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Understanding Osteoarthritis in the Foot and Ankle

What is Osteoarthritis?

Osteoarthritis is a medical condition that results from the degradation and potential loss of joint cartilage. This cartilage serves as a protective and cushioning layer for the bones within a joint, aiding mobility. When cartilage wears away, daily tasks can become challenging due to developing symptoms.

Commonly known as degenerative arthritis, osteoarthritis occurs more frequently with aging and is a primary type of arthritis. Although there are numerous forms of arthritis, many people refer to osteoarthritis simply as “arthritis.”

This condition can affect different joints throughout the body, including the fingers, feet, back, hips, and knees. In the foot, it is commonly seen in the big toe but can also affect the midfoot and ankle.

Osteoarthritis in the Foot and Ankle, treatment women picture

Causes of Osteoarthritis

The primary cause of osteoarthritis is considered to be the repeated stress and use of joints over time, known as wear and tear. As joint cartilage wears away, the underlying bones can come into direct contact, leading to painful and inflamed joints.

Injuries can also precipitate osteoarthritis, albeit usually after a delay of months or years. In the big toe, typical causes include impact injuries or drops, while midfoot osteoarthritis often stems from dropped objects or sprains. Ankle osteoarthritis frequently follows fractures and sometimes severe sprains.

Abnormal foot mechanics, such as flat feet or high arches, may also contribute to osteoarthritis. Flat feet can overstrain joints due to unstable ligaments, whereas high arches can lead to joint jamming and a higher risk of developing arthritis.

Symptoms

Those suffering from osteoarthritis in the foot or ankle may experience:

  • Pain and stiffness in the affected joint
  • Swelling in or near the joint
  • Challenges in walking or joint mobility

Bone spurs may form as a consequence of osteoarthritis. If they exert pressure through the shoe or develop blisters or calluses, additional discomfort can occur. These spurs could also restrict joint movement.

Diagnosis

To diagnose osteoarthritis, a surgeon will conduct a thorough examination of the foot for signs of joint swelling, pain during movement, and reduced mobility. In some instances, joint deformity or bone spurs may be visible. An X-ray might be required to assess the disease severity.

Nonsurgical Treatment Options

When treating osteoarthritis. The following nonsurgical methods may be employed:

  • Oral Medications: NSAIDs like ibuprofen can reduce inflammation and pain. Steroid prescriptions may be necessary for symptom control in some cases.
  • Orthotic Devices: Custom shoe inserts might be recommended to enhance foot mechanics or reduce pain.
  • Bracing: Employing a brace to support the joint can alleviate pain during activity and prevent further deformation.
  • Immobilization: A cast or removable boot can protect the foot, aiding inflammation resolution.
  • Steroid injections: These can provide targeted anti-inflammatory relief directly to the joint.
  • Physical therapy: Strengthening exercises can improve stability, particularly with ankle osteoarthritis, helping to prevent further injury.

When Is Surgery Needed?

When osteoarthritis has significantly progressed or hasn’t improved with nonsurgical treatments, surgery might be advised. In advanced cases, it might be the only option. The primary goal of surgery is to reduce pain and restore function. Multiple factors determine the selection of the most appropriate surgical procedure for the patient’s specific needs and lifestyle.

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Dr. Kris Dinucci