joints of the foot

Chronic inflammation of the ankle joints (longitudinal, ankle, metatarsophalangeal and interphalangeal joints) leads to deformations, contractures and loss of function.

Osteoarthritis and flat feet: What is the connection?

Flat feet are one of the factors that cause osteoarthritis. The foot deformity results in abnormal load distribution when walking upright, which can affect the knee, hip and ankle. Can they be avoided?

Clubfoot is not a harmless foot deformity.

Why does flat foot occur?

The foot deformity can be congenital or acquired. The causes are diverse:

• Fractures, injuries, dislocations of the ankle joint;
• Injuries to the bones of the foot, heel and tarsus;
• Rickets, in which the bones lose density and suffer from strain;
• weakening of muscles, ligaments and bones;
• disorders of metabolism;
• excessive body weight;
• unsuitable, tight and uncomfortable shoes.

The percentage of congenital flat feet is not high – only 3 %. The foot is deformed as a result of joint dysplasia. Whatever the cause of the problem, it must be treated because the pathology disrupts the normal biomechanics of movement and contributes to musculoskeletal disorders.

Bad feet combined with excess weight are a major threat to your joints

Symptoms of osteoarthritis in the foot

• Painful, aching sensations in the feet. They occur not only after physical exertion, but also when the body is at rest. The pain intensifies and increases with each passing day;
• The big toe begins to 'grow' and increases in size;
• The gait changes and a limp begins.

The body reacts sensitively to changes in the weather. The lower limbs begin to twist from rain, snow or a sudden change in temperature. Such symptoms can affect quality of life. Many people are deprived of joy and unable to complete simple tasks at home or at work. It becomes difficult to squat, bend, and do anything that requires bending and extending the limbs.

The main symptoms of foot osteoarthritis include:

• A feeling of stiffness in the feet in the morning after waking up. The joints cannot be moved well. When you warm up, the symptoms disappear;
• Limited mobility. In the final stages of sling arthritis, movement is very difficult and painful for those affected. Therefore, the person tries to relieve the affected leg and shifts the body weight to the other leg. This changes the gait and results in a noticeable limp.
• Hyperthermia occurs over the lesion, the skin turns red and the tissue swells;
• The legs tire very quickly when exerted;
• A crunching sound is heard when the joint is moved;
• The pain in the joint is initially only bothersome during physical exertion. They then intensify and become noticeable even when at rest;
• The feet become sensitive to the weather, with foot pain in the cold season;
• The shape of the foot changes, causing the bones to deform and causing calluses and corns to appear on the skin of the foot.

Causes of osteoarthritis in the feet

People in their 50s are particularly at risk of developing osteoarthritis. Because the disease needs time to take hold. It can be caused by problems or defects in the musculoskeletal system, including flat feet. The load on the bones and joints begins to be distributed unevenly. This causes the cartilage tissue to wear and deteriorate, causing damage to the bones and joints. This happens much faster in overweight people, as the strain on the limbs increases.

The shoes are not the last factor. If they don't fit properly, are too loose or too tight, symptoms worsen. In women, beautiful but uncomfortable high-heeled shoes can cause osteoarthritis in the foot. These shoes do not cushion the foot and all the load is transferred to the toes. This can lead to the development of osteoarthritis in the toes.

This condition is often the result of a medical illness. These can include:

• Injuries. Broken bones, torn ligaments and dislocated joints can lead to post-traumatic arthritis. This is most common among professional athletes;
• dysplasia and abnormal tissue development that occurred during skeletal formation before birth;
• Rheumatoid arthritis or other autoimmune diseases that attack connective tissue;
• Inflammatory diseases, including arthritis, that have not been treated or managed properly.

