Osteoarthritis of the foot: symptoms and treatment

Osteoarthritis of the foot is one of the most common types of pathology, localized in the articular apparatus of the distal lower limb.

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

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

What it is?

Simply put, osteoarthritis of the foot is a serious injury to the joints of the arch of the foot, associated with progressive degeneration and complete destruction of the cartilage tissue they contain. In addition to the intense pain syndrome that accompanies the pathology, it ultimately leads to the impossibility of the proper functioning of the foot, the loss of its impairment and other functions and, as a result, the patient's disability.

Causes of occurrence

The causes of osteoarthritis of the joints of the foot are mainly poor blood circulation, deterioration of supporting tissues due to injury or age-related changes. For effective treatment, you need to know what causes osteoarthritis in the foot.

The main root causes are described below:

1. Too much weight, which puts more strain on the joints of the legs.
2. Deterioration of bone and cartilage tissue over the years.
3. Genetic predisposition.
4. Walk with tight or oversized shoes.
5. Special features of the foot: wide width, curvature of the toes, flat feet. In addition, different leg lengths can be the cause.
6. Excessive mechanical workload on the limbs, characteristic of people who prefer strenuous physical work or certain sports.
7. Traumatic leg injuries, muscle sprains.
8. Constant cold action.
9. Wear high heels.

In addition, the following causes of osteoarthritis of the foot are distinguished:

• allergies and autoimmune diseases;
• congenital displacement or 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 not possible to completely cure such a disease, but it is quite possible to significantly improve the vital qualities of the patient by stopping other degenerative tendencies. In this regard, osteoarthritis of the foot should be treated after identifying the main signs of the disease.

What is the risk of osteoarthritis of the foot?

In the absence of competent and timely treatment, osteoarthritis of the joints of the foot progresses quite rapidly, leading to the destruction of cartilage tissue and inflammatory processes in the muscles.

This is accompanied not only by severe pain, but also by deformation of the foot, growth of bone tissue in the joints. As a result, mobility is lost to the point that it is completely impossible to move the foot. This leads to disability, an inability to move around independently, as well as psychological discomfort due to the feeling of inferiority.

Symptoms of osteoarthritis of the foot

Osteoarthritis of the foot is accompanied by different severities 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 for a long time it may not show any external signs.

In addition to fatigue in the legs after a long walk, signs of minor deformation appear: the formation of a small bony protuberance 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 ignore 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 unload the painful leg, which disturbs the gait and causes lameness;
3. Painful pains as a result of prolonged physical exertion, after complete destruction of the joint, the pain syndrome is constantly present;
4. Painful pain may appear with a change of weather or hypothermia of the legs;
5. The affected area periodically swells, with inflammation of the joint, hyperemia appears, the skin becomes hot to the touch;
6. During the movement of the foot, a cracking noise is heard, a consequence of a lack of synovial fluid and the presence of bone deformations in the joint;
7. Gradually, the degenerative process spreads to the periarticular tissues, forming 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 atrophy and decreased blood circulation;
10. Osteoarthritis of the foot is accompanied by rapid fatigue of the legs after standing for a long time in one place or a short walk.

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

Diagnostic

The X-ray technique is of decisive importance in the question of diagnosis. In medicine, we use the classification of radiographic stages of osteoarthritis of the foot, proposed in 1961 by a doctor of medical sciences, professor, major specialist in the diagnosis of osteoarticular pathologies. It consists of three stages:

• Initial, in which the roentgenogram records a slight narrowing of the interarticular space, noticeable only in relation to a healthy joint, and weakly expressed damage to the articular cartilage;
• The stage of pronounced changes - the narrowing of the interarticular gap is clearly visible, as it becomes two or more times below the norm. The destruction of cartilage tissue assumes a pronounced character in places of greatest load on the joint;
• The stage of pronounced changes - the x-ray shows the complete destruction of the cartilage cover of the bone. Interarticular space is practically absent, the bone tissues of the joints are in contact with each other, they completely coincide, their surfaces are deformed, bone growths are strongly expressed. This stage is called deforming arthritis of the foot, in which the motor functions of the joints of the foot are severely impaired.

This technique is still used when a person undergoes a medico-social examination in order to constitute a group of disabled people. There is another radiological classification of osteoarthritis according to Kellgren Lawrence, proposed in 1957.

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

Treatment of osteoarthritis of the foot

It should be said right away that the treatment should only be carried out in consultation with the doctor. Improper treatment of osteoarthritis of the foot at home, which is carried out by some careless patients, only worsens the course of the disease and delays healing.

