Osteoarthritis of the foot: symptoms and treatment

Osteoarthritis of the foot is one of the most common pathologies localized in the articular apparatus of the distal lower extremity.

The unpleasant consequences of destructive joint disease include chronic pain and loss of motor skills. Degenerative damage to the joint tissue occurs after regular heavy loads on the foot and as a complication after injuries and concomitant diseases. Osteoarthritis is accompanied by pain and deformity of the foot.

Treatment consists of correcting with orthopedic insoles and relieving symptoms with medication.

What is that?

In simple terms, osteoarthritis of the foot is severe damage to the joints of the arch of the foot, which is associated with gradual degeneration and complete destruction of the cartilage tissue in them. In addition to the intense pain syndrome that accompanies the pathology, it eventually leads to the impossibility of the full function of the foot, the loss of its depreciation and other functions, and, accordingly, to the disability of the patient.

Causes of occurrence

The main causes of osteoarthritis of the ankles are poor blood circulation, damage to the supporting tissue due to injuries or age-related changes. For effective treatment, you need to know what causes osteoarthritis of the foot.

The main causes are described below:

1. Too much weight that puts more pressure on the joints of the legs.
2. Bone and cartilage tissue deterioration over the years.
3. Genetic predisposition.
4. Walking in tight or oversized shoes.
5. Individual characteristics of the foot: great width, curvature of the toes, flat feet. Different leg lengths can also be the cause.
6. Excessive mechanical stress on the limbs, characteristic of people who prefer strenuous physical work or sport.
7. Traumatic lesions of the legs, muscle sprains.
8. Constant cold effect.
9. Wear high heels.

In addition, a distinction is made between the following causes of osteoarthritis of the foot:

• Allergies and autoimmune diseases;
• Displacement or congenital irregularity of the hip bone;
• hormonal and endocrine disorders in the body;
• Lack of useful and vital elements;
• chronic infectious lesions of the limbs.

It is impossible to completely cure such a disease, but it is quite possible to significantly improve the patient's vitality by stopping further degenerative tendencies. In this context, osteoarthritis of the foot should be treated after identifying the primary symptoms.

How big is the risk of osteoarthritis damage to the foot?

Without competent and timely treatment, osteoarthritis of the ankles progresses fairly quickly, which leads to the destruction of cartilage tissue and inflammatory processes in the muscles.

This is accompanied not only by severe pain, but also by deforming the foot and the growth of bone tissue in the joints. As a result, mobility is lost to such an extent that it is completely impossible to move your foot. This leads to disability, inability to move and psychological complaints due to one's own feeling of inferiority.

Symptoms of osteoarthritis of the foot

Osteoarthritis of the foot is associated with varying degrees of severity of symptoms, the degree of manifestation of which depends on the stage and severity of the lesion. As a rule, the disease begins gradually and may not show any external signs for a long time.

In addition to fatigue in the legs after a long walk, there are slight signs of deformation: the formation of a small bony protrusion in the metatarsophalangeal joint of the big toe, a change in the shape of the fingers. A person may perceive these signs as an unpleasant cosmetic defect and be unaware of the presence of a destructive disease.

The main symptoms of osteoarthritis of the foot:

1. After waking up there is stiffness in the joints, they lose mobility, after a short warm-up, flexibility returns to the foot;
2. In the later stages of the pathology, the range of motion decreases sharply, the person involuntarily tries to relieve the painful leg, as a result of which the gait is disturbed and lameness appears;
3. Aching pains as a result of prolonged physical exertion, after a thorough destruction of the joint, a pain syndrome is constantly present;
4. Painful pain can occur with changes in weather or hypothermia of the legs;
5. The affected area regularly swells, with inflammation of the joints hyperemia occurs, the skin becomes hot.
6. A grinding sound is heard during the movement of the foot, which is due to a lack of synovial fluid and the presence of bone deformities in the joint;
7. Gradually, the degenerative process spreads to the periarticular tissue and forms dense cysts in the muscles;
8. Calluses appear on the soles of the feet;
9. A person intuitively spares a sore leg, which leads to muscle wasting and a decrease in blood flow;
10. Osteoarthritis of the foot is accompanied by rapid fatigue of the legs after long periods of standing in one place or a short walk.

