Foot osteoarthritis: 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.

The 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 concomitant injuries and diseases. Osteoarthritis is accompanied by pain and foot deformity.

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

Things?

Put simply, osteoarthritis of the foot is severe damage to the joints of the arch of the foot, associated with gradual degeneration and complete destruction of the cartilage tissue within them. In addition to the severe pain syndrome that accompanies the pathology, it eventually leads to the impossibility of full functioning of the foot, the loss of its depreciation and other functions and, consequently, the patient's disability.

Causes of the event

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

The main root causes are described below:

1. Too much weight, which puts more pressure on the leg joints.
2. Deterioration of bone and cartilage over the years.
3. Genetic predisposition.
4. Walk in tight or oversized shoes.
5. Individual characteristics of the foot: wide width, curvature of the toes, flat feet. Also, different leg lengths can be the cause.
6. Excessive mechanical workload of the limbs, characteristic of people who prefer grueling physical work or some 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 ailment, but it is quite possible to significantly improve the patient's vital qualities by arresting further degenerative tendencies. In this regard, osteoarthritis of the foot should be treated after identifying the primary signs of the disease.

What is the danger of osteoarthritis damage to the foot?

In the absence of competent and timely treatment, arthrosis of the joints of the foot progresses rather quickly, leading to the 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, 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 foot. This leads to disability, the inability to move independently, as well as psychological distress due to the sense of one's inferiority.

Foot Osteoarthritis Symptoms

Osteoarthritis of the foot is accompanied by a different 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 leg fatigue after a long walk, slight signs of deformation appear: the formation of a small bony protrusion 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 be unaware 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 sharply decreases, the person involuntarily tries to unload the sore leg, as a result of which the gait is disturbed and lameness appears;
3. Aching pains as a result of prolonged physical exertion, after careful destruction of the joint, the pain syndrome is constantly present;
4. Aching pains can appear with a change in the 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. A creak is heard during the movement of the foot, 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 decreased blood circulation;
10. Osteoarthritis of the foot is accompanied by rapid leg fatigue after a long stop at one point or a short walk.

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

Diagnostics

The X-ray technique is of decisive importance in the problem of diagnostics. In medicine, the classification of the radiographic stages of osteoarthritis of the foot is used, proposed in 1961 by a doctor of medical sciences, professor, one of the leading specialists in the diagnosis of osteoarticular pathologies. It includes three stages:

• Initial, in which the roentgenogram records a slight narrowing of the interarticular gap, evident only when compared with a healthy joint and a weakly expressed lesion of the articular cartilage;
• The stage of pronounced changes - the narrowing of the interarticular gap is clearly visible, as it becomes two or more times lower than the norm. The destruction of the cartilage tissue takes on a pronounced character in the places of greatest load on the joint;
• The stage of pronounced changes: the x-ray shows the complete destruction of the cartilage covering of the bone. The interarticular 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 foot osteoarthritis, in which the motor functions of the foot joints are severely impaired.

This technique is still used when a person is undergoing a medical and social examination to establish a disability group. There is another radiological classification of osteoarthritis according to Kellgren Lawrence, proposed in 1957.

In addition to radiography, modern methods of instrumental diagnostics of foot arthrosis are used. Ultrasound examination and computed tomography of the joints of the foot provide additional information on the condition of the bone, cartilage, and periarticular tissue in the affected area.

Foot osteoarthritis treatment

It should be said right away that therapy should only be carried out in consultation with the doctor. Improper treatment of arthrosis of the foot at home, which is carried out by some negligent patients, only aggravates the course of the disease and delays recovery.

In the treatment of arthrosis of the feet, a complex of procedures is used, including conservative and surgical techniques. Conservative methods include:

1. Drug treatment - painkillers and anti-inflammatory drugs in tablets, local and injectable forms, chondroprotectors 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 toes with osteoarthritis of the foot develop very quickly, prevent walking and contribute to the appearance of painful corns and calluses. Experts recommend changing shoes to more comfortable ones to prevent such bends, as well as contacting an orthopedist who will help you choose orthopedic insoles and special splints that hold your toes in the correct position.

In the third stage of the deformation of osteoarthritis of the foot, it is too late to drink pills and apply physiotherapy, since at this stage the treatment of osteoarthritis of the foot with drugs is no longer able to give a lasting positive result. First, the cartilage membrane is completely destroyed, then the bone tissue of the joint. Furthermore, one of the consequences of foot osteoarthritis is spinal pathologies (curvature, herniated intervertebral discs) due to persistent posture and gait disturbances.

To restore normal motor functions of the joint, surgical methods of treatment are used. This can be an operation to remove the remains of cartilage, artificially close the joint to immobilize it to prevent further destruction of the bone, partial replacement of the joint tissue with an artificial one. One radical method of treatment involves a complete replacement of the joint with an endoprosthesis. But all these manipulations are performed only with one large joint - the ankle.

