What Is Foot Arthritis

There are many causes of foot pain, some of them involving choice of footwear and other lifestyle factors. One of the leading causes, however, is arthritis of the foot.

Although it is common to associate arthritis with advancing years, there are in fact many different varieties of the disease. Some of them can strike children as young as a few months. Neither is juvenile arthritis particularly rare. For all these reasons, parents and others would do well to learn about the signs and symptoms of the various kinds of arthritis.

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Three Main Kinds of Foot Arthritis

Arthritis can strike at any joint in the body, including the many joints that make up the foot. However, when arthritis of the foot is detected, it is likely due to one of three main forms of the disease:  osteoarthritis, rheumatoid arthritis, and post-injury arthritis (also called post-traumatic arthritis).


This is the most familiar form of the disease, as well as the one that is most associated with the aging process. Classed as a degenerative disease, osteoarthritis rarely strikes people prior to middle age. After that, it may occur and proceed to increasingly debilitating stages.

osteoarthritis in the footThe main process that takes place during osteoarthritis is that the cartilage becomes worn down or in some cases even shredded. Since cartilage is what covers the ends of our bones in every joint, when it wears away the bones begin to contact one another. This causes a variety of symptoms, with joint pain being the most troublesome for most people; it is not unusual for severe and debilitating joint pain to result.

Another debilitating symptom is joint stiffness. In advanced cases of the disease, joints may have stiffened up to the point where the patient can no longer move them. In truly extreme cases it may not be possible for such joints to be manipulated by the exterior pressure of a physician trying to move them.  In addition to pain and stiffness, worn down cartilage can also lead to swelling and inflammation of the affected joint.

midfoot osteoarthritisThe typical pattern for osteoarthritis is for symptoms to gradually worsen over time. There is no cure for the condition, but there are treatment options that may alleviate symptoms and slow down the progression of the disease.


Rheumatoid Arthritis

This form of arthritis has symptoms which are similar to osteoarthritis, but several distinguishing characteristics set it apart from osteoarthritis.

rheumatoid arthritis in the foot

Some common facts about Rheumatoid Arthritis

  • It can develop in people of any age, including children. In fact, the author of this article suffers from juvenile rheumatoid arthritis; in her case, the condition was diagnosed when she was just three years old.
  • It does not result from the gradual wearing down of cartilage, a process which is in some respects natural. Instead, rheumatoid arthritis is a condition in which the body attacks its own cartilage and causes it to partially or in severe cases, wholly disintegrate.
  • As an auto immune disease (conditions in which the body’s own immune system attacks elements of the physical structure of the body), rheumatoid arthritis is considered an inflammatory disease.
  • Rheumatoid arthritis can attack the joints across the whole body, sometimes at once. In contrast, osteoarthritis tends to settle into the joints that have been most physically used over the course of the past decades (for example, the hips).
  • Rheumatoid arthritis can attack joints that are rarely used in comparison to other joints. The joints between the vertebrae in the neck are one such example.

Post-Injury Arthritis

Any kind of serious injury can lead to the development of arthritis in the affected joint or joints. Since the foot is one of the most significant weight bearing areas of the body, injuries there and to the ankle are quite common. As a consequence, arthritis can frequently set into the joints of the foot.

As this type of arthritis is based on physical trauma rather than old age or genetic profile, it can occur to people both young and old. However, joints and bones do heal better in the young than in the old. Therefore, it is more likely that an injury when you are an adult or older will develop into foot arthritis, then one that takes place when you are a teenager or younger.

Symptoms of Foot Arthritis

No matter what sort of foot arthritis is involved, symptoms tend to be similar, though they can vary according to the exact joint or joints affected by the condition. Among the most commonly reported symptoms are:

  • Joint pain and tenderness
  • Joint stiffness
  • Reduced ROM (range of motion)
  • Swelling in the joint
  • Heat in the joint

Obviously, given the symptoms above, walking may be painful and difficult if not impossible.

A common layman’s “test”  for arthritis is to ascertain if the affected joint is hot. The recommended procedure is to place one hand on the affected joint and the other hand on the parallel (hopefully non-affected joint). For example, one hand on the base joint of each big toe. Wait at least a minute to gauge the relative temperature of each joint. Then switch hands and repeat the procedure. By doing it this way, you will avoid thinking that a joint is hot when really, the problem is the heat differential between you left and right hands.

What Causes Foot Arthritis?

There are three different ranges of answer to this question, one for each major branch of the condition.

Causes of Osteoarthritis

The main cause of osteoarthritis is unfortunately the aging process itself. Since that is a process that nobody can avoid undergoing, there is no true way to eliminate this risk factor. What happens during the aging process is that cartilage gradually loses the ability to heal itself. As this happens, more and more naturally occurring cartilage damage becomes fixed and permanent.