The lack of therapeutic measures contributes to the progression of pathological processes. Persistent changes in the cartilage and joint structure lead to the appearance of a characteristic clinical picture.

diagnosis

X-ray technology is of crucial importance in diagnostics. In medicine, the classification of the X-ray stages of foot arthrosis is used, which was proposed in 1961 by a doctor of medical sciences, professor, a leading specialist in the diagnosis of osteoarticular pathologies. It consists of three phases:

• Initially, in which the x-ray shows a slight narrowing of the inter-articular gap, which can only be seen in comparison to a healthy joint, and a weakly pronounced lesion of the articular cartilage;
• The stage of pronounced changes - the narrowing of the joint spaces is clearly visible, as it is less than two or more times the norm. The destruction of the cartilage tissue takes on a pronounced character at the points of greatest stress on the joints;
• The stage of pronounced changes - the X-ray shows the complete destruction of the cartilaginous covering of the bone. The inter-articular gap is practically absent, the bone tissues of the joints touch, they completely collapse, their surfaces are deformed, bone growth is pronounced. This stage is known as deforming osteoarthritis of the foot, in which the motor functions of the ankles are severely impaired.

This technique is still used when a person undergoes a medical and social exam to form a disabled group. There is another Kellgren Lawrence radiological classification of osteoarthritis proposed in 1957.

In addition to x-rays, modern methods of instrumental diagnosis of foot arthrosis are used. Ultrasound and computed tomography of the ankles provide additional information about the condition of the bone, cartilage, and periarticular tissue in the affected area.

Treatment of osteoarthritis of the foot

It must be said at once that the therapy should only be carried out in consultation with the doctor. Improper treatment of osteoarthritis of the foot at home, carried out by some careless patients, only aggravates the course of the disease and delays recovery.

In the treatment of osteoarthritis of the feet, a complex of procedures is used, including conservative and surgical techniques. Conservative methods include:

1. Drug treatment - pain relievers and anti-inflammatory drugs in tablet, local and injectable form, chondroprotectors injected into the joint;
2. Physiotherapy - UV radiation, treatment with high-frequency currents, shock wave therapy, therapeutic exercises and massage, mud treatments, mineral baths;
3. Spa treatment.

The treatment of osteoarthritis of the small ankle joints represents a particular problem. Deformations and curvatures of the fingers in osteoarthritis of the foot develop very quickly, make walking difficult and contribute to the appearance of painful corns and calluses. Experts recommend replacing shoes with more comfortable ones to avoid such curvatures and contact an orthopedic surgeon to help you choose orthopedic insoles and special splints that keep the toes in the correct position.

In the third stage of deforming osteoarthritis of the foot, it is too late to drink tablets and perform physiotherapy, since at this stage the drug treatment of osteoarthritis of the foot can no longer bring a permanent positive result. First, the cartilage membrane is completely destroyed, and then the bone tissue of the joint. Diseases of the spine (curvature, herniated disc) due to persistent posture and gait disorders are also one of the consequences of osteoarthritis of the foot.

Surgical methods of treatment are used to restore the normal motor functions of the joint. This can be an operation to remove cartilage remnants, artificially seal the joint in order to immobilize it in order to prevent further destruction of the bone, partial replacement of the joint tissue with an artificial one. One radical method of treatment involves the complete replacement of the joint with an endoprosthesis. But all of these manipulations are carried out using only one large joint - the ankle.

change of lifestyle

The patient needs to rethink some of their everyday habits that contribute to and provoke the progression of osteoarthritis of the foot. Without this, drug treatment will not have the desired effect. Pain relievers and anti-inflammatory drugs only eliminate the symptoms of the disease, but the pathological process itself will progress.

The first important point in changing your lifestyle is to reduce the stress on the diseased joint. First of all, it is necessary to reduce the load on the joint in order to prevent the progression of the disease and stabilize the process. This can be achieved by changing certain habits and lifestyle.

The main rules for relieving the foot are as follows:

• avoid long walking;
• alternating walking with rest for 5 minutes;
• do not stand in one place for a long time (the static load on the affected joint is tolerated much worse than the dynamic one);
• Frequent climbing and descending stairs is not recommended, if possible you should use the elevator more often;
• do not carry weights;
• use a stick.

Another important point is weight loss. As mentioned above, osteoarthritis of the foot progresses much faster in obese patients due to the increased stress on the joints when walking. For treatment, it is important to determine the so-called body mass index (BMI) and try to normalize this indicator.

