Joint pain complaints are commonplace, and almost expected as people age. Arthritis 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. The word arthritis literally means pain within a joint and 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; they also 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
There are three main types of arthritis that may affect your foot and ankle -- osteoarthritis, rheumatoid arthritis and gout.
Osteoarthritis is wear and tear arthritis. It is common in many people after they reach middle age. Over the years, the smooth cartilage at the ends of the bone wear 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. Arthritis can develop after an injury to the foot or ankle, especially if the injuries have been ignored without treatment. This type of arthritis is similar to osteoarthritis and may develop years after a fracture or severe sprain.
Rheumatoid arthritis is an inflammatory disease seen in joints all over the body caused by the person's own immune system attacking and destroying the cartilage.
Gout is a form of arthritis caused by a buildup of the salts of uric acid -- a normal byproduct 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 joint, bowel disorders and even some drugs.

Symptoms
Different forms of arthritis affect the body in different ways. Once cartilage is damaged, it cannot be reversed. Signs and symptoms of arthritis of the foot 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 shows how the bones in the leg and foot 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 for 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.
o Education is very important.
o Physical therapy and exercise are important to make sure the joint continues to move. It is best to exercise in the sea or pool or perform other non-weight-bearing exercises to prevent pain and further damage to the joint.

Other non-surgical treatment options include:
o Pain relievers and anti-inflammatory medications to reduce swelling, shoe inserts (orthotics)
o Custom-made shoes, such as a stiff-soled shoe with a rocker bottom, a brace or a cane
o Weight loss and control
o Nutritional supplements such as Chondritin and Glucosamine. Persons can also use tumeric, ginger, fever grass and other natural herbs and spices that have anti-inflammatory properties to help control the pain and inflammation
o Medications such as steroids, anesthetics or joint-filler fluid can be 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 (fusing the joints together permanently) 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 in your feet and ankle, 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.apma.org. To see a podiatrist visit Bahamas Foot Centre on Rosetta Street, telephone 325-2996 or Bahamas Surgical Associates Centre, Albury Lane, telephone 394-5820, or Lucayan Medical Centre on East Sunrise Highway, Freeport Grand Bahama, telephone 373-7400.

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