All of the above causes lead to poor blood circulation in the legs and contraction of certain muscle groups. The cartilage tissue is not adequately supplied with nutrients. As a result, they lose flexibility and deteriorate. The joint space narrows and foot osteoarthritis begins to develop.

symptoms

In order to properly plan treatment, all symptoms of foot osteoarthritis must be identified in order to determine their causes. Most arthritic diseases share common clinical symptoms. Patients complain of a more or less severe pain syndrome. In addition, the joint changes externally, may be swollen or deformed, and its function is impaired. However, each type of osteoarthritis has its own specific symptoms.

With osteoarthritis, the pain is usually constant, can increase when walking or standing for long periods of time, and gradually decreases during periods of rest. In cystic fibrosis, the pain syndrome is attack-like. The tissue over the affected joints reddens, its temperature rises and its function - the mobility of the foot - is severely impaired, the range of motion and reach are limited. The patient can no longer walk properly not only because of the pain, but also because osteophytes grow inside the joint - secondary osteoarthritis develops. A cracking or grinding noise can be heard when moving.

Morning stiffness is also typical of osteoarthritis, in which the ankle joints are repeatedly affected and the toes and the arch of the foot are deformed. The stiffness usually occurs after a night of sleep when the foot has not been moved for a long time. The limited mobility of the foot can lead to a limp, which can sometimes make walking very uncomfortable at first. As the disease progresses, subluxations, joint stiffness and valgus deformities, claw or hammer toes can occur.

Which doctor should you see?

At the first signs of osteoarthritis you should consult a general practitioner or a trauma surgeon, orthopedist or rheumatologist. The doctor will carry out a series of examinations to determine the cause of osteoarthritis in the foot and draw up the necessary treatment and rehabilitation plan.

The first step in determining the cause of foot osteoarthritis is a comprehensive examination of the limb.
Ultrasound and X-ray examinations, CT or MRI scans are used to clarify the diagnosis and determine the extent of joint damage. The doctor assesses the alignment of the foot, the nature of active and passive movements, changes in the shape and size of the foot, local temperature increases, changes in gait and pain on palpation. To rule out an inflammatory or autoimmune nature of the lesion, blood tests for rheumatoid factors, C-reactive protein, glucose and uric acid levels are performed. If necessary, a joint puncture is performed to obtain samples of synovial fluid.

stages of arthritis

Osteoarthritis in the different parts of the foot has 4 stages:

• I – Stiffness, discomfort after long-term walking, changes in the composition of the synovial fluid, which are accidentally detected during instrumental examination
• II – redness, swelling, local hyperthermia, severe pain, gait disturbance
• III - persistent pain, deformation of the joint
• IV - permanent loss of function

diagnosis

A series of diagnostic tests are performed to determine the location and type of inflammation:

• physical examination
• X-rays of the foot
• Ultrasound examination of the joint
• MAGNETIC RESONANCE IMAGING
• Blood test in the laboratory
• arthroscopy
• Puncture of a joint

Magnetic resonance imaging is the most informative, safest and clearest method for displaying all parts of the joint and the surrounding tissue. With MRI it is now possible to determine the cause of pain and inflammation without additional trauma techniques.

Symptoms and diagnosis of osteoarthritis of the foot

The disease develops gradually, with new symptoms appearing as it worsens. This is done as follows:

• In the first stage of the disease, the patient regularly experiences severe pain in the forefoot area. The pain usually occurs after vigorous physical activity (sports, long walks or prolonged standing).
• In the second stage of foot osteoarthritis, the pain increases significantly and the bones of the big toe thicken. After physical activity, the pain lasts for a long time and the mobility of the foot is limited.
• In the third stage, the pain syndrome worsens, the joint deforms and movement becomes difficult due to inflammation. The skin on the joint becomes red and the foot swells. In addition, the patient tries to transfer the load to another part of the foot, which is noticeable by limping when walking.

In the early stages, symptoms may be mild. X-rays, CT scans, or MRI scans can show changes in the joint. If osteoarthritis of the foot is already advanced, an experienced doctor can diagnose it by examining the foot, palpating it and analyzing the patient's complaints.

