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If the feet seem more susceptible to arthritis than
other parts of the body, it is because each foot has 33
joints that can be afflicted, and there is no way to avoid
the pain of the tremendous weight-bearing load on the
feet.
Arthritis is a disabling and occasionally crippling
disease; it afflicts almost 40 million Americans. In some
forms, it appears to have hereditary tendencies. While the
prevalence of arthritis increases with age, all people
from infancy to middle age are potential victims. People
over 50 are the primary targets.
Arthritic feet can result in loss of mobility and
independence, but that may be avoided with early diagnosis
and proper medical care.
Some Causes
Besides heredity, arthritic symptoms may arise in a
number of ways:
Through injuries, notably in athletes and industrial
workers, especially if the injuries have been ignored
(which injuries of the feet tend to be).
Through bacterial and viral infections that strike the
joints. The same organisms that are present in pneumonia,
gonorrhea, staph infections, and Lyme disease cause the
inflammations.
In conjunction with bowel disorders such as colitis and
ileitis, frequently resulting in arthritic conditions in
the joints of the ankles and toes. Such inflammatory bowel
diseases seem distant from arthritis, but treating them
can relieve arthritic pain.
Using drugs, both prescription drugs and illegal street
drugs, can induce arthritis.
As part of a congenital autoimmune disease syndrome of
undetermined origin. Recent research has suggested, for
instance, that a defective gene may play a role in
osteoarthritis.
Symptoms
Because arthritis can affect the structure and
function of the feet it is important to see a doctor of
podiatric medicine if any of the following symptoms occur
in the feet:
-
Swelling in
one or more joints
-
Recurring
pain or tenderness in any joint
-
Redness or
heat in a joint
-
Limitation
in motion of joint
-
Early
morning stiffness
-
Skin
changes, including rashes and growths
Some
Forms of Arthritis
Osteoarthritis
is the most common form of arthritis. It is frequently
called degenerative joint disease or “wear and tear”
arthritis. Although it can be brought on suddenly by an
injury, its onset is generally gradual; aging brings on a
breakdown in cartilage, and pain gets progressively more
severe, although it can be relieved with rest. Dull,
throbbing nighttime pain is characteristic, and it may be
accompanied by muscle weakness or deterioration. Walking
may become erratic.
It is a particular problem for the feet when people are
overweight, simply because there are so many joints in
each foot. The additional weight contributes to the
deterioration of cartilage and the development of bone
spurs.
Rheumatoid arthritis (RA) is a major crippling
disorder, and perhaps the most serious form of arthritis.
It is a complex, chronic inflammatory system of diseases,
often affecting more than a dozen smaller joints during
the course of the disease, frequently in a symmetrical
pattern—both ankles, or the index fingers of both hands,
for example. It is often accompanied by signs and
symptoms—lengthy morning stiffness, fatigue, and weight
loss—and it may affect various systems of the body, such
as the eyes, lungs, heart, and nervous system. Women are
three or four times more likely than men to suffer RA.
RA has a much more acute onset than osteoarthritis. It is
characterized by alternating periods of remission, during
which symptoms disappear, and exacerbation, marked by the
return of inflammation, stiffness, and pain. Serious joint
deformity and loss of motion frequently result from acute
rheumatoid arthritis. However, the disease system has been
known to be active for months, or years, then abate,
sometimes permanently.
Gout (gouty arthritis) is a condition caused by a
buildup of the salts of uric acid—a normal byproduct of
the diet—in the joints. A single big toe joint is commonly
the affected area, possibly because it is subject to so
much pressure in walking; attacks of gouty arthritis are
extremely painful, perhaps more so than any other form of
arthritis. Men are much more likely to be afflicted than
women, an indication that heredity may play a role in the
disease. While a rich diet that contains lots of red meat,
rich sauces, shellfish, and brandy is popularly associated
with gout, there are other protein compounds in foods such
as lentils and beans that may play a role.
Diagnosis
Different forms of arthritis affect the body in
different ways; many have distinct systemic affects that
are not common to other forms. Early diagnosis is
important to effective treatment of any form. Destruction
of cartilage is not reversible, and if the inflammation of
arthritic disease isn’t treated, both cartilage and bone
can be damaged, which makes the joints increasingly
difficult to move. Most forms of arthritis cannot be
cured, but can be controlled or brought into remission;
perhaps only five percent of the most serious cases,
usually of rheumatoid arthritis, result in such severe
crippling that walking aids or wheelchairs are required.
Treatment
The objectives in the treatment of arthritis are
controlling inflammation, preserving joint function (or
restoring it if it has been lost), and curing the disease
if that is possible.
Because the foot is such a frequent target, the doctor of
podiatric medicine is often the first physician to
encounter some of the complaints—inflammation, pain,
stiffness, excessive warmth, injuries. Even bunions can be
manifestations of arthritis.
Arthritis may be treated in many ways. Patient education
is important. Physical therapy and exercise may be
indicated, accompanied by medication. In such a complex
disease system, it is no wonder that a wide variety of
drugs have been used effectively to treat it; likewise, a
given treatment may be very effective in one patient and
almost no help at all to another. Aspirin is still the
first-line drug of choice for most forms of arthritis, and
the benchmark against which other therapies are measured.
The control of foot functions with shoe inserts called
orthoses, or with braces or specially prescribed shoes,
may be recommended. Surgical intervention is a last resort
in arthritis, as it is with most disease conditions; the
replacement of damaged joints with artificial joints is a
possible surgical procedure.
Your podiatric physician/surgeon has been trained
specifically and extensively in the diagnosis and
treatment of all manners of foot conditions. This training
encompasses all of the intricately related systems and
structures of the foot and lower leg including
neurological, circulatory, skin, and the musculoskeletal
system, which includes bones, joints, ligaments, tendons,
muscles, and nerves. |
Arthritis, in general terms, is inflammation and
swelling of the cartilage and lining of the joints,
generally accompanied by an increase in the fluid in the
joints. Arthritis has multiple causes; just as a sore
throat may have its origin in a variety of diseases, so
joint inflammation and arthritis are associated with many
different illnesses.
