral medication.
Dr. Guadino: In addition to the oral medication, we have a series of steroid injections, which can reduce the inflammation. The only thing about the steroid injections, we have to be careful because if the patient’s diabetic, it can increase their blood sugars.
Daria N.: Are there any other treatments you may prescribe?
Dr. Guadino: Other treatment options are orthotics. At Deloor Podiatry, we make our orthotics with a computerized scan which tells us where the areas of pain are, so we’re able to reduce the pressure on the patient’s foot and leave them pain free.
Dr. Guadino: In addition to orthotics, we tell the patient to lose weight. To go on a strict weight loss program. As they lose weight, there will be less pressure upon the foot.
Dr. Guadino: We also encourage the patient to start physical therapy, which also helps reduce inflammation and pain on the foot.
Daria N.: Is surgery ever necessary?
Dr. Guadino: Yeah, surgery’s an option, but only and only after all conservative methods have failed. The type of surgery that is done will depend upon the type of arthritis the patient has, the location of the arthritis and the impact the arthritis has on the patient’s life.
Daria N.: What kind of surgeries are available?
Dr. Guadino: Well, at Deloor Podiatry we started doing regenerative medicine. Regenerative medicine means we have PRP injections; platelet rich plasma injections, where we take blood from the patient’s arm, spin it down and inject the platelets the areas of pain. This is a way for the body to heal itself, and it’s remarkable. We find patients who couldn’t walk, couldn’t ambulate for months to years, are able to go back to work and function within 24 hours. And the interesting thing about it is they leave the OR with a band-aid.
Daria N.: What other kinds of surgeries are available?
Dr. Guadino: There’s other procedures we could do such as ankle arthroscopes, which is we take out all the scar tissue in the joint, allowing the joint to move more freely. If that doesn’t work, we have options of arthrodesis, which is we fuse the joint, or a joint implant.
Daria N.: If you think you may be suffering from foot arthritis, Deloor Podiatry recommends you consider the options Dr. Guadino discussed. After all, getting you pain free and back on your feet is what it’s all about.