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

1. Drug therapy - analgesics and anti-inflammatory drugs in the form of tablets, local and injectable, chondroprotective injected into the joint;
2. Physiotherapy - ultraviolet irradiation, treatment with high frequency currents, shock wave therapy, therapeutic exercises and massages, mud applications, mineral baths;
3. Spa treatment.

A particular problem is the treatment of osteoarthritis of the small joints of the foot. Deformation and curvature of the fingers with osteoarthritis of the foot develop very quickly, hamper walking and contribute to the appearance of painful corns and calluses. Experts recommend changing shoes for more comfortable shoes to avoid such curvatures, as well as contacting an orthopedic surgeon who will 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 pills and apply physiotherapy, because at this stage, treatment of osteoarthritis of the foot with drugs is no longer able to give a result. lasting positive. First, the cartilage membrane is completely destroyed, and then the bone tissue in the joint. Also, one of the consequences of osteoarthritis of the foot are pathologies of the spine (curvature, herniated disc) due to persistent disorders of posture and gait.

To restore normal motor functions of the joint, surgical methods of treatment are used. It can be an operation to remove the remains of cartilage, artificially close the joint in order to immobilize it to prevent further destruction of the bone, partially replacing the joint tissue with artificial tissue. A radical method of treatment involves a complete replacement of the joint with a stent. But all these manipulations are carried out only with one large joint - the ankle.

Lifestyle change

The patient needs to reconsider a number of his habits in daily life, which contribute to and cause the progression of osteoarthritis of the foot. Without this, drug treatment will not have the desired effect. Pain relievers and anti-inflammatory drugs will 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. The load on the joint must first of all be reduced to prevent the progression of the disease and stabilize the process. This can be achieved by changing certain habits and lifestyle.

The most important rules for reducing the load on the foot are:

• avoid long walks;
• alternate walking and resting for 5 minutes;
• do not stay in one place for a long time (the static load on the affected joint is much less well tolerated than the dynamic load);
• frequent descents and ascents of stairs are not recommended; if possible, you should use the elevator more often;
• do not carry weight;
• use a cane.

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

Treatment of osteoarthritis of the foot with drugs

Medicinal methods for treating osteoarthritis of the foot at home are reduced to taking certain medications. They partially eliminate the symptoms of the disease, help improve the nutrition of the joint. The problem is that deformities in cartilage and bones are very difficult to repair. Most often, for a complete correction, surgical intervention is still necessary. However, treatment tactics depend on the stage. Before pronounced changes in the joint, the main method is precisely drug therapy.

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

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

• Proton pump inhibitors.
• histamine H2 receptor blockers.

To improve the function of the joint, chondroprotectors are used. These are drugs that improve the metabolism of articular cartilage, which slows down and prevents its destruction. The main components of these 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 to 3 months, the treatment should be repeated.

In addition to tablets, capsules and injections, which have a systemic effect (on the whole body), local therapy is also used. It comes down to the use of ointments and creams. In addition, some drugs are injected directly into or near the ankle. This treatment generally gives a faster and more stable effect.

For local therapy, the following methods can be used:

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

Physiotherapy

In the treatment of patients with osteoarthritis of the feet, the following physiotherapeutic procedures are used:

1. Pulse magnetotherapy - inducers are placed on both sides on the affected joint and moved slowly for 5-10 minutes. The course consists of 10 procedures.
2. Application of heat transfer fluids - during such procedures the temperature of the tissues exposed to the action rises. The metabolism of the cartilage is activated, its regeneration is stimulated. Applications of peat slurry at temperatures up to 40 degrees, paraffin and ozokerite at temperatures up to 55 degrees are used. Such procedures are performed in 10 - 15 for a course of 20 minutes each.
3. Electrophoresis - lidocaine, analgin, sodium salicylate. The exposure time is 20 minutes per 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 - lasting 5-8 minutes on the painful joint every day for 10 days.

Gymnastic

In the acute period of osteoarthritis of the feet of the lower extremities, the legs are at rest. However, as soon as the pain subsides, it is necessary to start exercise therapy.

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

• alternately pull the socks away from you and towards you;
• make circular movements with your thumb;
• squeeze the toes as hard as possible and also loosen strongly;
• try to pick up small objects on the ground with your toes.