Treatment options for osteoarthritis of the foot

Treating this condition requires a holistic approach. The aim of all measures is to relieve pain and inflammation, restore motor functions and stop degenerative phenomena.

The following therapeutic measures are used at all stages of the disease.

physical therapy In combination with medication, they achieve good results. Patients with foot arthrosis are most often prescribed electrophoresis, phonophoresis, UHF therapy, magnetic therapy and laser treatment. Radon baths and mud treatments can also be prescribed.

Shock wave therapy (UWT). With the help of a special device, the affected joint is exposed to sound waves of a specific frequency. This leads to increased blood circulation, increased permeability of cell membranes and activation of regeneration processes in the tissues. UHT also has an anti-inflammatory and anti-edema effect. The number of sessions is determined by the doctor, but there must be at least five or seven. At Health Plus clinics, you can undergo shock wave therapy under the guidance of highly qualified doctors.

Therapeutic exercises and massages can also help relieve pain and strengthen the muscles around the joint. Your doctor will prescribe appropriate exercises and therapeutic massages.

Traditional remedies can also help relieve pain. Baths with decoctions of peppermint, burdock, holly, hay and other herbs bring some relief. Walking barefoot on sand or loose ground is also recommended for arthritic feet - such a massage improves blood circulation in the feet.

Change in diet.. Osteoarthritis in the foot affects the cartilage in the foot. Their reinforcement is collagen. It is found in sausages and jelly-like foods. Fish oil, lean meat, berries, fruits and vegetables are also recommended. Carbonated drinks and alcohol should be avoided, and consumption of sweets and cookies should be kept to a minimum.

Deforming arthritis of the foot: causes

There are a number of factors that hinder blood circulation in the lower limbs. These factors then lead to inflammation of the joints. Deforming arthrosis of the foot, the causes of which are not yet exactly known, arises from:

• Flat feet, asymmetrical structure of the limbs;
• persistent stress on the feet;
• wearing unsuitable footwear,
• foot injuries;
• hypothermia;
• endocrine disorders;
• osteochondrosis and other diseases of the spine;
• chronic inflammatory conditions;
• unhealthy eating habits;
• lack of physical activity.

Which doctor should I see?

A rheumatologist can treat early-stage arthritis of the foot. It should be noted that all people over the age of thirty are recommended to undergo an annual examination. During this period, the elasticity of the cartilage tissue decreases due to changes in the body. If the disease has become chronic, the rheumatologist will recommend which doctor to see for further treatment. Often the patient is referred to specialists such as: E.g.:

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During the examination, the doctor usually asks the patient questions. This serves to clarify the clinical picture. The questions can be as follows:

treatment of osteoarthritis

Conservative therapy

To slow the progression of the disease and make the patient's life easier, podiatrists recommend wearing wide, comfortable shoes with stiff soles. Personal orthopedic insoles and various types of silicone bursa protectors should be used.

In the early stages of the disease, physiotherapy – UHF, magnetotherapy, electro- and phonophoresis can be used.

Inflammation and pain can also be relieved with nonsteroidal anti-inflammatory drugs. But unfortunately, NSAIDs have harmful effects on the stomach lining. They are contraindicated only in patients with gastritis or stomach ulcers, as these drugs can favor the development of these diseases.

Intra-articular corticosteroid injections can also be used to reduce pain and reduce inflammation.

The problem is that all these methods can only relieve symptoms and slow the progression of the disease. The only possible solution to osteoarthritis is surgery.

surgical treatment

The choice of the appropriate method depends on the severity of the problem and is determined by the orthopedic surgeon.

In the early stages of arthrosis, joint-preserving operations are performed: cheilotomy (removal of cartilage exostoses) and decompressive osteotomy of the metatarsal bone and the basal phalanx (shortening of the basal phalanx of the first toe). This eliminates the pain syndrome, protects the articular surfaces and restores joint mobility.

