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Arthritis of the foot
Last reviewed: 07.06.2024
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Arthritis of the foot is an inflammatory condition in which the joints and tissues in the foot area become inflamed. This condition can cause pain, swelling, redness, restricted movement and even joint deformities. Arthritis of the foot can have different types and causes, including rheumatoid arthritis, osteoarthritis, gout, and others.
Treatment depends on the type and severity of arthritis and may include medications, physical therapy, surgery, and other methods aimed at relieving inflammation and pain and restoring foot function.
Causes of the foot arthritis
The following are some of the most common causes of arthritis of the foot:
- Rheumatoid Arthritis: Rheumatoidarthritis is a chronic autoimmune disease in which the immune system attacks your own joints. It can affect the joints in the foot and cause inflammation and joint destruction.
- Osteoarthritis (osteoarthritis): Osteoarthritis of the foot is the most common type of arthritis and is associated with wear and tear of the cartilage in the joints of the foot. It usually occurs with age or due to excessive stress on the joints.
- Psoriatic arthritis: Psoriatic arthritis is a form of arthritis that develops in people with psoriasis (a skin disease). It can affect the joints of the foot and cause painful inflammation.
- Systemic Lupus erythematosus (SLE): This is a rare systemic autoimmune disease that can cause arthritis of the foot by impairing joint function.
- Injuries and strains: Injuries, fractures associated with improper footwear or sports injuries can contribute to the development of foot arthritis.
- Infections: Sometimes infections such as osteomyelitis (inflammation of the bones) can cause arthritis in the foot.
- Genetic predisposition: Heredity can also play a role in the development of foot arthritis. If you have a family history of arthritis, you may be more at risk.
- Other medical conditions: Some medical conditions, such as gout or Bechterew's disease, can also present with arthritis of the foot.
Symptoms of the foot arthritis
Symptoms of foot arthritis can vary depending on its type and severity, but common signs of foot arthritis may include the following:
- Pain: Pain in the joints of the foot is one of the most characteristic symptoms of arthritis. It can be sharp or dull, intensified by movement or strain on the foot.
- Swelling: Inflammation of the joints of the foot can lead to swelling in the joint area. The joints may become bulkier and more inflamed.
- Redness: Inflammation of the joints can cause redness of the skin around the joints of the foot.
- Warmth: The joints of the foot may feel warmer than the surrounding tissues due to inflammation.
- Limitation of movement: Arthritis can limit the mobility of the joints in the foot, which can make walking and normal movements difficult.
- Deformities: In cases of chronic arthritis, deformities can develop in the joints of the foot, which can lead to changes in their shape.
- Leg fatigue and weakness: Prolonged inflammation and pain can cause fatigue and weakness in the leg.
- Crunching and creaking: Some patients with foot arthritis may experience crunching and creaking in their joints when they move.
Foot arthritis pain can be varied and can vary depending on the type of arthritis, its severity, and the individual patient. Here are some common characteristics of foot arthritis pain:
- Pain on movement: Often the pain is worse when you move or put stress on the foot. Walking, standing, and performing everyday tasks can cause discomfort and pain.
- Morning stiffness: Many people with arthritis of the foot notice that in the morning or after a long rest, the foot becomes stiff and pain begins. This phenomenon is called "morning stiffness."
- Resting pain: Some patients may experience pain even at rest, especially at night.
- Pain Features: Foot arthritis pain can be sharp, dull, throbbing, or burning. It can also vary with activity.
- Increased pain when pressing on joints: In arthritis, pressing or palpating the joints of the foot can cause additional pain.
- Radiating pain: Sometimes pain can spread from the joints of the foot to nearby areas, such as the lower leg or calf.
- Pain "flare-ups": Some patients may experience periodic pain "flare-ups" when the pain becomes particularly intense.
Arthritis of the foot in a child
This is a serious condition that requires medical evaluation and treatment. It is important to see a doctor in a timely manner if your child has symptoms of arthritis of the foot. Diagnosis and treatment of arthritis in children may differ from treatment in adults and should be managed by a pediatric rheumatologist or other specialist.
Here are a few important things to consider when you have arthritis of the foot in a child:
- Symptoms: Symptoms of arthritis in children may include pain, swelling, morning stiffness, redness or heat in the foot. Children may also complain of worsening general condition, weakness, and loss of appetite.
- Diagnosis: Diagnosis of arthritis of the foot in a child includes a physical examination, blood laboratory tests, and a medical history. Sometimes a joint puncture is needed to analyze synovial fluid.