Treatment of osteoarthritis of the foot with medication

Medicines to treat osteoarthritis of the foot at home are limited to taking certain medications. They partially eliminate the symptoms of the disease and help improve the nutrition of the joint. The problem is that cartilage and bone deformities are very difficult to repair. In most cases, full correction still requires surgery. However, the treatment tactics depends on the stage. Before pronounced changes in the joint, the main method is precisely drug treatment.

Prescribing drugs can provoke the development of gastropathies, which are manifested in erosions and ulcers of the stomach and duodenum. Risk factors for developing complications are age, a history of peptic ulcer and chronic gastritis, simultaneous administration of 2 - 3 drugs of this group at once.

For the prevention of exacerbations, the following are prescribed in parallel:

• Proton pump inhibitors.
• H2-histamine receptor blockers.

Chondroprotectors are used to improve the functioning of the joint. These are drugs that improve the metabolism of the articular cartilage, which slows down and prevents its destruction. The main components of such drugs are glycosaminoglycans and sodium chondroitin sulfate. All chondroprotectors are used for long courses - from 1 month to six months. After a break of 2-3 months, the treatment should be repeated.

In addition to tablets, capsules and injections that act systemically (on the whole body), local therapy is also used. It all comes down to the use of ointments and creams. In addition, some drugs are injected directly into or near the ankle. This treatment usually results in a faster and more stable effect.

The following methods can be used for local therapy:

• intra-articular and peri-articular administration of glucocorticoids;
• intra-articular administration of hyaluronic acid preparations;
• local application of ointments (gels, creams) to the area of the affected joint, based on non-steroidal anti-inflammatory drugs.

physical therapy

The following physiotherapeutic procedures are used to treat patients with osteoarthritis of the feet:

1. Pulse magnetotherapy - inductors are placed on both sides of the affected joint and slowly moved for 5 to 10 minutes. The course consists of 10 procedures.
2. Use of heat transfer fluids - during such interventions, the temperature of the tissues exposed to the action rises. The cartilage metabolism is activated and its regeneration is stimulated. Peat mud with temperatures of up to 40 degrees, paraffin and ozokerite with temperatures of up to 55 degrees are used. Such procedures are carried out in 10 - 15 for a course of 20 minutes each.
3. Electrophoresis - lidocaine, analgin, sodium salicylate. The exposure time is 20 minutes a day. The course consists of 15 procedures.
4. Ultraphonophoresis - hydrocortisone, analgin. Duration 5 minutes per affected joint. The course of treatment consists of 10 procedures.
5. Infrared radiation - daily for 5 - 8 minutes on the painful joint for 10 days.

gymnastics

In the acute phase of osteoarthritis of the feet of the lower extremities, the legs show themselves at rest. However, as soon as the pain subsides, exercise therapy must be started.

Exercises that can be done at home for osteoarthritis of the feet:

• Alternately pull the socks away from you and towards you;
• make circular movements with your thumb;
• squeeze the toes as tightly as possible and also loosen them strongly;
• Try to use your toes to pick up small objects from the floor.

If the patient has osteoarthritis of the small ankle joints, treatment with movements (kinesitherapy) is considered basic. In the beginning it is better to study with a teacher - he will show what and how to do things

Wear special shoes

In the complex treatment of osteoarthritis of the foot, doctors prescribe the constant wearing of special shoes. It's easy to find orthopedic boots, shoes, and even slippers for home use on sale now.

Specially developed instep supports and insoles support the foot in the desired position and provide additional shock absorption when walking, while bandages and additional insoles fix the ankle joint and prevent further deformation of the articular cartilage and the development of osteoarthritis of the toes.

Home remedies

The following folk remedies are most effective for treating and preventing osteoarthritis:

