Arthritis is a leading cause of disability no matter where it strikes, but when the foot and ankle are affected, just walking can be a difficult experience. You're likely to first notice a stiffness in the ankle or foot and then pain, depending on the severity of the condition. You may also notice a swelling in the ankle, foot or even the toes. While there is no cure for arthritis, there are a number of treatment options which can help alleviate the discomfort that accompanies those nagging symptoms.
There are basically two types of arthritis: rheumatoid arthritis and osteoarthritis. Rheumatoid arthritis (RA) is a disease of the immune system and affects the lining of the joints. RA usually occurs in the hands and the feet and can lead to deformity of the affected joints. Osteoarthritis (OA) results from the wear and tear on joints, in which healthy cartilage breaks apart. OA is much more common than RA and, if it affects the foot, can usually be found around the big toe. However, the rest of the foot and the ankle can also be subject to the pain and stiffness of OA.
Both types of arthritis in the feet can lead to joint stiffness, swelling and pain, especially when walking. RA is often accompanied by bunions, hammertoes and/or pain in the heel, Achilles tendon and ankle. RA sometimes leads to rheumatoid lumps, which are especially painful if they form on the bottom of the foot. OA usually has few associated problems, although bone spurs may occur.
As arthritis in the foot progresses, walking becomes more painful. Even wearing shoes can exacerbate problems if bone spurs or rheumatoid lumps develop. This leads people to limit their exercise and activity. Unfortunately, doing so results in poor overall physical function and can contribute to conditions such as obesity, diabetes and cardiovascular dysfunction. Because RA is an immune disorder, many patients also experience other medical problems related to a compromised immune system.
Foot and ankle braces can support an arthritic joint, while also restricting movement. Orthotic devices such as shoe inserts, or even specially designed shoes, can also support the joint and cushion the foot while walking. Steroid injections can help both OA and RA by reducing inflammation. OA patients may also find some relief by taking non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen. RA patients can sometimes find relief by having the fluid around the joint drained.
If you start to experience symptoms in your feet, ankles or any joints, tell your doctor, but be ready to answer specific questions: When did it start? When does it hurt the most? Does anything relieve the pain? How would you describe the pain/stiffness/discomfort? How would you rate the intensity of the pain on a scale from one to ten? A gait test, which allows the doctor to examine how you stand and walk and how your feet and ankles function when you walk, will also be given. X-rays and an MRI may also be required to get a better look at the joint itself. If RA is suspected, you'll likely take a blood test.
Most risk factors associated with arthritis cannot be modified. Age, for example, is accompanied by a decline in the body's ability to repair cartilage. A family history of arthritis will also increase your odds. Obesity is a common risk factor. One of the things you can do to lower your risk is to lose weight and put less stress on all joints, particularly the hips, knees, feet and ankles. Also, if you're especially active, be sure to wear supportive footwear and have foot injuries treated promptly to avoid long-term damage to the joint.
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