- Treatment: Treatment for pediatric foot arthritis usually involves a combination of medications, physical therapy, and lifestyle recommendations. The use of anti-inflammatory drugs and cytokine inhibitors can help reduce inflammation and pain. Physical therapy may be prescribed to maintain mobility and strengthen muscles.
- Lifestyle and rehabilitation: It is important to provide the child with suitable physical activity and activity level according to their condition. Regular assessment and monitoring of the foot condition is also important.
- Psychological support: Given the impact of arthritis on the quality of life of the child and family, it is important to provide psychological support and information.
Treating arthritis in a child requires an individualized approach, and parents should work with their doctors to provide the best treatment and support for their child.
Stages
Arthritis of the foot can have varying degrees of severity depending on the following factors:
- Type of arthritis: Different types of arthritis can cause varying degrees of inflammation and damage to the joints of the foot. For example, rheumatoid arthritis and psoriatic arthritis usually have more severe symptoms and can lead to serious joint damage, while osteoarthritis (osteoarthritis) may have less severe symptoms.
- Disease stage: The severity of foot arthritis can depend on the stage of the disease. Early stage arthritis may present with mild pain and swelling, while advanced stages may show joint deformities and severe pain.
- Treatment and care: Effective treatment and care can help reduce the severity of foot arthritis. Early medical attention and proper treatment can slow the progression of the condition and reduce painful symptoms.
- Individual factors: Each person's response to arthritis is different. Some people may have more severe symptoms and the disease may progress more quickly, while others may have it slowly and have less severe symptoms.
The severity of foot arthritis is determined by a doctor based on a physical examination, lab results, and imaging such as x-rays.
Forms
Arthritis of the foot can be caused by different types of arthritis, and each has its own characteristics and treatment features:
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Rheumatoid arthritis of the foot:
- It is a chronic autoimmune disease that can affect the joints of the foot.
- Treatment includes anti-inflammatory drugs like NSAIDs and disease modifying drugs (like methotrexate).
- Physical therapy and rehabilitation can help improve foot function.
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Gouty arthritis of the foot (gout):
- It is a form of arthritis caused by a buildup of uric acid in the joints, which can lead to pain and inflammation.
- Treatment includes a diet to reduce uric acid levels and medications such as allopurinol to lower uric acid levels.
- Anti-inflammatory medications may be used to relieve inflammation.
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Arthritis of the metatarsophalangeal joint of the foot:
- This type of arthritis affects the joints of the toes of the foot.
- Treatment may include NSAIDs to relieve pain and inflammation, and physical therapy to support joint mobility.
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Psoriatic arthritis of the foot:
- Psoriatic arthritis is often accompanied by psoriasis, a skin disease.
- Treatment includes anti-inflammatory drugs, including biologic drugs that can slow the progression of the disease.
- Physical therapy can help improve joint function.
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Reactive arthritis of the foot:
- Reactive arthritis can occur after an infection such as clamidia disease or a urogenital tract infection.
- Treatment is aimed at treating the underlying infection and relieving joint inflammation with anti-inflammatory drugs.
- Deforming arthritis of the foot: This type of arthritis is usually associated with osteoarthritis, which is characterized by the gradual wearing down of joint cartilage. As a result, the joints of the foot can become deformed, which can cause pain, restricted movement, and even changes in the shape of the foot.
- Purulent arthritis of the foot: Usually is an acute infection of the joint and can be caused by a bacterial or other infection. It is a serious condition that presents with pain, swelling, redness, and restricted movement. Treatment includes antibiotics and possibly drainage of the purulent contents.
- Post-traumatic arthritis of the foot: This type of arthritis develops after an injury to the foot, such as a fracture or joint damage. The damaged joints may become prone to inflammation and arthritis as a result of the injury. Treatment depends on the severity of the injury and may include physical therapy, anti-inflammatory medications and, in some cases, surgery.
- Diabetic arthritis of the foot: Can develop in people with diabetes, especially if blood sugar levels are poorly controlled. This can cause damage to the nerves and blood vessels in the foot, which can cause inflammation of the joints and the development of arthritis. Blood sugar management and foot care are important aspects of treatment.
Diagnostics of the foot arthritis
Diagnosing foot arthritis usually involves several steps and medical procedures to make an accurate diagnosis and determine the type of arthritis. Here are the basic steps to diagnosing foot arthritis:
- Medical History and Physical Exam: The doctor will begin by taking your medical history and discussing your symptoms and complaints. He or she will also perform a physical examination of your foot and joints to look for signs of inflammation, pain, swelling and limitation of movement.
