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Next Step Foot & Ankle Clinic

Arthritis: The mystery disease

Arthritis simply means inflammation of the joint.  There are over 100 types of arthritis and associated diseases but a few top the list and account for most of the problems people have in their feet:

Managing Your Arthritis

Common Types of Arthritis

Osteoarthritis

Osteoarthritis is very common.  It is the type of arthritis that merely wears out the joint.  I see many patients that have been diagnosed with arthritis for any type of foot pain.  The problem with osteoarthritis is that usually it is caused by something else.  Some abnormal biomechanics which places excessive stress on the joint, some genetic predisposition, some history of trauma, with just excessive repetitive activities can cause the joint to develop some inflammation, malalignment of the joint can also contribute to early arthritis.  The way the patient walks has a big effect on the development of arthritis.  Osteoarthritis has several stages.  The early stages are inflammation with no joint damage and the more advanced stages can lead to complete immobility of the joint with complete joint destruction.  Probably 80% of the patients that we see with arthritis have this type of arthritis.

Rheumatoid Arthritis (RA)

RA is a disease of the immune system.  The bodies on immune system attacks the joints and causes severe destruction of the articular surfaces.  This type of arthritis can lead to severe deformities and joint destruction.  Thankfully, many new medications have been developed which slow the process of this disease.  Most people with RA are able to control the disease with medications.  Some of these medications are immunosuppressants which can make the patient more susceptible to infections and slow healing.

Fibromyalgia

Fibromyalgia is another type of arthritis.  The joints and muscles are painful to move and stiff.  It has been associated with stress, lack of sleep and mental fog.  There are other associated symptoms including stiffness in the morning, fatigue, headaches, jaw pain, anxiety and reduced tolerance to activity. 

Treatments

Osteoarthritis

Osteoarthritis can be treated in lots of different ways.  In the acute stage steroid injections or anti-inflammatory medications can be helpful.  However, these only treating the symptoms.  We like to approach arthritis in a more preventative way.  Supporting the joint or decreasing the stress across the joint with the use of biomechanics or even possibly surgery can be very helpful in decreasing the symptoms of osteoarthritis.  Sometimes if the joint is badly damaged then removal of the offending joint or fusion of the joint can give tremendous relief.  Basically each treatment of osteoarthritis is more or less customized to the patient based on the joint that is affected, the severity of the symptoms, the expectations of the patient, and other social issues.  THE KEY TO TREATING THIS TYPE OF ARTHRITIS IS TO IDENTIFY THE CAUSE AND TREAT THAT PROBLEM.  Pills can help but they are just symptomatic treatment. 

Rheumatoid Arthritis

Everyone with RA should be seeing a rheumatologist. The use of disease modifying drugs has really changed the outlook for RA patients.  Bracing is often helpful for patients with RA.  Bracing or supports can take pressure off joints and make the feet feel better.  If the deformities of the RA become too advanced then we can help straighten out the feet so they don’t have pressure points and look better.  One thing we have noted in patients with RA is adult onset flat feet.  This can be really crippling.  We can help with that too.

Fibromyalgia

Fibromyalgia is a global disease.  It affects almost everything in your life.  Fibromyalgia is associated with chronic fatigue, lack of sleep, stress, muscle aches and pains, trigger point pain and a general decrease in energy.  Fibromyalgia can make pretty much any part of your foot (or any part of your body for that matter) hurt.  There is no cure for fibromyalgia.  Sometimes multiple medications for chronic pain and sleep disorders or needed to lessen the symptoms of this disease.  Sometimes memory loss is associated with fibromyalgia.  Generally the parts affected suffer from widespread pain tenderness and then this subsequently leads to disuse which seems to aggravate the pain and tenderness.  It can be a vicious cycle.  Treatments include treatment for sleep, gentle exercise (swimming, walking, light weight lifting shows great benefit), medications to manage pain, and other physical therapies.  If the patient has a deformity with fibromyalgia, and this needs surgical correction, this can be a difficult conundrum.  Patients with fibromyalgia have a tough time of surgery.  They have more pain that lasts longer and require more physical therapy in order to get the postoperative pain under control.  Sometimes something as simple as a good arch support can create a lot of relief for patients with fibromyalgia in their feet.

Next Step Foot & Ankle Clinic has many treatment options available to you including MLS Laser Therapy.  So if you have been told you have arthritis in your feet or ankles give us a call and see what can be done to make your feet (and life) better.

PowerPoint Presentation

 Ankle Arthritis:  A Common Overuse Condition of the Foot & Ankle

Ankle Replacement:  Today's Solution for Debilitating Ankle Arthritis