Unfortunately, if you have severe osteoarthritis (Hallux rigidus), saving the joint is pointless. In recent years, endoprostheses have been used to treat hallux rigidus. Unfortunately, the results are not always satisfactory. The best treatment for severe osteoarthritis is to remove the joint.

surgical treatment

Invasive treatment is mainly used in the third stage of osteoarthritis, when self-reconstruction of the joint is no longer possible.

In some cases, arthroplasty (replacing the damaged cartilage in the joint capsule with artificial cartilage) or arthrodesis (complete immobilization of the joint - less common) is performed.

Treatment is therefore possible even in the most severe stages of the disease. The most important thing is not to let the problem go uncontrolled and find a good specialist to deal with it.

Experienced orthopedist and traumatologist Petrosyan AS has extensive experience in the treatment of diseases of small joints, including surgical treatment of late arthrosis of the foot.

For more information about surgical treatment of foot osteoarthritis, see the following sections:

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arthrosis

Treatment of osteoarthritis in the foot

Medicine is currently unable to definitively cure this disease. However, patients require therapeutic treatment to prevent loss of full joint mobility.

The following drugs are used in drug therapy:

1. Non-steroidal anti-inflammatory drugs. They not only effectively combat the inflammation, but also prevent the pain. As a rule, these drugs are prescribed in courses. The doctor determines the dose and duration of treatment.
2. Painkillers – are used for acute pain. If the pain is unbearable, the person may receive an injection of corticosteroids. These injections can be given a maximum of once a week and a maximum of a few times a year.
3. Chondroprotectors are among the main medications used to treat arthritis. Their job is to rebuild the damaged cartilage and protect it from further destruction.
4. They are hyaluronic acid-based drugs that are injected into the joints damaged by the disease. Such injections increase joint mobility and reduce friction.
5. Ointments and creams for osteoarthritis with nutritional effects.

In addition to drug treatment, non-drug methods of treating the disease are also widely used in medicine:

1. The 'shoe' patch. It is effective when the pathology is severe - when any movement of the foot needs to be suppressed.
2. Wearing orthoses and supinators to improve blood circulation in the joint and tissue metabolism.
3. Massage treatments. They can be carried out with particular care and only after a period of exacerbation. This method can be used at different stages of the disease.
4. Laser and magnetic therapy, phonophoresis and UHF. These methods enhance the effectiveness of drug treatment.
5. Mud therapy. This method makes it possible to supply the joint with the necessary building materials and to eliminate tension during movement.
6. Surgical intervention. This is used when the disease has progressed to its final stage and other methods do not have the desired effect. During surgery, certain parts of the joint are absolutely fused or replaced. In the first case, the foot is no longer mobile, while in the second method, mobility is retained, but the shape of the limb is changed.

Preventive measures to improve foot health

Osteoarthritis of the foot is a complex disease with specific symptoms and treatment options. The success of medical procedures depends on the patient leading an appropriate lifestyle. Above all, alcohol and unhealthy foods should be avoided and smoking should be stopped. Food should be consumed in small portions, ideally five meals per day. The patient should consume at least one and a half liters of fluid per day.

Preventative measures can include simple exercises to strengthen the musculoskeletal system.

In addition, medicine recommends a number of preventive measures to prevent the occurrence and further development of arthrosis. These include in particular:

• Reducing body weight and therefore the stress on the joints;
• strengthening the body's defense system, which prevents infectious changes and inflammation;
• reducing salt consumption;
• timely elimination of chronic abnormalities in the body;
• Protection against injuries, bruises and successful recovery after operations;
• Wearing low-heeled shoes of an appropriate size. The models should be made of high-quality materials and be fully tailored in size and parameters to the specific characteristics of the foot;
• Be careful when wearing high-heeled shoes - remember that their height puts a strain on the joints;
• Daily training of feet;
• walking barefoot on the ground or in the sand.

This disease can significantly impact a person's life and often results in disability. The only way to improve the patient's abilities is to prevent the disease and treat it in a timely manner.

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