- Laboratory tests: Various laboratory tests may be needed to determine the type of arthritis and assess the degree of inflammation, such as blood tests (including a general blood test, rheumatoid factor or C-reactive protein test), synovial fluid from the joint, and others.
- Imaging: Various images such as radiographs, ultrasound (ultrasound), or magnetic resonance imaging (MRI) may be ordered to visually assess the condition of the joints. These images can help identify structural changes such as cartilage breakdown and joint deformities.
- Biopsy: Sometimes, a biopsy of synovial tissue may be needed to rule out other conditions such as infections or tumors.
- Consultation with a rheumatologist: If rheumatic arthritis is suspected, a rheumatology specialist may be involved for more detailed examination and diagnosis.
Differential diagnosis
Arthritis and osteoarthritis are two different conditions that can affect the foot, and they have different causes, symptoms and treatments:
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Arthritis of the foot:
- Arthritis is an inflammatory disease of the joints. Arthritis of the foot can be caused by a variety of reasons, including rheumatoid arthritis, gout, post-infectious arthritis, and others.
- Symptoms of foot arthritis can include pain, swelling, redness, and restricted movement in the joints of the foot. Morning stiffness may also be a characteristic feature.
- Treatment for foot arthritis usually includes anti-inflammatory medications, physical therapy, physical rehabilitation and, in some cases, surgery.
-
Osteoarthritis of the foot:
- Osteoarthritis, also known as osteoarthritis or degenerative arthritis, is a condition in which the cartilage in the joints breaks down over time. Osteoarthritis usually develops with age or after joint injuries.
- Symptoms of osteoarthritis of the foot may include pain, creaking or crunching in the joints when moving, morning stiffness, and decreased mobility of the joints in the foot.
- Treatment for osteoarthritis of the foot aims to relieve pain and improve joint function. It may include anti-inflammatory drugs, physiotherapy, physical rehabilitation, but weight management, physical activity and joint stress management are also important.
Treatment of the foot arthritis
Treatment for foot arthritis usually depends on the type of arthritis and its severity. The following are common steps and protocols for treating foot arthritis:
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Diagnosis and evaluation:
- The first step is the diagnosis and evaluation of arthritis. The doctor will perform a physical exam and may order additional tests such as x-rays, MRIs, or blood tests to determine the type of arthritis and its severity.
-
Treatment of inflammation and pain:
- Anti-inflammatory drugs (NSAIDs) such as ibuprofen or diclofenac may be prescribed to relieve inflammation and pain.
- Glucocorticosteroid injections can be applied to the joint if inflammation needs to be relieved quickly.
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Physical therapy and rehabilitation:
- Physical therapy and rehabilitation may include exercises to strengthen foot muscles, improve joint mobility, and teach proper movement patterns.
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Orthopedic aids:
- Orthopedic shoes or insoles may be recommended to provide proper support and reduce stress on the joints of the foot.
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Medications for the underlying disease:
- If foot arthritis is caused by an underlying condition such as rheumatoid arthritis or gout, treatment will focus on managing that underlying condition.
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Hyaluronic acid injections:
- These injections may be considered to improve joint lubrication and reduce pain in osteoarthritis.
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Surgical treatment:
- In some cases, when conservative treatment fails, surgery such as arthrodesis (fixing a joint) or arthroplasty (joint replacement) may be required.
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Self-governance and lifestyle:
- It is important to maintain an active lifestyle, control your weight, and avoid risk factors such as supramental weight and excessive foot strain.
- Learning self-massage and stretching techniques can help improve foot function.
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Ongoing follow-up and regular counseling:
- Patients with foot arthritis often require ongoing follow-up with a physician and regular consultations to evaluate the effectiveness of treatment and adjust the treatment plan if necessary.
Drug treatment
Treatment for arthritis of the foot may include a variety of medications that help reduce inflammation, relieve pain, and improve joint functionality. Your doctor will decide which medications are appropriate for your particular case, taking into account the type and severity of your arthritis, as well as your overall health. Listed below are some of the medications that can be used for arthritis of the foot:
- Non-steroidal anti-inflammatory drugs (NSAIDs): Examples include ibuprofen, diclofenac, meloxicam, and others. They help reduce inflammation and relieve pain. NSAIDs are available as tablets, capsules, creams, and gels.
- Glucocorticosteroids: Glucocorticosteroid injections can be given directly into the joint to quickly relieve inflammation and pain.
- Disease-modifying drugs (DMDs): Examples include methotrexate, leflunomide, and hydroxychloroquine. These drugs are used to control chronic inflammation and prevent joint destruction.
