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Arthritis in Foot - Pain & Symptom Overview

by Jaydee Vykoukal, PT, DPT March 15, 2022 0 Comments

foot

Developing arthritis in your foot causes significant pain and affects your daily life. Since there are 26 bones and 33 joints in each foot, there are a lot of potential areas that can become painful and stiff with illness, injury, or wear. The feet are quite complex structures that need to be well taken care of for the best quality of life into your golden years. Today, we will dive into the types of arthritis, what causes it, symptoms, and why it’s important to get an appropriate diagnosis and treatment plan started as soon as possible.

Types of Arthritis in the Foot

There are four main types of arthritis that can develop in the feet. We will cover each type here to help you understand the unique differences.

  • Osteoarthritis (OA)

    This is the most common type of arthritis, affecting as much as 15% of the U.S. population over 50 years of age. It is most often caused by a gradual wearing out of the cartilage within a joint, which is why it is most common in older adults. However, traumatic injury, such as a fracture or dislocation (sometimes referred to as posttraumatic arthritis), or repetitive overuse can also lead to the onset of OA in younger individuals too. The joint in the foot that is usually affected is the first metatarsophalangeal joint (MTP) where the big toe and the base of the foot meet.

  • Rheumatoid Arthritis (RA)

    Also known as inflammatory arthritis, RA is a systemic autoimmune disease that attacks the body’s connective tissue and can quickly lead to disability. It can affect any joint in the body, with the feet being a common place of insult. Most often, both feet are affected at the same time due to its systemic nature.

  • Psoriatic Arthritis (PA)

    PA is also caused by systemic inflammation within the body. This can lead to irritation of local tendons, ligaments, and even cause the growth of bone spurs in the feet. Swelling of the toes, known as dactylitis, can also occur.

  • Gout

    Gout can occur in the hands and feet when there is too much uric acid in the body. This is most common with a poor diet that is high in salt and protein. It most commonly affects the big toe(s).

Causes

Determining the cause of your arthritis lies in first figuring out what type of arthritis you are dealing with. This is why it’s so important to get medical advice as soon as a foot problem arises (or even sooner). Let’s review what typical causes are for each form of arthritis.

  • Osteoarthritis

    Caused by breakdown of cartilage (the slippery cushion type substance on the ends of the bones) within a joint due to overuse, physical labor, being overweight, repetitive motion, aging, injury, poor movement mechanics, and/or genetics.

  • Rheumatoid and Psoriatic Arthritis

    Joint inflammation and damage that is caused by the body attacking its own tissues due to an overactive immune system, the triggers are largely unknown but typically involve a mix of environmental and genetic factors.

  • Gout

    Caused by a buildup of uric acid in the limbs due to a diet high in red meat, seafood, sugar, salt, and/or alcohol (especially beer).

  • Other general causes

    Lifestyle factors can play a role in the onset of arthritis, such as diet, stress, exercise, sleep, activity level, body weight and more.

Symptoms

Regardless of which type of arthritis you are suffering from, there are some pretty basic symptoms to look out for that can alert you to a potential problem. The onset of any of these symptoms should be taken seriously and warrant appropriate medical attention to prevent unnecessary suffering and future aggravation.

  • Tenderness in the foot- particularly near one of your joints
  • Joint pain with foot use and movement
  • Foot, toe, or ankle pain
  • Difficulties with daily weight bearing activities, such as standing or walking
  • Limited joint range of motion
  • Swelling and inflammation of the foot or toes (more commons with RA, PA and gout)
  • General stiffness in the foot, particularly in the morning or after a period of rest with OA

Locations in the Foot

Arthritis can strike any joint within the foot. As mentioned above, with 26 bones and over 30 joints within the foot that leaves a lot of places for arthritis to develop. However, there are a few joints that tend to get overworked more than others; putting them at a higher risk of onset.

  • The top contender is the largest toe joint where the big toe and the midfoot meet, a common site for bunions and other types of mechanical dysfunction.
  • Additionally, the heel bone articulates with two bones in the midfoot, called the cuboid and navicular. These areas are most susceptible to arthritic changes because of their location the arch of the foot (most often due to the midfoot being too flat or too stiff).

Since there are so many tiny joints in the foot, it’s best to leave the assessment of your feet to a professional that has in-depth knowledge of foot anatomy, such as a podiatrist, orthopedic doctor, or physical therapist. Foot arthritis might also be accompanied by symptoms or arthritis within the ankle joint as well.

Diagnosis

Getting the correct diagnosis for your foot pain starts with getting an in-depth evaluation. First, your doctor will ask you about your medical history and family history. Then, they will do a physical examination to assess local joint mobility, strength, mechanics, and more. If needed, your doctor can order diagnostic tests depending on what they suspect your underlying issue is. This might include one or more of the following:

  • An x-ray to assess cartilage health, rule out fractures, and see if there are any bone spurs or calcified tissues
  • An MRI to assess any soft tissue damage
  • A blood test to evaluate inflammatory markers related to autoimmune diseases (RA and PA) and/or uric acid
  • A urine test to assess uric acid levels related to gout

Finding Effective Treatments

Once you know what type of arthritis you are suffering from and what the potential causes are, you are now in the right position for starting appropriate treatment. Your doctor can discuss what treatment options are best for you, which will typically involve a mix of remedies. Common recommendations will include physical therapy, pain medication (nonsteroidal anti-inflammatory drugs such as ibuprofen), medication for managing autoimmune disease, losing weight, prescription of proper footwear or orthotics, or even joint replacement surgery. Continue through our guide on foot arthritis to learn more about treating symptoms.

Sources:

https://creakyjoints.org/symptoms/arthritis-foot-pain/

https://www.webmd.com/osteoarthritis/foot-ankle-osteoarthritis

https://my.clevelandclinic.org/health/diseases/13900-foot-and-ankle-arthritis

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Jaydee Vykoukal, PT, DPT
Jaydee Vykoukal, PT, DPT



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