What Is Arthritis?
Arthritis is a condition characterized by inflammation and swelling of the cartilage and lining of the joints that leads to joint pain and stiffness [1]. While all forms of arthritis share certain symptoms, arthritis has numerous forms. This article will review several different causes and forms of arthritis, especially those that affect the foot and ankle.
Arthritis and the Feet: What Are the Causes?
The feet are particularly susceptible to arthritis because each foot has 33 different joints. Because there’s no way to keep weight off of arthritic feet, developing this condition in the foot and ankle joints can result in a loss of mobility. Fortunately, early diagnosis and proper podiatric care can prevent this outcome.
Some forms of arthritis are hereditary. Other causes of arthritis include:
- Past foot and ankle injuries, especially if injuries weren’t properly treated. [2]
- Bacterial, viral, or fungal infections that spread to the joints. [3]
- Complications of irritable bowel disorders, particularly colitis. [4]
- Biomechanical irregularities such as flat feet or high arches that result in unbalanced weight distribution across the different joints of the foot.
Podiatric Arthritis Symptoms
Because arthritis can affect the structure and function of the feet, it is important to see a doctor specialized in podiatry if any of the following foot symptoms develop:
- Swelling in one or more joints
- Chronic joint pain or tenderness
- Redness or heat in a joint
- Limitation in joint mobility
- Early morning stiffness
- Skin changes, including rashes and growths
Understanding the Forms of Arthritis
While over 100 identified forms of arthritis exist, three are most commonly seen in podiatric practice. These are:
Osteoarthritis
Osteoarthritis (OA) is also known as degenerative joint disease. Although an injury can trigger sudden OA, its onset is generally gradual and associated with aging [5]. With each year, the body’s cartilage continues to break down, resulting in joint pain and inflammation. OA is characterized by dull, throbbing nighttime pain, which may be accompanied by muscle weakness or deterioration. Overweight individuals are particularly at risk for osteoarthritis of the feet because carrying extra weight accelerates cartilage deterioration and bone damage.
Rheumatoid Arthritis
Rheumatoid arthritis (RA) is a complex, chronic inflammatory disease. No cure for RA exists, but the disease can be sent into remission. RA affects the joints, but it can also affect other parts of the body. During the course of the disease, RA frequently progresses in a symmetrical pattern, affecting joints in both feet and ankles. RA affects the lining of the joints, leading to pain and swelling, as well as potential joint deformities [6]. If RA affects the feet, bone erosion and deformed joints can drastically impact mobility.
Gout
Gout is an arthritic condition caused by a buildup of uric acid in the joints. Like RA, gout is characterized by flares and periods of remission. Initially, gout will likely manifest in a single big toe joint; the toe will become red, inflamed, and extremely painful to the touch. Changes in diet to avoid purine-rich foods can help prevent new gout flares [7].
Diagnosing and Treating Arthritis
An early arthritis diagnosis is important because cartilage destruction is not reversible, and untreated arthritis in any form can lead to bone and cartilage damage. Physical exams will be sufficient to diagnose some forms of arthritis; other conditions, such as RA, may require further testing to diagnose. Unfortunately, most forms of arthritis are incurable, but preventing progression or achieving remission is possible with proper care.
The main objectives in arthritis treatment are controlling inflammation and preserving or restoring joint function. Because the foot is frequently affected by arthritis, podiatric specialists are often the ones to diagnose this condition. In some cases, a developing bunion may even be a sign of arthritis [8].
Arthritis can be treated in various ways. Physical therapy and exercise may be indicated, accompanied by medication and patient education. Many medications can target arthritis symptoms, as well as disease progression, but not all patients will respond to medications in the same way. Aspirin is typically the first indicated medication for most forms of arthritis; it’s often considered the benchmark against which other therapies are measured [9].
If arthritis of the foot and ankle affects mobility, orthoses, a form of shoe insert, may be helpful. A podiatrist can also prescribe special shoes or foot braces to help control foot function. Although a last resort, joints damaged by arthritis may be surgically replaced [10].