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Osteoarthritis and the Foot

Osteoarthritis is easily one of the most common causes of discomfort in the foot. It is typically seen in older patients, and is a result of gradual degeneration of the bony joints.

In a joint, the ends of each bone are lined with cartilage which helps the bones to glide smoothly along one another. If this cartilage begins to wear away, or is damaged, the ends of each bone in a joint are more likely to rub against one another which can cause pain. In addition, this movement can also cause the bones to chip away, causing small particles of bone to float around in the joint space and contribute to irritation of the joint.

Cartilage as a substance typically has a very poor blood supply. It heals very poorly as a result. Damage to the cartilage of the joints can occur through a number of means. Genetic predisposition can lead to early breakdown of cartilage. Excessive wear on a particular joint – such as through some athletic activities – can cause it to also wear away faster. Poor biomechanics may lead to an uneven loading of the joints. Being overweight can also place additional force through the feet, causing a faster degeneration of the joint. Finally, direct injury to a joint can cause cartilage damage which can result in long term joint pain.

Osteoarthritis generally takes a while to become a serious problem. Initially the joint may only be uncomfortable in a certain position, or demonstrate some stiffness. With time, the joint can become more problematic. The joint may show swelling, heat, or redness. It can be painful to touch or move. Many patients advise that the joint is most painful after getting up, and may often ease for a while with movement. Some can experience pain even when the joint is not being used at all.

The foot is a complex structure. It contains 33 joints, each of which are theoretically capable of suffering osteoarthritis. As a result, the presentation of osteoarthritis pain can be extremely varied between patients. Because of this, treatment for osteoarthritis needs to be tailored to the individual and the joint affected. Pain management through medication may be needed. In most cases, reducing stiffness and improving mobility are the goal. Appropriate footwear and orthotics can be particularly helpful in correcting poor biomechanics and redistributing pressure away from the painful joint. Exercises, stretching, and mobilisation of the joint may be required. In severe cases, immobilisation of the joint may be necessary, which may require surgery.

Your podiatrist can assist you with identifying the joints that may be affected with osteoarthritis, as well as developing a treatment plan to assist with pain management and joint function.