Osteoarthritis of the foot: symptoms and treatment

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

Unpleasant consequences of destructive joint disease include chronic pain and loss of motor function. Degenerative damage to joint tissues 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?

In simple words, osteoarthritis of the foot is a severe damage to the joints of the arch of the foot, associated with gradual degeneration and complete destruction of cartilage tissue in them. In addition to the intense pain syndrome that accompanies the pathology, this ultimately leads to the inability of the foot to function properly, the loss of its amortization and other functions, and thus the patient's disability.

Causes

The causes of osteoarthritis of the foot are mainly poor blood flow, deterioration of the supporting tissues 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. Excessive weight, which puts more pressure on the joints of the legs.
2. Deterioration of bone and cartilage tissue over the years.
3. Genetic predisposition.
4. Walking in tight or large shoes.
5. Individual features of the foot: large width, curvature of the toes, flat feet. In addition, the cause may be different leg lengths.
6. Excessive mechanical load on the limbs, typical of people who prefer strenuous physical labor or certain sports.
7. Traumatic lesions of the legs, muscle sprains.
8. Constant cold action.
9. Wearing high heels.

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

• allergies and autoimmune diseases;
• displacement or congenital anomaly 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 patient's vital qualities by stopping further 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 damage to the foot in osteoarthritis?

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

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

Symptoms of osteoarthritis of the foot

Osteoarthritis of the foot is accompanied by varying 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 for a long time may not show external signs.

In addition to foot fatigue after a long walk, there are slight signs of deformity: the formation of a small bony protrusion in the metatarsophalangeal joint of the big toe, a change in the shape of the toes. One may perceive these signs as an unpleasant cosmetic defect and not be aware 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 unload the inflamed leg, due to which the gait is disturbed and lameness appears;
3. Painful pain as a result of prolonged physical exertion, after complete destruction of the joint, there is a constant pain syndrome;
4. Painful pain may occur with changing 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 squeaking sound is heard, which is a consequence of the lack of synovial fluid and the presence of bone deformities 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 reduced blood circulation;
10. Osteoarthritis of the foot is accompanied by rapid fatigue of the legs after a long stay in one place or a short walk.

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

Diagnosis

X-ray technique is crucial in the matter of diagnosis. In medicine, the classification of X-ray stages of osteoarthritis of the foot is used, proposed in 1961 by a doctor of medical sciences, professor, leading specialist in the diagnosis of osteoarticular pathologies. It includes three stages:

• Initially, the radiograph showed a slight narrowing of the interstitial space, noticeable only in comparison with a healthy joint, and a mild lesion of the articular cartilage;
• The stage of pronounced changes - the narrowing of the joint gap is clearly visible, as it becomes two or more times less than normal. The destruction of cartilage tissue acquires a pronounced character in the places of the greatest load on the joint;
• The stage of pronounced changes - the X-ray shows the complete destruction of the cartilaginous coating of the bone. The interstitial space is practically absent, the bone tissues of the joints are in contact with each other, they completely coincide, their surfaces are deformed, the bone growths are sharply expressed. This stage is called deforming osteoarthritis 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 medical and social examination to identify a disability group. There is another radiological classification of osteoarthritis according to Kellgren Lawrence, proposed in 1957.

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

Treatment of osteoarthritis of the foot

It should be immediately said that therapy should be carried out only after consulting a doctor. Improper treatment of osteoarthritis of the foot at home, which is performed by some careless patients, only worsens the course of the disease and slows recovery.

A set of procedures, including conservative and surgical techniques, is used to treat osteoarthritis of the legs. Conservative methods include:

1. Drug treatment - painkillers and anti-inflammatory drugs in tablets, topical and injectable forms, chondroprotectors injected into the joint;
2. Physiotherapy - ultraviolet radiation, treatment with high frequency currents, shock wave therapy, therapeutic gymnastics and massage, mud applications, mineral baths;
3. Spa treatment.

