Arthritis in the Foot and Ankle — Causes, Symptoms & Relief

Arthritis is a complex and painful disease that can affect patients of every age. If you're experiencing aching pain, swelling, and inflammation in your feet and ankles, you may be suffering from arthritis.

Girl and grandmother coloring together

What is arthritis in the feet and ankles?

Arthritis is a frequent component of complex disease processes that may involve more than 100 identifiable disorders. It is characterized by inflammation of the cartilage and lining of the body’s joints. If the feet seem more susceptible to arthritis than other parts of the body, it is because each foot has 33 joints that can be affected, and there is no way to avoid the pain of the tremendous weight-bearing load on the feet. Arthritis may be a disabling and occasionally crippling disease; it afflicts almost 40 million Americans. In some forms, it appears to have hereditary tendencies.

While the prevalence of arthritis increases with age, people of all ages — from infants to seniors — are potential victims. The primary age group affected is people over 50. Arthritic feet can result in loss of mobility and independence. With early diagnosis and proper medical care, this may be avoided.

Definition of arthritis

Arthritis, in general terms, is the inflammation and swelling of the cartilage and lining of the joints, generally accompanied by an increase in the fluid in the joints. There are multiple causes of arthritis; just as a sore throat may have its origin in a variety of diseases, so joint inflammation and arthritis are associated with many different illnesses. Besides heredity, arthritic symptoms may have their source in a number of phenomena:

  • Traumatic injuries, notably in athletes and industrial workers, can damage the joints, especially if the injuries have been ignored (which injuries of the feet tend to be).
  • Bacterial and viral infections can strike the joints. The same organisms that are present in pneumonia, gonorrhea, staph infections, and Lyme disease cause inflammation.
  • Arthritis can frequently develop in the joints of the ankles and toes in conjunction with bowel disorders, such as colitis and ileitis. Such inflammatory bowel diseases may seem distant from arthritis, but their control can relieve arthritic pain.
  • Drugs, both prescription drugs and illegal street drugs, can induce arthritis.
  • Arthritis can be part of a congenital autoimmune disease syndrome of undetermined origin. Recent research has suggested, for instance, that a defective gene may play a role in osteoarthritis.

Various forms of arthritis

Osteoarthritis is the most common form of arthritis. It is frequently called degenerative joint disease or “wear and tear” arthritis. Although it can be brought on suddenly by an injury, its onset is generally gradual. Aging brings on a breakdown in cartilage, and pain becomes progressively more severe, although it can be relieved with rest. Dull, throbbing nighttime pain is characteristic, and it may be accompanied by muscle weakness or deterioration. Gait patterns (normal walking) may become erratic. Osteoarthritis is a particular problem for the feet when people are overweight, simply because there are so many joints in each foot; the additional weight contributes to the deterioration of cartilage and the development of bone spurs.

Rheumatoid Arthritis (RA) is a major crippling disorder and perhaps the most serious form of arthritis. It is a complex, chronic inflammatory system of disease, often affecting more than a dozen smaller joints during the course of the disease, frequently in a symmetrical pattern — both ankles, or the index fingers of both hands, for example. It is often accompanied by constitutional signs and symptoms — lengthy morning stiffness, fatigue, and weight loss — and it may affect various systems of the body, such as the eyes, lungs, heart, and nervous system. Women are three to four times more likely than men to suffer from RA, indicating a linkage to heredity. RA has a much more acute onset than osteoarthritis. It is characterized by alternating periods of remission — during which symptoms disappear — and exacerbation, marked by the return of inflammation, stiffness, and pain. Serious joint deformity and loss of motion frequently result from acute rheumatoid arthritis. However, the disease system has been known to be active for months or years, then to abate, sometimes permanently. Gout (gouty arthritis) is a condition caused by a buildup of the salts of uric acid — a normal byproduct of the diet — in the joints. A single big toe joint is commonly the locus, possibly because it is subject to so much pressure in walking. Attacks of gouty arthritis are extremely painful, perhaps more so than any other form of arthritis. Men are much more likely to be afflicted than premenopausal women, an indication that heredity may play a role. While a rich diet that contains red meat, rich sauces, and brandy is popularly associated with gout, there are other protein compounds in such foods as lentils and beans which may also play a role.

Older woman suffering from arthritis in foot and ankle

Symptoms and signs of arthritis?

Because arthritis can affect the structure and function of the feet, it is important to see a doctor of podiatric medicine if any of the following symptoms occur in the feet or ankles:

  • Swelling in one or more joints
  • Recurring pain or tenderness in any joint
  • Redness or heat in a joint
  • Limitation in the motion of a joint
  • Early morning stiffness
  • Skin changes, including rashes and growths

Arthritis treatment and relief

The primary objectives in the treatment of arthritis are controlling inflammation, preserving joint function (or restoring it if it has been lost), and curing the disease if possible. Because problems in the foot are frequent early warning signs, the podiatrist is often the first physician to encounter some of the complaints — inflammation, pain, stiffness, excessive warmth, injuries. Even bunions can be manifestations of arthritis.

Arthritis may be treated with several modalities. Patient education is important. Physical therapy and exercise may be indicated, accompanied by medication. In such a complex disease system, it’s no wonder that a wide variety of drugs have been used effectively to treat it; likewise, a given treatment may be very effective in one patient and almost no help at all to another.

Aspirin is still the first-line drug of choice for most forms of arthritis and the benchmark used to measure the efficacy of a host of therapies. The control of foot functions with shoe inserts — called orthoses — or with braces or specially prescribed shoes may be indicated. Surgical intervention is a last resort in arthritis, as it is with most disease conditions; the replacement of damaged joints with artificial joints is a possible surgical solution.

Diagnosis of arthritis

Different forms of arthritis affect the body in different ways; many have distinct systemic affects that are not common to other forms. Early diagnosis is important for effective treatment of any form.

Destruction of cartilage is not reversible, and if the inflammation of arthritic disease isn’t treated, both cartilage and bone can be damaged, which makes the joints increasingly difficult to move. Most forms of arthritis cannot be cured, but they can be controlled or brought into remission. Perhaps only five percent of the most serious cases, usually of rheumatoid arthritis, result in such severe crippling that walking aids or wheelchairs are required.

For additional information and professional diagnosis of arthritis, contact Scottsdale’s top podiatry practice.

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