Arthritis is inflammation of one or more of your joints. It can cause pain and stiffness in any joint in the body and is common in the small joints of the foot and ankle.
There are more than 100 forms of arthritis, many of which affect the mid-foot and ankle. All types can make it difficult to walk and perform activities you enjoy.
Although there is no cure for arthritis, there are many treatment options available to slow the progress of the disease and relieve symptoms. With proper treatment, many people with arthritis are able to manage their pain, remain active, and lead fulfilling lives.
During standing, walking, and running, the mid-foot and ankle provide support, shock absorption, balance, and several other functions that are essential for motion. Three bones make up the ankle joint, primarily enabling up and down movement. There are 7 bones in the mid-foot that provide stability which helps us to stand and walk.
In many of these joints the ends of the bones are covered with articular cartilage—a slippery substance that helps the bones glide smoothly over each other during movement. Joints are surrounded by a thin lining called the synovium. The synovium produces a fluid that lubricates the cartilage and reduces friction.
Tough bands of tissue, called ligaments, connect the bones and keep the joints in place. Muscles and tendons also support the joints and provide the strength to make them move.
Symptoms arise particularly when walking or taking part in sport. The pain may be sharp or burning. Midfoot arthritis can result in problems finding suitable and comfortable footwear.
There are two main causes of midfoot arthritis.
A specific injury, sometimes relatively minor, can lead to joint damage and osteoarthritis. This same process can occur over years if the middle part of the foot is under strain because of, for example, a long-standing bunion.
Rheumatoid arthritis and other inflammatory joint conditions may also affect the midfoot.
Painkillers and anti-inflammatory medication help to reduce discomfort. Limiting activities that aggravate the symptoms is also sensible. Shoes should be stiff, rather than soft. An extreme example would be walking boots; MBT trainers are a more modern alternative. The stiff soles protect the painful joints, which bend less and therefore hurt less.
Orthotics can be useful to either correct abnormal foot biomechanics or to help stiffen existing shoes (see above).
In selected cases, where localized arthritic spurs have developed, they can be removed using a relatively small operation.
If the arthritis is severe, and all non-operative treatments have been tried, fusion of the arthritic joints may be considered. By fusing together the joints using screw plates and/or staples, pain is much reduced.
Prior to surgery, scans and/or injections are needed to decide which small joints to fuse. This sort of surgery for metatarsalgia (forefoot pain) takes many months to recover from and is very much a last resort.
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