My doctor says I have osteoarthritis.
What is it, and how is it treated?
Osteoarthritis is the breakdown and eventual loss of cartilage in one or more joints. Cartilage protects and cushions the bones during movement. When cartilage deteriorates or is lost, swelling pain and stiffness of joints can occur with normal daily activities.
Osteoarthritis is also known as degenerative joint disease, reflecting its nature to develop as part of the aging process. As the most common form of arthritis, osteoarthritis affects millions of Americans. This condition is not to be confused with rheumatoid arthritis and other autoimmune conditions affecting joints.
Osteoarthritis appears at various joints throughout the body, including the hands, feet, spine, hips, and knees. In the foot, the disease most frequently occurs in the big toe, although it is also often found in the midfoot, hind foot and ankle.
What causes osteoarthritis?
Osteoarthritis is considered a “wear and tear” disease because the cartilage in the joint wears down with repeated stress and use over time. As the cartilage deteriorates and gets thinner, the bones lose their protective covering and eventually may rub together, causing pain and inflammation of the joint. An injury may also lead to osteoarthritis, although it may take months or years after the injury for the condition to develop. For example, osteoarthritis in the big toe is often caused by kicking or jamming the toe, or by dropping something on the toe. Osteoarthritis in the midfoot is often caused by dropping something on it, or by a sprain or fracture. In the ankle, osteoarthritis is usually caused by a fracture and occasionally by a severe sprain. Abnormal flat foot or stiff high arched foot types are more likely to have undue stress across the foot and ankle joints which may lead to osteoarthritis.
What are the symptoms of osteoarthritis?
People with osteoarthritis in the foot or ankle experience, in varying degrees, one or more of the following:
- Pain and stiffness in the joint
- Swelling in or near the joint
- Difficulty walking or bending the joint
Some patients with osteoarthritis also develop a bone spur (a bony protrusion) at the affected joint. Shoe pressure may cause pain at the site of a bone spur, and in some cases blisters or calluses may form over its surface. Bone spurs can also limit the movement of the joint.
How is it diagnosed?
In diagnosing osteoarthritis, the foot and ankle surgeon will ask questions about pain stiffness timing of symptoms and perform a physical exam looking for swelling in the joint, limited mobility, and pain with movement. In some cases, deformity and/or enlargement (spur) of the joint may be noted. X-rays may be ordered to evaluate the extent of the disease and plan for surgical treatment if needed.
How is it treated?
To help relieve symptoms, the surgeon should begin treating osteoarthritis with one or more of the following non-surgical approaches:
Oral medications. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, are often helpful in reducing the inflammation and pain. Occasionally a prescription for a steroid medication is needed to adequately reduce symptoms.
Orthotic devices. Custom orthotic devices (shoe inserts) are often prescribed to provide support to improve the foot’s mechanics or cushioning to help minimize pain.
Bracing. Bracing, which restricts motion and supports the joint, can reduce pain during walking and help prevent further deformity.
Immobilization. Protecting the foot from movement by wearing a cast or removable cast-boot may be necessary to allow the inflammation to resolve.
Steroid injections. In some cases, steroid injections are applied to the affected joint to deliver anti-inflammatory medication.
Physical therapy. Exercises to strengthen the muscles, especially when the osteoarthritis occurs in the ankle, may give the patient greater stability and help avoid injury that might worsen the condition.
When Is Surgery Needed?
When osteoarthritis has progressed substantially or failed to improve with non-surgical treatment, surgery may be recommended. The goal of surgery is to decrease pain and improve function. An experienced foot and ankle surgeon will be able to give information and recommendations for which surgical intervention is best suited to meet each individual patient’s needs.
If you are experiencing any of the above symptoms, please feel free to call our office for a consultation at (812) 372-6274.
Dr. Travis Hubbuch, DPM
Columbus Foot and Ankle Clinic
