Osteoarthritis of the Foot and Ankle

Description


Joints and T-shirts don’t, on the surface, appear to be all that related.
Joints are places where bones meet (and usually move around). T-shirts are
knitted from wonderfully breathable cotton. Joints have fluid in them. T-
shirts are often printed with hilarious sayings, political messages, or
pictures of kittens. Not at all similar, right?



As odd as it may seem, joints and T-shirts do have one characteristic in
common: they both wear out. When T-shirts wear out, you have a holey T-
shirt, or perhaps a pile of cleaning rags all ready to be cut out. When
joints wear out, you probably have what doctors like to call
osteoarthritis.



Osteoarthritis is only one of many different kinds of arthritis, (the term
‘arthritis’ does, after all, merely refer to problems with the joint), but
it is among the most common. Sometimes called the “wear and tear”
arthritis, osteoarthritis obviously includes a gradual deterioration over
time of the cartilage in the joint, but it also may refer to joint problems
that spring from injuries, such as sprains and fractures.



It’s really all about cartilage. You see, cartilage is the stuff at the
ends of bones that cushions them during movement and helps shield bones
from harm. Unfortunately, as we get older, our bodies begin to lose their
ability to repair themselves, and so as the cartilage continues to
experience wear and tear, our bodies are less able to heal that damage.
Eventually, the cartilage may wear away, leaving the bones themselves to
rub against each other. As you might imagine, bone-on-bone rubbing is not
comfortable, and usually causes pain and inflammation in the joint.



Osteoarthritis may also develop due to an injury, such as a severe sprain,
a dislocation, or a fracture. Arthritis from injuries may take months or
even years to develop. Or, arthritis may develop because of abnormal
mechanics in the foot, such as unusually high or low arches. You may also
experience more wear and tear on your joint if you are overweight. Being
overweight tends to put more stress on the joint than usual, resulting in
more damage which can later lead to arthritis.

Symptoms


Whatever the root cause of your arthritis, you’re likely to experience
certain symptoms once your joints have worn out. One of the first warning
signs is, of course, pain in the joint, which is often accompanied by
stiffness. Your joint (or the area around your joint) may begin to swell,
become reddened, and may be warm to the touch. Because of these symptoms,
you may also find it difficult to walk.

Diagnosis


Your podiatrist has seen osteoarthritis many times before. (He or she has
probably also seen worn out T-shirts plenty of times, too.) In order to
determine what exactly is causing your joint pain, your foot doctor will
likely ask for a history of your symptoms, such as how long you’ve been
experiencing problems with your joint, when pain usually occurs (such as
morning or evening), and whether you’ve had any injuries in the affected
area.



The podiatrist will probably also perform a physical examination of your
foot, testing the range of motion of the affected joint and checking for
swelling and pain. He or she may also ask you to walk about for a bit so
your gait can be analyzed. (And remember, this is probably not a great time
to demonstrate your ability to do silly walks. Your podiatrist has a sense
of humor, but in this case, it’s probably best to keep to witty sayings on
your T-shirt.)



Because your podiatrist may want an inside look at your joint, he or she
may also use various imaging technologies to look at the extent of joint
damage you’ve experienced. X-rays, CT scans, MRIs or bone scans may be used
to get that visual analysis.

Treatment


Unfortunately, arthritis isn’t really a curable disease. And, unlike worn
out T-shirts, worn out joints don’t usually make good cleaning rags.
Fortunately, there are plenty of things you can do to reduce pain and
prevent further damage to your joint.



Your podiatrist will likely start with more conservative treatments, which
may include medication to reduce your pain (oral anti-inflammatory
medications such as ibuprofen are often used, and aspirin is often helpful,
or your doctor may decide that a cortisone or other steroidal injection
will be most effective). Immobilizing your joint through casts or cast
boots may also help reduce the inflammation and pain from your arthritis,
or your podiatrist may merely reduce mobility and add support by using a
brace.



Orthotics (prescription shoe inserts designed specifically for your foot)
may help resolve some of the abnormal mechanical issues in your foot that
may have contributed to your developing arthritis in the first place. They
can also provide cushioning and support for your foot and thus improve your
foot’s function and reduce inflammation and pain. Your podiatrist may also
recommend physical therapy in order to strengthen your muscles and improve
the stability of your foot.



If your joint fails to respond to the above treatments, your doctor may
recommend surgery as the best way to reduce your pain. Surgery may be
performed to clean up the joint, removing foreign and inflamed tissue and
any bone spurs that may have developed. Or, your surgeon may opt to fuse
the joint, which involves attaching the bones of the joint together (often
with screws) so that they will grow together. While this will reduce some
foot mobility, it also will help get rid of the pain associated with
movement of the damaged joint.



In the case of osteoarthritis in the ankle, a joint replacement is also
possible, although this is used most often in very severe cases. (The fun
thing about joint replacement is that you can feel just a little bit more
like a cyborg. Laser eyes are just a step away.)



Dealing with a worn-out joint is just a bit more difficult than dealing
with a worn-out T-shirt. And treating osteoarthritis may be a long-term
prospect. But following the advice of your podiatrist will likely lead you
to a life of decreased pain and increased mobility. And you can put that on
a T-shirt, if you want.