Osteoarthritis
Foot & Ankle Care of Colorado
Osteoarthritis is a condition characterized by the breakdown and eventual loss of cartilage in one or more joints. Cartilage, the connective tissue at the end of bones in the joints, protects and cushions the bones during movement. When cartilage deteriorates or is lost, symptoms develop that can restrict one’s ability to perform daily activities.
Also known as degenerative arthritis, osteoarthritis reflects the aging process and is the most common form of arthritis, affecting millions of Americans. Some people refer to osteoarthritis simply as arthritis, though there are many different types of arthritis.
Osteoarthritis can affect various joints throughout the body, including the hands, feet, spine, hips, and knees. In the foot, the disease most frequently occurs in the big toe but is also commonly found in the midfoot and ankle.
Causes of Osteoarthritis
Osteoarthritis Symptoms
People with osteoarthritis in the foot or ankle experience, in varying degrees, one or more of the following:
- Pain and stiffness in the joint
- Swelling in or near the joint
- Difficulty walking or bending the joint
Some patients with osteoarthritis also develop a bone spur (a bony protrusion) at the affected joint. Shoe pressure may cause pain at the site of a bone spur, and in some cases, blisters or calluses may form over its surface. Bone spurs can also limit the movement of the joint.
Osteoarthritis Diagnoses
In diagnosing osteoarthritis, the foot and ankle surgeon will examine the foot thoroughly, looking for swelling in the joint, limited mobility and pain with movement. In some cases, deformity and/or enlargement (spur) of the joint may be noted. X-rays may be ordered to evaluate the extent of the disease.
Nonsurgical Treatments
To help relieve symptoms, the surgeon may begin treating osteoarthritis with one or more of the following nonsurgical approaches:
- Oral medications. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, are often helpful in reducing the inflammation and pain. Occasionally, a prescription for a steroid medication is needed to adequately reduce symptoms.
- Orthotic devices. Custom orthotic devices (shoe inserts) are often prescribed to provide support to improve the foot’s mechanics or cushioning to help minimize pain.
- Bracing. Bracing, which restricts motion and supports the joint, can reduce pain during walking and can help prevent further deformity.
- Immobilization. Protecting the foot from movement by wearing a cast or removable cast-boot may be necessary to allow the inflammation to resolve.
- Steroid injections. In some cases, steroid injections are applied to the affected joint to deliver anti-inflammatory medication.
- Physical therapy. Exercises to strengthen the muscles, especially when osteoarthritis occurs in the ankle, may give the patient greater stability and may help him or her avoid injury that might worsen the condition.
When Is Surgery Needed?
When osteoarthritis has progressed substantially or has failed to improve with nonsurgical treatment, surgery may be recommended. In advanced cases, surgery may be the only option. The goal of surgery is to decrease pain and improve function. The foot and ankle surgeon will consider a number of factors when selecting the procedure best suited to the patient’s condition and lifestyle.