- Biologic drugs: Such as adalimumab, infliximab, and others. They are used when other drugs are not effective enough. Biologic drugs block certain inflammatory molecules.
- Analgesics: Used to relieve pain. Opiate analgesics are rarely prescribed and only in cases of severe pain.
- Vitaminsand supplements: Vitamins and supplements such as glucosamine and chondroitin may be recommended in some cases, although their effectiveness may be subjective.
- Topical medications: Ointments, gels and creams with anti-inflammatory ingredients can be used to apply to the skin of the foot.
In addition to medications, physical therapy, exercise, lifestyle changes, and surgery can also be part of the treatment for foot arthritis.
Pain medications for arthritis of the foot
Pain medications can help reduce the pain and discomfort of foot arthritis. Here are a few types of pain medications that are commonly used:
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Nonsteroidal anti-inflammatory drugs (NSAIDs):
- Medications such as ibuprofen (Advil), diclofenac (Voltaren), naproxen (Aleve) and others can help reduce inflammation and pain.
- They are available as tablets, capsules, creams and gels for external application.
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Acetaminophen (paracetamol):
- Acetaminophen, sold under different brand names (such as Tylenol), can help relieve pain, but it does not have anti-inflammatory effects.
- This medication is often used to relieve arthritis pain.
-
Opiates and narcotic painkillers:
- These drugs, such as oxycodone or tramadol, may be prescribed by a doctor in cases of severe pain that cannot be controlled by other means.
- However, they can have side effects and can be addictive, so they should be used strictly as prescribed by a doctor.
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Glucocorticosteroid injections:
- Glucocorticosteroids such as prednisolone can be injected directly into the joint to relieve inflammation and pain.
- This is often used in cases of acute inflammation or exacerbation of arthritis.
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Disease-Modifying Antirheumatic Drugs (DMARDs):
- DMARDs such as methotrexate, hydroxychloroquine, and others can be used to treat the underlying autoimmune process that leads to rheumatoid arthritis and other forms of arthritis.
- They can help reduce inflammation and pain symptoms.
Antibiotics for arthritis of the foot
Antibiotics can be used to treat foot arthritis, especially if the arthritis is caused by an infection. Treatment of foot arthritis of infectious origin usually begins with antibiotics. The treatment approach will depend on the type of infectious agent and its sensitivity to antibiotics. Below are some of the antibiotics that can be used in the treatment of infectious foot arthritis:
- Cephalosporins: Generally, initial therapy may be with cephalosporins such as cefazolin or ceftriaxone.
- Vancomycin: Vancomycin may be used when infection caused by methicillin-resistant Staphylococcus aureus (MRSA) is suspected.
- Fluoroquinolones: For example, ciprofloxacin or levofloxacin may be used if the infection is caused by gram-negative bacteria.
- Other antibiotics: Sometimes more specialized antibiotics may be used, depending on the type of infection and its sensitivity to the drugs.
The dosage and duration of antibiotics will depend on the characteristics of the infection and your doctor's recommendations.
Ointments for arthritis of the foot
Ointments for foot arthritis can help in reducing pain, inflammation and improving joint function. However, the choice of ointment depends on the type of arthritis and your doctor's recommendations. Below are some ointments and gels that can be used for foot arthritis:
- Anti-inflammatory ointments: Ointments containing non-steroidal anti-inflammatory drugs (NSAIDs) such as diclofenac, ibuprofen, or naproxen can help reduce inflammation and joint pain.
- Glucocorticosteroid ointments: Ointments containing glucocorticosteroids can be used for localized reduction of inflammation and joint pain. However, they should be used with caution and with a doctor's prescription as they can have side effects.
- Ointments with capsaicin: Capsaicin is an active ingredient that can help reduce arthritis pain. It works by irritating nerve endings, which can temporarily reduce pain.
- Menthol ointments: Ointments with a menthol effect, such as gels with menthol or camphor, can provide a cooling sensation and relief from pain and discomfort.
- Chondroprotective gels: Gels containing chondroprotective agents, such as glucosamine and chondroitin, can help improve the cartilage in your joints and reduce pain.
- Gels with aromatic oils: Some aromatic oils, such as lavender or rosemary, can be used in foot massage gels to reduce pain and relax muscles.
