Osteoarthritis of the foot and ankle can be very painful and require changes in your lifestyle and activities. What are the signs of osteoarthritis of the foot and ankle?
Osteoarthritis, also known as the wear-and-tear arthritis typically has a slow and progressive onset. The age of onset varies and becomes worse with age. Osteoarthritis has a predisposition for joints that have previously been injured. Remember that bad ankle sprain while playing on your high school basketball team? Or when the horse stepped on your foot? These historical injuries can contribute to the onset and severity of osteoarthritis of the foot and ankle.
Although osteoarthritis is considered to be a polyarticular disease (affecting more than one joint at a time), joints that have been affected by injuries or repetitive stress from your occupation are uniquely prone to early onset of pain. Let’s take a look at three common areas of the foot and ankle that are affected by osteoarthritis.
Osteoarthritis of the forefoot-
Osteoarthritis of the forefoot most commonly affects the great toe joint. Osteoarthritis of the great toe joint is referred to as hallux limitus. In hallux limitus, the hallux or great toe is limited in its range of motion that progressively results in degenerative changes in the great toe joint. The onset of symptoms is progressive. Symptoms include sharp shooting pain and locking of the joint. In many cases, the top of the great to joint becomes enlarges with a bone spur that further limits range of motion of the joint.
Conservative treatment of hallux limitus may include an insole that limits range of motion of the great toe joint. A Morton’s extension is an extension or splint that extends to the tip of the great toe, limiting range of motion of the joint. Hallux limitus can also be treated surgically by shortening the bone adjacent to the joint, fusing the great toe joint or replacing the joint with an implant.
Osteoarthritis of the midfoot –
Osteoarthritis of the midfoot can affected any number of the joints found in the arch of the foot. Symptoms of osteoarthritis of the midfoot include sharp, shooting pain with activity and dull aching of the foot after activity. Characteristic findings of the midfoot include localized enlargement of the midfoot as we see multiple joints that have arthritic pain and associated spurring of the joint periphery.
Conservative treatment of midfoot osteoarthritis includes bracing with compression bandages and splinting the foot with specialty insoles that provide rigidity of the midfoot and forefoot rocker. Surgical correction of osteoarthritis of the midfoot is complex and results in significant post-op disability. Surgical correction for osteoarthritis of the midfoot is not typically recommended.
Osteoarthritis of the ankle –
The joints of the rearfoot include the ankle and subtalar joints. The ankle range of motion is within the sagittal plane (toes towards the shin and toes away from the shin) while the range of motion of the subtalar joint is within the frontal plane (soles towards each other, soles facing away). The combined range of motion of both the ankle and subtalar joints are what make us able to be bipedal and able to adapt to uneven surfaces. Osteoarthritis of the ankle and/or subtalar joints can be difficult to differentiate and often are best defined with x-rays. Symptoms of ankle and subtalar joint osteoarthritis include swelling, sharp pain with activity and dull achiness at rest. An additional finding of ankle osteoarthritis includes a sense of the joint ‘giving out’. Many patients describe weakness of the joint where the joint no longer reliably will support them.
Initial treatment of osteoarthritis of the ankle and subtalar joints make include elastic compression bandages or prescription braces to stabilize the joint. Cortisone injections are often used to temporarily decrease painful inflammation within the joint. Arthroscopic surgery can also be used as a temporary stopgap for osteoarthritis of the joint. End stage osteoarthritis of the ankle and subtalar joints may include fusion of the joint or ankle joint replacement.
Successful management of osteoarthritis of the foot and ankle
Osteoarthritis is a common foot and ankle problem that affects each of us as we age. Osteoarthritis of the foot and ankle does not need to limit our ability to be active and participate in the majority of activities that we enjoy. The key is to find the appropriate duration and intensity of activity and to find which products can help splint and manage joint pain.