Arthritis of the Foot and Ankle

What is Arthritis of the Foot and Ankle?

Arthritis of the foot and ankle is a common condition that causes inflammation and pain in these joints. It can make daily activities difficult and may worsen over time.

Impact of Arthritis of the Foot and Ankle on Anatomy and Health

Arthritis in the foot and ankle can affect various parts of its anatomy, including:

• Cartilage: Arthritis is the breakdown of articular cartilage, the smooth tissue that cushions the joints and makes them frictionless, resulting in bone-on-bone contact.
• Bones: Without cartilage, bones can develop spurs or deformities, causing further pain, immobility and deformity
• Muscles and Ligaments: Inflammation and joint damage can weaken the surrounding muscles and ligaments, reducing the foot's stability and flexibility.
• Overall Health: Persistent pain and reduced mobility can lead to decreased physical activity, which may contribute to weight gain, cardiovascular problems, and a decline in mental well-being due to reduced independence.

Risk Factors for Arthritis of the Foot and Ankle

Certain groups are more prone to developing arthritis in the foot and ankle, including:

• Older Adults: Aging increases joint wear and tear, making osteoarthritis more likely.
• Individuals with a Family History of Arthritis: Genetic predisposition plays a role in conditions like rheumatoid arthritis and gout.
• Athletes and Active Individuals: Repeated stress and injuries to the foot can increase the risk of post-traumatic arthritis.
• People with Pre-existing Conditions: Conditions like obesity, diabetes, or flat feet can place additional stress on foot joints, increasing susceptibility.
• Women: Women, particularly postmenopausal, are at higher risk due to hormonal changes affecting bone and joint health.

Causes of Arthritis of the Foot and Ankle

The causes of arthritis in the foot vary depending on the type of arthritis but may include:

• Osteoarthritis (caused by wear and tear on the joint over time)
• Rheumatoid arthritis (an autoimmune disorder)
• Gout (caused by a build-up of uric acid crystals in the joint)
• Psoriatic arthritis (a form of arthritis that can develop in people with psoriasis)
• Foot or ankle injuries (such as sprains or fractures) that can lead to arthritis in the affected joint.

Symptoms of Arthritis of the Foot and Ankle

• Pain in the foot or ankle
• Stiffness of the joints
• Swelling of the joints
• Difficulty walking or standing
• Warmth in the joints
• Grinding or clicking sound when moving the joint
• Joint deformity or misalignment

Prevention of Arthritis of the Foot and Ankle

While some forms of arthritis cannot be entirely prevented, several measures can help reduce the risk:

• Maintain a Healthy Weight: Reduces stress on foot joints and minimises the risk of osteoarthritis.
• Wear Supportive Footwear: Choose shoes with good arch support, cushioning, and shock absorption.
• Avoid High-Impact Activities: Engage in low-impact exercises like swimming or cycling to protect foot joints.
• Prevent Injuries: Use proper technique during physical activities and wear appropriate protective gear.
• Stay Physically Active: Regular exercise improves joint flexibility and strengthens muscles that support the foot.
• Early Management of Health Conditions: To prevent foot complications and control conditions like gout, diabetes, or rheumatoid arthritis.
• Diet and Supplements: A balanced diet rich in omega-3 fatty acids, calcium, and vitamin D supports joint health.

Types of Arthritis of the Foot and Ankle

Arthritis of the foot and ankle can manifest in several forms, including:

• Osteoarthritis: Often called "wear-and-tear" arthritis, it results from the gradual breakdown of cartilage due to aging or overuse.
• Rheumatoid Arthritis: An autoimmune condition where the immune system attacks the joint lining, leading to inflammation, pain, and joint deformity.
• Post-Traumatic Arthritis: Develops after an injury, such as a fracture, sprain, or dislocation, causing long-term joint damage.
• Gout: A metabolic condition where uric acid crystals accumulate in the joints, commonly affecting the big toe but also impacting other foot and ankle joints.
• Psoriatic Arthritis: Associated with psoriasis, this type causes joint inflammation and skin symptoms.
• Septic Arthritis: Rare but serious; this form occurs due to a joint infection and requires immediate medical intervention.

Stages of Arthritis of the Foot and Ankle

Arthritis progresses in stages, which vary in severity:

• Early Stage: Minor discomfort or stiffness, especially after prolonged activity or in the morning. There is little or no visible damage on imaging tests.
• Mild Stage: Persistent pain, swelling, and difficulty with certain movements. Cartilage begins to deteriorate, which may be visible on X-rays.
• Moderate Stage: Increased pain, reduced range of motion, and visible joint swelling. Bone spurs and moderate cartilage loss are often present.
• Severe Stage: Significant pain, joint deformities, and limited mobility. Complete cartilage loss may cause bones to rub against each other, severely affecting function.

Diagnosis of Arthritis of the Foot and Ankle

Diagnosis of foot and ankle arthritis typically involves a physical examination, medical history, and imaging tests such as X-rays, CT scans, or, in some instances, MRI. Blood tests may also be performed to check for signs of inflammation or infection.

Treatment of Arthritis of the Foot and Ankle

Treatment for arthritis of the foot and ankle depends on the cause and severity of the condition. Mild cases may be treated with rest, ice, compression, elevation, and over-the-counter pain relievers. More severe cases may require prescription medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs). Corticosteroid injections may be helpful. Physiotherapy, assistive devices such as braces or orthotics, and lifestyle changes such as weight loss and exercise can also help manage symptoms and prevent further damage to the joint. Surgery may sometimes be necessary to repair or replace the damaged joint.

What if Arthritis of the Foot and Ankle is Untreated?

Leaving arthritis untreated can lead to severe complications, including:

• Chronic Pain: Worsening pain can interfere with daily activities and significantly reduce quality of life.
• Joint Deformities: Untreated inflammation can cause irreversible joint damage, leading to deformities.
• Loss of Mobility: Progressive stiffness and pain can limit the ability to walk or stand, leading to dependency on assistive devices.
• Muscle Weakness: Reduced activity levels can weaken the muscles supporting the foot and ankle.
• Secondary Health Issues: Lack of physical activity can contribute to weight gain, cardiovascular problems, and mental health challenges like depression.

Prompt diagnosis and appropriate treatment can effectively manage symptoms, slow their progression, and help maintain mobility and quality of life.

Useful Website

• Arthritis Australia

Arthritis of the Foot and Ankle Information Sheet