Treatment of arthritis of the foot with folk remedies
Treatment of arthritis of the foot with folk remedies can be an additional method of symptom relief, but it cannot replace mainstream medical treatment. Before using folk remedies, be sure to consult your doctor or rheumatologist to ensure that the methods chosen are safe for you and do not conflict with your main treatment. Below are some folk remedies that may help with arthritis of the foot:
- Heat baths for feet: Heat baths can help relax muscles and reduce pain. Add warm water to the bathtub and if desired, you can add sea salt or aromatic oils. Immerse your feet in the water for 15 to 20 minutes.
- Compresses: You can apply compresses using hot water, such as with a warm, damp cloth. This helps to improve blood circulation and relieve pain. You can also use compresses with a hot honey-mustard mixture, but these should be applied carefully to avoid burning.
- Massage: A light foot massage can help improve circulation, relax muscles and relieve tension.
- Inhalation with aromatic oils: Vapor inhalation using aromatic oils, such as lavender or eucalyptus, can help relax and relieve stress, which can make arthritis symptoms worse.
- Inhalation with aromatic salt: Add aromatic salt to hot water and inhale the vapors. This can help relieve tension and improve your overall health.
- Use of oil compresses: Compresses with heated vegetable oil (e.g., olive oil) can help improve circulation and reduce pain. First dampen a cloth with oil, then cover the sore area with it and cover with a food film or plastic bag, then wrap with a warm shawl. Leave the compress on overnight.
Gymnastics, exercises and massage
Gymnastics, exercises and massage can be useful components of a comprehensive treatment for arthritis of the foot. They can help strengthen muscles, improve joint mobility, and reduce pain. It is important to start exercises and massage after consulting with your doctor or physical therapist to make sure they are safe for your particular condition and type of arthritis.
Gymnastics and exercises:
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Stretching and rotation of the foot:
- Rotate the foot left and right and make circular movements.
- Perform shin and foot muscle stretches, paying attention to each joint.
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Raising and lowering the foot:
- While sitting in a chair or lying on your back, raise and lower the foot, tightening and relaxing the muscles.
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Easy exercises with a rubber loop:
- Use a rubber loop or rubber band to perform pull-up and foot stretching exercises.
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Acomb and a pencil:
- Try lifting objects, such as a pencil or comb, with the toes of your foot, strengthening your muscles.
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Balance exercises:
- Place one foot on an uneven surface such as a sponge or pillow to improve balance and strengthen the foot.
Massage:
Massage can help relax muscles, improve circulation and reduce pain. You can apply massage techniques on your own or see a professional massage therapist. It is important to follow gentle and careful techniques to avoid injury and pain.
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Circular foot massage:
- Start with gentle circular movements in the instep and toe area of the foot, gradually moving to a more intense massage.
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Gentle stretching:
- Gradually stretch and massage the muscles of the foot and lower leg, starting at the toes and moving toward the heel bone.
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Use of massage oils:
- Using massage oils or creams can make the massage more comfortable and promote relaxation.
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Toe Massage:
- Massage each toe of the foot from root to tip, paying attention to the joints.
Physiotherapy
Physical therapy for foot arthritis can be an effective treatment option to improve joint function, reduce pain and inflammation. A physical therapist can design an individualized physical therapy program, taking into account your arthritis severity and your current condition. Here are some of the physical therapy techniques that can be used for arthritis of the foot:
- Muscle strengthening exercises: Strengthening the muscles around the joints of the foot can help improve joint stability and support. Your physical therapist can teach you how to do specific exercises for this purpose.
- Stretching and mobility exercises: The mobility of the joints in the foot can be impaired by arthritis. Stretching and mobility exercises can help improve range of motion and reduce joint stiffness.
- Chiropractic care: A physical therapist may use gentle manipulation and massage to improve circulation, relax muscles and relieve pain.
- Improve balance and coordination: Certain exercises and workouts can help improve balance and coordination, which is especially important with arthritis of the foot to prevent falls and injuries.
- Using pain relief techniques: A physical therapist can teach you self-massage techniques and the application of ice or heat to relieve pain and inflammation.
- Use of supportive devices: In some cases, the physiotherapist may recommend the use of orthotic insoles or shoes to support the joints of the foot.
- Learning proper foot placement: A physical therapist can teach you how to properly place your foot when walking and performing everyday tasks to reduce stress on your joints.
Do you get in the army with arthritis of the feet?
Determining fitness for military service depends on many factors, including the type and severity of arthritis, the presence of symptoms, their impact on physical ability, etc.
In many cases, persons with serious medical conditions such as arthritis may be exempted from conscription or placed in the category of unfit for military service (category "D"). However, each decision is made on an individual basis and may depend on consultation with a military doctor and expert.