Arthritis is inflammation and swelling of the cartilage and lining of the joints. It is characterized by inflammation of the cartilage and lining of the body’s joints. If the feet seem more susceptible to arthritis than other parts of the body, it is because each foot has 33 joints which can be afflicted, and there is no way to avoid the pain of the tremendous weight-bearing load on the feet without treatment.
According to the most recent statistics released by the Centers for Disease Control (CDC), nearly 50 million Americans have been diagnosed with some form of arthritis. In some forms, it appears to have hereditary tendencies. The prevalence of arthritis increases with age, with people over 50 being the majority of those affected. Arthritic feet can result in loss of mobility and independence. But that may be avoided with early diagnosis and proper medical care.
With osteoarthritis, the cartilage that covers the ends of bones in the joints gradually wears away leaving a damaged, rough surface that causes painful joint motion. Osteoarthritis usually develops after many years of use, and most often affects people who are middle-aged or older.
Other risk factors for osteoarthritis include:
- Previous injury or trauma to the affected joint notably in athletes and industrial workers, especially if the injuries have been ignored.
- Family history of osteoarthritis.
- Bacterial and viral infections can strike the joints.
- Bowel disorders such as colitis and ileitis, can present with arthritis.
- Congenital autoimmune diseases of undetermined origin.
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 a joint
- Early morning stiffness
- Skin changes, including rashes and growths
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 and Prevention:
The American Academy of Orthopedic Surgeons (AAOS) recently released a report highlighting the benefits of a balanced exercise program in preventing, and easing the symptoms of, osteoarthritis.
If done in 30-to-45 minute intervals, three-to-five days a week, exercise can help:
- reduce pain and inflammation associated with osteoarthritis
- improve flexibility and range of motion
- enhance muscle strength and endurance
- improve balance and coordination
- maintain a healthy weight
According to the AOSSM, a successful exercise program should include four components:
1. Warm-up – A warm-up helps the body get ready to exercise by elevating the heart rate slowly and increasing body temperature. Some warm-up activities include five minutes of mild intensity walking or riding a stationary bike.
2. Stretching/flexibility – Flexibility is essential to joint health, and yet everyone’s degree of flexibility varies greatly. Stretching should not be painful and should begin with easy stretches being held for 20 to 30 seconds each.
3. Aerobic (cardio) activity – A stationery bicycle may provide the best aerobic exercise for an arthritic patient. It is easy on the joints and maintains flexibility, motion and strength. Start with five minutes on the bicycle and gradually increase activity by one minute or two minutes per week.
4. Anaerobic (strength) activity – Strength training is beneficial for the prevention and treatment of osteoarthritis, especially light-to-moderate resistance exercise.
The objectives in the treatment of arthritis are controlling inflammation, preserving joint function (or restoring it if it has been lost), and managing symptoms. Because the foot is such a frequent target, a podiatrist is often the first physician to encounter some of the complaints — inflammation, pain, stiffness, excessive warmth, injuries. Arthritis must be addressed in many different ways:
- Patient education is important.
- Physical therapy and exercise may be indicated.
- Medication- Aspirin is still the first-line drug of choice for most forms of arthritis.
- The control of foot functions with shoe inserts called orthoses, or with braces or specially prescribed shoes, may be required.
- Surgical intervention is a last resort in arthritis; the replacement of damaged joints with artificial joints is may be indicated.
The Many 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. 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 debilitating 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 a variety of related 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, indicating a linkage to heredity.
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, followed by periods of remission.
– Gout (gouty arthritis) is a condition caused by a build-up of uric acid in the joints. The big toe joint is commonly the joint involved. 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, and brandy is popularly associated with gout, there are other protein compounds in such foods as lentils and beans which may play a role.