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Physical activity of any kind will stress cartilage and cause it to wear down or even tear, but the younger you are, the more quickly and effectively your body will be able to repair this damage.

The degree of your physical activity when young can have implications for developing osteoarthritis when you are older. In fact, the incidence of this form of arthritis developing in a person’s 50s rather than his 60s or 70s has been linked to high levels of high impact exercise over the course of a lifetime. Those who jog several miles at a stretch, and do so several times each week, may see arthritis setting into their hips at younger than average ages.

However, other factors do play a role in the likelihood that any particular individual will develop osteoarthritis. The genetic factors that govern your chances of developing it are not well understood, but there is a definite link between a family  history of this disease and your chances of developing it early, at all, or in its most severe forms.

Additionally, being overweight can increase your risk factor of developing osteoarthritis. Excess weight on the joints causes additional destruction to cartilage every time any damage occurs at all.  Those who suffer from osteoarthritis are often enjoined to lose as much weight as possible, and as quickly as possible, until their body mass index reaches a healthy level.

Causes of Rheumatoid Arthritis

Rheumatoid arthritis is considered a genetic condition rather than one that is specifically linked to aging or certain physical behaviors. However, it is not a disease which is strictly transmitted through lines of inheritance. If your mother or grandmother suffered from rheumatoid arthritis, you may or may not develop the condition yourself.

The best research currently suggests that what is inherited is a gene that makes some people more vulnerable to the development of rheumatoid arthritis. Merely possessing this gene does not mean a person will develop the condition; other trigger factors are considered to be necessary. The exact number and nature of possible triggers is still a matter of vigorous debate in the scientific community, but most researchers agree that infections are one trigger while a host of various environmental factors is probably another.

The trigger, once activated, will cause the immune system to begin to regard the cartilage between joints as some kind of invading enemy. Just as the immune system will attack germs and other substances which are foreign to the body, in an auto immune condition such as rheumatoid arthritis, the immune system will attack the body itself. Immune functions are normally a very good thing as they keep us from getting sick. In the case of rheumatoid arthritis, however, the immune system has become over active and is the cause of the condition itself.

Causes of Post-Injury Arthritis

As the name of this condition suggest, the root cause of it is some form of injury to any of the joints in the foot.  One major such type of injury is a fracture, although fractures that affect only the middle of a bone and not the surface of any joints do not tend to lead to arthritis.

Injury statistics collected over the course of many years indicate that injured joints have a 7 fold increase in the likelihood of developing arthritis, as compared to the same joint that has not been injured. Part of this is probably due to the body’s natural chemical reaction following a joint injury: your endocrine system will secrete hormones that actually cause the death of cartilage cells. Currently, scientists are still researching why these hormones would be secreted at this time, as it seems counterproductive to the body to have its own systems actively destroying cartilage.

Treatment of Foot Arthritis

Common Foot Arthritis Treatments

Both surgical and nonsurgical treatments exist. Surgery is the more extreme form of treatment. Before surgery is deemed necessary, and all of the following may be tried by your arthritis specialist or general practitioner:

  • Pain relief medication such as NSAIDS. In over the counter form, these commonly include ibuprofen (Motrin, Advil) and Naproxen (Aleve). Other pain medications that are used may require a prescription. Arthritis pain relief medications commonly help reduce inflammation in addition to alleviating pain, but their long term use has drawbacks.
  • Injected medications. Among some of the injections in common use are steroids and gold, both of which are injected directly into the affected joint or joints.
  • Orthotic inserts for shoes, including custom made orthotics or custom made shoes
  • Exercises to maintain and gradually increase ROM (range of motion)
  • Exercises to strengthen muscles to better support damaged joints
  • Other forms of physical therapy
  • Implements to assist with walking, such as canes or braces
  • Losing weight in order to relieve unnecessary stress on joints.
Surgical Foot Arthritis Treatments

There are several major types of operations that are used in the treatment of foot arthritis. Some patients may need only a single type of surgery while others may need more than one variety. The most common procedures in use at the current time are:

  • Joint Elimination (Arthrodesis)
  • Exploratory Microsurgery (Arthroscopic Debridement)

Joint elimination surgery is also called fusion or arthrodesis. In this procedure, the two sides of the joint are connected together using a variety of hardware such as rods, pins, plates, and screws. The objective is the hold the bones against one another until such time as they grow into a continuous whole, eliminating any joint.

This is a serious procedure not to be undertaken lightly and is typically reserved for severe cases.

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Arthroscopic Debridement, on the other hand, is a form of exploratory surgery  sometimes used with less severe cases of arthritis. The procedure involves inserting a tiny camera into a joint, using a device known as an arthroscope. A surgeon can examine the interior of the joint and if needed, thread tiny instruments through the arthroscope in order to remove any swollen tissue, bone spurs, or other elements that would be contributing to arthritis.