Arthritis is one of the oldest diseases known to mankind. It has been found in the remains of Earths' earliest settlers. When people think of osteoarthritis they generally think of older people whose hips, knees and hands are affected. But statistics suggest that more than half of people in their 60s and 70s have osteoarthritis that affect their feet and ankles.
Arthritis is still a common disease today. It is the leading cause of disability in the United States affecting more than 40 million people. It is more common as you get older, however it can occur at any age, and the word literally means "pain within a joint". Arthritis describes the inflammation and swelling of the cartilage and lining of the joints, along with increased fluid in the joints.
Arthritis and the feet: The feet seem more susceptible to arthritis than other parts of the body because the feet have 52 bones and 33 joints that can be affected, and they bear the brunt of walking and standing. Arthritis in the feet can cause loss of motion in the joints and independence, but that may be avoided with early diagnosis and proper medical care.
Causes: Arthritis can develop after an injury to the foot or ankle. Joints that have been injured are more likely to be injured again than those that have not. Studies have shown that young people with knee injuries are six times more likely to develop osteoarthritis by age 65 than those who have not had a knee injury. Those with previous hip injury are three times more likely to develop osteoarthritis. There are three main types of arthritis that may affect your foot and ankle.
Osteoarthritis known as "wear and tear" arthritis, is common in many people after they reach middle age. Over the years, the smooth cartilage at the ends of the bone wears down causing inflammation, swelling and pain in the joint as the bone edges rub together. It progresses slowly, and the pain and stiffness worsen over time.
Rheumatoid arthritis: An inflammatory disease seen in joints all over the body caused by the person's own immune system attacking and destroying the cartilage.
Gout: A form of arthritis caused by a buildup of the salts of uric acid -- a normal by-product of protein in the diet. The big toe joint is the most commonly affected area. Avoiding proteins such as shellfish, red meat, cold cuts and cheese can prevent or delay the attack of arthritis.
There are other causes of arthritis including bacterial and viral infections to the joints, bowel disorders and even some drugs.
Symptoms: Different forms of arthritis affect the body in different ways. Once the cartilage is damaged, it cannot be reversed. Signs and symptoms of arthritis of the foot may vary, depending on which joint is affected. Common symptoms include joint pain or tenderness, early morning stiffness or reduced motion, swelling and difficulty walking.
Diagnosis: Early diagnosis is important for effective treatment of all types of arthritis. Your podiatrist will diagnose arthritis by using medical history, a physical examination and other tests.
Additional tests may include an exam of the way you walk (gait analysis). This test shows how the bones in the leg and feet affect walking. X-rays can show changes in the joint space between the bones or in the shape of the bones themselves. A bone scan, computed tomographic (CT) scan, or magnetic resonance image (MRI) may also be ordered for more evaluation.
Treatment: The objectives of treatment of arthritis are controlling inflammation, preserving or restoring joint function and curing the disease if possible. Depending on the type, location, and severity of the arthritis, there are many types of treatment available. Arthritis may be treated in many ways.
Education is very important. Physical therapy and exercise are important to make sure the joint continues to move. Other non-surgical treatment options include pain relievers and anti-inflammatory medications to reduce swelling, shoe inserts (orthotics), custom-made shoes, such as a stiff-soled shoe with a rocker bottom, a brace or a cane, weight loss and control or nutritional supplements such as Chondritine and Glucosamine and medications such as a steroid medications or fluid injected into the joint.
If arthritis doesn't respond to non-surgical treatment, surgical treatment might be considered. The choice of surgery will depend on the type of arthritis, the severity of the disease, the impact of the disease on the joints and the location of the arthritis. Sometimes more than one type of surgery will be needed. Surgery performed for arthritis of the foot and ankle may include arthroscopic debridement to clean out the joint, arthrodesis - or fusing the joints together permanent - and arthroplasty - a joint replacement.
Remember, arthritis is a chronic, long-term condition that will require long-term treatment. If you have symptoms of arthritis you don't have to suffer in silence, there is relief available if you see your podiatrist.
o For more information, email foothealth242@gmail.com or visit www.foothealth.org, apma.org or orthoinfo.aaos.org. To see a podiatrist visit Bahamas Foot Centre on Rosetta Street, telephone 325-2996 or Bahamas Surgical Associates on Albury Lane telephone 394-5820.

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