A special problem is the treatment of osteoarthritis of the small joints of the foot. Deformity and curvature of the toes in osteoarthritis of the foot develop very quickly, make it difficult to walk and contribute to the appearance of painful calluses and calluses. Experts recommend changing shoes with more comfortable ones to prevent such distortions, as well as contact an orthopedist, who will help you choose orthopedic insoles and special splints that keep your toes in the right position.

In the third stage of deforming osteoarthritis of the foot, it is too late to take pills and apply physiotherapy, because at this stage the treatment of osteoarthritis of the foot with drugs can no longer give a lasting positive result. First, the cartilage membrane is completely destroyed, and then the bone tissue of the joint. Also, one of the consequences of osteoarthritis of the foot are pathologies of the spine (curvature, herniation of the intervertebral discs) due to constant impaired posture and gait.

Surgical treatment methods are used to restore normal motor function of the joint. This may be an operation to remove the remnants of cartilage, artificial closure of the joint to immobilize it to prevent further destruction of the bone, partial replacement of joint tissue with artificial. A radical method of treatment involves complete replacement of the joint with an endoprosthesis. But all these manipulations are performed only with a large joint - the ankle.

Lifestyle change

The patient needs to reconsider a number of their daily habits that contribute to and provoke the progression of osteoarthritis of the foot. Without this, drug treatment will not have the desired effect. Painkillers 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 stress on the diseased joint. The load on the joint, in the first place, must be reduced to prevent the progression of the disease and to stabilize the process. This can be achieved by changing certain habits and lifestyles.

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

• avoid long walks;
• alternating walking with rest for 5 minutes;
• do not stay in one place for a long time (static load on the affected joint is tolerated much worse than dynamic);
• frequent descents and ascents of stairs are not recommended; if possible, you should use the elevator more often;
• do not carry weights;
• 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 greater strain 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 drugs

Medical methods for the treatment of osteoarthritis of the foot at home are reduced to taking certain drugs. They partially eliminate the symptoms of the disease, help to improve the nutrition of the joint. The problem is that cartilage and bone deformities are very difficult to repair. Most often, complete correction still requires surgery. However, treatment tactics depend on the stage. Before pronounced changes in the joint, the main method is medical treatment.

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 use of 2-3 drugs from this group at once.

To prevent exacerbations, the following are prescribed in parallel:

• Proton pump inhibitors.
• H2 histamine receptor blockers.

Chondroprotectors are used to improve joint function. These are drugs that improve the metabolism of 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, treatment should be repeated.

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

The following methods can be used for local therapy:

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

Physiotherapy

The following physiotherapy procedures are used in the treatment of patients with osteoarthritis of the legs:

1. Pulse magnetic therapy - inductors are placed on both sides on the affected joint and move slowly for 5 to 10 minutes. The course consists of 10 procedures.
2. Application of heat transfer fluids - during such procedures the temperature of the tissues that are exposed increases. Cartilage metabolism is activated, its regeneration is stimulated. Applications of peat mud with temperatures up to 40 degrees, paraffin and ozokerite with temperatures up to 55 degrees are used. Such procedures are performed for 10 - 15 for a course of 20 minutes.
3. Electrophoresis - lidocaine, analgin, sodium salicylate. The duration of the exhibition is 20 minutes a day. The course consists of 15 procedures.
4. Ultraphonophoresis - hydrocortisone, analgin. Duration 5 minutes on the affected joint. The course of treatment consists of 10 procedures.
5. Infrared radiation - lasting 5-8 minutes on the patient's joint daily for 10 days.

Gymnastics

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

Exercises that can be performed for osteoarthritis of the legs at home:

• consistently pull the socks away from you and towards you;
• make circular motions with your thumb;
• squeeze your toes as hard as possible and also squeeze hard;
• try to pick up small objects from the floor with your toes.

If the patient has osteoarthritis of the small joints of the foot, movement therapy (kinesitherapy) is considered essential. In the beginning it is better to study with an instructor - he will show what and how things should be done

Wearing special shoes

In the complex treatment of osteoarthritis of the foot, doctors prescribe constant wearing of special shoes. Orthopedic boots, shoes and even slippers are easy to find at home.