• Potato compresses. They are mainly used to relieve swelling and pain in the area of the affected joint. Potatoes are thoroughly washed and chopped without peeling them. Then it is thrown into warm water (40-50 degrees) and soaked for a few minutes. The resulting mass is wrapped in a cloth and applied to the affected joint twice a day.
• Angelica root baths. The angelica root is crushed and wrapped in a cloth (gauze folded several times). 250-300 g of roots are required for 5 liters of water. The fabric is placed in a bowl of hot water, waiting for the water to cool to a temperature of 30-40 degrees. After that, foot baths are made for 10 to 15 minutes. In this case, the bag is not removed.
• Fir oil. Fir oil is thoroughly rubbed into the area of the affected joint twice a day. For the best effect, it is advisable to apply a warming compress before rubbing in the ointment.
• Garlic juice. A few young cloves of garlic are ground until mushy and vegetable oil is added. The resulting mixture is applied to the painful joint in a thin layer before going to bed and a bandage is applied.
• Needle balm. This tool will help improve the metabolism in the cartilage tissue and delay the deformation of the joint. To prepare the balm, 50 g of young needles are poured into 2 liters of boiling water. The mixture is boiled over low heat for 15 to 20 minutes. In this case, you can add a teaspoon of garlic juice, pureed rose hips and finely chopped licorice root. The broth is poured in a thermos for 18-20 hours. Then it is filtered through a cheesecloth, chilled in the refrigerator and drunk 0. 5-1 liters per day for a week.
• Ointment made from hops and St. John's wort. To prepare the ointment, thoroughly grind 10 g of washed herbs St. John's wort and hops. Add 50 g of petroleum jelly to the resulting slurry and stir well until a homogeneous mass is formed. The ointment is applied to the joint area twice a day.

The above remedies are recommended for people who are at risk of developing osteoarthritis of the feet. These are primarily patients with rheumatoid arthritis and other inflammatory diseases of the joints. As a preventive measure, these recipes can also be used by the elderly, athletes, patients after fractures or sprains of the ankle.

surgery

Osteoarthritis of the foot refers to chronic pathologies that gradually progress and aggravate degenerative processes. In the 3rd stage of the disease, the disorders are so pronounced that the cartilage tissue is completely destroyed and cannot be restored with medication. To get rid of deformations and severe pain, and restore the ability to walk, only surgical methods are used. The rest of the treatments are ineffective.

Modern types of surgical intervention:

1. Arthroscopy. An arthroscope is inserted into the intra-articular cavity - this is a special device that allows you to examine the joint from the inside. The doctor removes all foreign objects from the synovial fluid: torn cartilage particles, bones or blood clots. Manipulation reduces the severity of the pain but only provides temporary relief. The pain returns within 6-12 months. It is mainly used in young people;
2. Arthrodesis. During the operation, the remaining cartilage is removed and the joint is fixed in one position. Gradually the bones grow together in a certain position, so that ankylosis occurs. The joint is completely eliminated, which leads to the immobility of the foot, but to the elimination of pain, inflammation and the ability to walk, although the quality of movement still remains poor. The technique is rarely used;
3. Endoprosthetics. It is only used in stage 3 of the disease, when there is practically no cartilage left. The method consists in implanting the implant. Its lifespan is 10-15 years, depending on the type of material used. With endoprosthetics, you can completely restore the quality of life.

Is it possible to completely cure osteoarthritis of the foot?

It is believed that it is impossible to fully manage osteoarthritis of the foot. The destroyed cartilage no longer grows. All therapies are aimed at maintaining the current condition of the joint and keeping it in the form in which the patient came to the doctor.

The doctor can only stop the process but cannot restore the tissue. If the recommendations are followed, the patient will not experience any restriction of movement, and only negative external factors or ignoring the advice of the doctor can again cause discomfort in the legs.

Prevention and Complications

To exclude the occurrence of an unpleasant disease, you need to follow simple rules. One of them is a healthy lifestyle. To prevent osteoarthritis requires:

• reduce the amount of salt you eat;
• organize proper nutrition;
• limit excessive physical activity;
• Get rid of excess weight;
• Strengthening immunity to exclude inflammatory infectious diseases.

Preventive methods of developing osteoarthritis include:

• Avoiding injuries to the lower extremities;
• Exclusion of hypothermia in the legs;
• Self-massage of the sole;
• Use of comfortable shoes with flexible soles, orthopedic insoles;
• Elimination of high heels;
• Perform gymnastics for the ankles;
• walking barefoot on grass, sand;
• timely treatment of inflammatory diseases.

The disease can be complicated by such pathologies as arthritis, foot bursitis, inflammation of the periarticular bursa. Osteoarthritis of the foot leads to deformation of the toes, in a neglected state it becomes the reason for the immobilization of the foot and the handicap of the patient.

forecast

With a timely diagnosis of osteoarthritis of the foot and properly selected treatment in the early stages, the prognosis is favorable. Despite the irreversible destruction of the cartilage, further progression of the pathology with destruction of the joint can be prevented. Osteoarthritis in later stages has an unfavorable prognosis, the functions of the foot are lost, and disabilities can only be avoided by replacing the destroyed joint with an artificial joint.