If the patient suffers from osteoarthritis of the small joints of the foot, movement therapy (physiotherapy) is considered essential. At first it is best to study with an instructor - he will show what and how things are to be done

Wear special shoes

With the complex treatment of arthritis of the foot, doctors prescribe the constant wearing of special shoes. Orthopedic boots, shoes, and even slippers for home use are easy to find on sale now.

Specially designed instep supports and insoles support the foot in the desired position and add shock absorption when walking, while additional orthotics and inserts secure the ankle, preventing deformation of the articular cartilageand the development of osteoarthritis of the toes.

Folk remedies

The following folk remedies are most effective for the treatment and prevention of osteoarthritis:

• Potato compresses. They are mainly used to relieve swelling and pain in the affected joint area. The potatoes are carefully washed and chopped without peeling them. Then it is thrown in warm water (40-50 degrees) and soaked for several minutes. The resulting mass is wrapped in a tissue and applied to the affected joint twice a day.
• Angelica root baths. Angelica root is crushed and wrapped in a cloth (gauze folded several times). For 5 liters of water, you need 250-300 g of root. The fabric is placed in a bowl of hot water and waits for the water to cool to a temperature of 30-40 degrees. After that, foot baths are performed for 10-15 minutes. In this case, the pouch is not removed.
• Fir oil. Fir oil is carefully rubbed into the affected joint area twice a day. For an optimal effect, it is advisable to apply a heating pad before rubbing the ointment.
• Garlic juice. A few cloves of young garlic are crushed until the vegetable, pasty oil is added. The resulting mixture is applied in a thin layer to the painful joint before going to bed and a bandage is applied.
• Conifer balm. This tool helps to improve the metabolism in the cartilage tissue, delaying 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 for 15-20 minutes over low heat. In this case, you can add a teaspoon of garlic juice, rosehip puree, finely chopped licorice root. The broth is infused in a thermos for 18-20 hours. After that, it is filtered through cheesecloth, cooled in the refrigerator and drunk 0, 5-1 liters per day for a week.
• Hop and St. John's Wort ointment. To prepare the ointment, carefully grind 10 g of washed herbs from St. John's Wort and hops. To the resulting suspension add 50 g of petroleum jelly and stir well until a homogeneous mass is obtained. The ointment is applied to the joint area twice a day.

The above means are recommended for people at risk of developing arthritis of the feet. First of all, these are patients suffering from 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 joint.

Operation

Osteoarthritis of the foot refers to chronic pathologies which progressively evolve and aggravate the 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 drugs. To eliminate deformities, severe pain, restore the ability to walk, only surgical methods are used. Other 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 elements from the synovial fluid: loose cartilage particles, bones or blood clots. The manipulation reduces the severity of the pain, but only provides temporary relief. The pain returns within 6 to 12 months. It is mainly used in young people;
2. Arthrodesis. During the operation, the remaining cartilage is removed, the joint is fixed in one position. Gradually, the bones are fused in a given position, so that ankylosis appears. The joint is completely eliminated, this leads to the immobility of the foot, but the elimination of pain, inflammation and the ability to walk, although the quality of movement is still poor. The technique is rarely used;
3. Endoprostheses. It is used exclusively in stage 3 of the disease, when there is hardly any cartilage left. The method consists of the implantation of the implant. Its service life reaches 10-15 years, depending on the type of material used. The stent allows you to completely restore the quality of life.

Is it possible to completely cure osteoarthritis of the foot?

It is believed that it is impossible to completely cope with osteoarthritis of the foot. The destroyed cartilage no longer grows. Any therapy is aimed at maintaining the current condition of the joint and preserving it in the form in which the patient came to the doctor.

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

Prevention and complications

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

• reduce the amount of salt you eat;
• organize good nutrition;
• limit excessive physical activity;
• get rid of excess weight;
• strengthen immunity to exclude inflammatory and infectious diseases.

Preventive methods for the development of osteoarthritis include:

• avoid injuries to the lower limbs;
• exclusion of hypothermia of the legs;
• self-massage of the sole;
• use of comfortable shoes with soft soles, orthopedic insoles;
• elimination of high heels;
• doing gymnastics for the joints of the foot;
• walk barefoot on the grass, the sand;
• timely treatment of inflammatory diseases.

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

Provide

With early diagnosis of osteoarthritis of the foot and correctly chosen treatment at an early stage, the prognosis is favorable. Despite the fact that the destruction of cartilage is irreversible, the further progression of the pathology with the destruction of the joint can be avoided. Osteoarthritis in the later stages has an unfavorable prognosis, the functions of the foot are lost, disability can only be avoided by replacing the destroyed joint with an artificial one.