Specially designed footrests and insoles keep the foot in the desired position and add shock absorption when walking, while braces and additional inserts fix the ankle, preventing further deformation of the articular cartilage and 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 soreness in the affected joint. The potatoes are washed well and cut without peeling. Then throw in warm water (40-50 degrees) and soak for a few minutes. The resulting mass is wrapped in cloth and applied to the affected joint twice a day.
• Baths with angelica root. The angelica root is crushed and wrapped in a towel (folded gauze 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 wait until the water cools to a temperature of 30-40 degrees. Then make foot baths for 10 to 15 minutes. In this case, the bag is not removed.
• Fir oil. Fir oil is rubbed profusely in the affected area twice a day. For best effect, it is recommended to apply a warming compress before rubbing the ointment.
• Garlic juice. Grind a few cloves of young garlic to a pulp and add vegetable oil. The resulting mixture is applied in a thin layer on the affected joint before bedtime and apply a bandage.
• Coniferous balm. This tool helps to improve the metabolism in the cartilage tissue, slowing down 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 to 20 minutes on low heat. In this case, you can add a teaspoon of garlic juice, rosehip puree, finely chopped licorice root. The broth is poured into a thermos for 18 - 20 hours. Then strain through cheesecloth, cool in refrigerator and drink 0, 5 - 1 liter per day for a week.
• Ointment of hops and St. John's wort. To prepare the ointment, grind well 10 g of washed herb St. John's wort and hops. Add 50 g of Vaseline oil to the resulting slurry and mix well until a homogeneous mass is obtained. The ointment is applied to the joint area twice a day.

The above remedies are recommended for people at risk of developing osteoarthritis of the legs. 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.

Surgery

Osteoarthritis of the foot refers to chronic pathologies that gradually progress and worsen degenerative processes. In stage 3 of the disease, the disorders are so severe that the cartilage tissue is completely destroyed and cannot be repaired with medication. Only surgical methods are used to remove deformity, severe pain, and restore the ability to walk. 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: detached cartilage particles, bones or blood clots. Manipulation reduces the severity of pain, but provides only temporary relief. The pain returns within 6-12 months. Used mainly in young people;
2. Arthrodesis. During the operation, the remaining cartilage is removed, the joint is fixed in one position. Gradually the bones merge into a position, so ankylosis occurs. The joint is completely eliminated, this leads to immobility of the foot, but the elimination of pain, inflammation and the ability to walk, although the quality of movement still remains low. The technique is rarely used;
3. Endoprosthesis. It is used exclusively in stage 3 of the disease, when there is practically no cartilage left. The method consists in implanting the implant. Its service life reaches 10-15 years, depending on the type of material used. Endoprosthesis allows you to fully restore the quality of life.

Is it possible to completely cure osteoarthritis of the foot?

It is believed that it is impossible to completely deal with osteoarthritis of the foot. Destroyed cartilage no longer grows. The whole therapy is aimed at maintaining the current condition of the joint and maintaining 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 restrictions in movement and only negative external factors or ignoring the doctor's advice can again make a person feel discomfort in the legs.

Prevention and complications

To rule out the appearance of an unpleasant disease, you need to follow simple rules. One of them is a healthy lifestyle. For the prevention of osteoarthritis it is necessary:

• reduce the amount of salt you eat;
• organize proper nutrition;
• limiting excessive physical activity;
• get rid of excess weight;
• strengthening immunity to rule out inflammatory, infectious diseases.

Preventive methods for the development of osteoarthritis include:

• avoid injuries to the lower extremities;
• exclusion of hypothermia of the legs;
• sole self-massage;
• use of comfortable shoes with flexible soles, orthopedic insoles;
• removal of high heels;
• performing gymnastics for the joints of the foot;
• walking barefoot on the grass, sand;
• timely treatment of inflammatory diseases.

The disease can be complicated by pathologies such as arthritis, bursitis of the legs, inflammation of the periarticular bursa. Osteoarthritis of the foot leads to deformity of the toes, in a neglected state causes immobilization of the foot and injury to the patient.

Forecast

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