Lifestyle change

The patient needs to reconsider some of her 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. Painkillers and anti-inflammatory drugs will only eliminate the symptoms of the disease, but the pathological process itself will progress.

The first important step in changing your lifestyle is to reduce the stress on the affected joint. The load on the joint, first of all, must 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 as follows:

• avoid long walks;
• alternate walking with resting for 5 minutes;
• do not stand in one place for a long time (the static load on the affected joint is much worse tolerated than the dynamic one);
• frequent descents and ascents of stairs are not recommended, if possible it is advisable to use the lift more often;
• do not carry burdens;
• use a stick.

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 during walking. For treatment, it is important to determine the so-called body mass index (BMI) and try to normalize this indicator.

Treatment of arthrosis of the foot with drugs

Pharmacological methods of treating arthrosis of the foot at home come down to taking certain drugs. They partially eliminate the symptoms of the disease, help improve the nutrition of the joint. The problem is that cartilage and bone deformities are very difficult to repair. Most often, for a complete correction, surgery is still required. However, the treatment tactics depend on the stage. Before pronounced changes in the joint, the main method is precisely drug 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 and chronic gastritis in the past, the simultaneous administration of 2 - 3 drugs of this group at the same time.

For the prevention of exacerbations, they 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 joint 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, the treatment must be repeated.

In addition to tablets, capsules and injections, which have a systemic (whole body) effect, local therapy is also used. It boils down to the use of ointments and creams. Additionally, some medications are injected directly into or near the ankle. This treatment usually 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 affected joint area of ointments (gels, creams), based on non-steroidal anti-inflammatory drugs.

Physiotherapy

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

1. Pulse magnetotherapy: Inductors are placed on both sides of 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 increases. The metabolism of the cartilage 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 carried out in 10 - 15 for a course of 20 minutes each.
3. Electrophoresis - lidocaine, analgin, sodium salicylate. The duration of exposure is 20 minutes per day. The course consists of 15 procedures.
4. Ultraphonophoresis - hydrocortisone, analgin. Duration 5 minutes for affected joint. The course of treatment consists of 10 procedures.
5. Infrared radiation - lasting 5 - 8 minutes on the aching joint every day for 10 days.

Gym

In the acute period of arthrosis of the feet of the lower limbs, the legs are shown at rest. However, as soon as the pain subsides, physical therapy should be started.

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

• alternately pull the socks away from you and towards you;
• make circular movements with your thumb;
• squeeze your toes as tightly as possible and also open strongly;
• try picking up small objects from the floor with your toes.

If the patient has osteoarthritis of the small joints of the foot, treatment with movements (kinesitherapy) is considered essential. At first, it is best to study with an instructor - he will show what and how things should be done

Wear special shoes

With the complex treatment of arthrosis of the foot, doctors prescribe the constant use of special shoes. It's easy to find orthopedic boots, shoes, and even slippers for home use now on sale.

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

Folk remedies

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

• Potato tablets. 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 into hot water (40-50 degrees) and soaked for several minutes. The resulting mass is wrapped in a cloth 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 waited for the water to cool to a temperature of 30-40 degrees. After that, foot baths are done for 10-15 minutes. In this case, the envelope is not removed.
• Fir oil. Fir oil is carefully rubbed into the affected joint area twice a day. For the best effect, it is recommended to apply a warming compress before rubbing the ointment.
• Garlic juice. A few young garlic cloves are ground until pasty and vegetable oil are added. The resulting mixture is applied in a thin layer on the aching joint before going to bed and a bandage is applied.
• Coniferous balm. This tool helps to improve the metabolism in the cartilage tissue, delaying the deformation of the joint. To prepare the conditioner, pour 50 g of young needles 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 liter per day for a week.
• Hops and St. John's wort ointment. To prepare the ointment, carefully grind 10 g of washed St. John's wort and hops. To the resulting suspension, add 50 g of vaseline oil and mix 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 arthrosis 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.

Surgery

Foot osteoarthritis refers to chronic pathologies that progress gradually and aggravate degenerative processes. In the 3rd stage of the disease, the ailments are so pronounced that the cartilage tissue is completely destroyed and cannot be restored with drugs. To eliminate deformation, severe pain, restore the ability to walk, only surgical methods are used. The rest of the treatments are ineffective.

Modern types of surgery:

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. Manipulation reduces the severity of pain, but provides only temporary relief. The pain returns within 6-12 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 fuse in a certain position, and then ankylosis appears. 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 the implantation of the implant. Its service life reaches 10-15 years, depending on the type of material used. Endoprosthesis 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 fully cope with arthrosis of the foot. The destroyed cartilage no longer grows. All therapy is aimed at maintaining the current state 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 restrictions on movement, and only negative external factors or ignoring the doctor's advice can make a person feel uncomfortable in the legs again.

Prevention and complications

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

• reduce the amount of salt you eat;
• organize proper 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;
• sole self-massage;
• use of comfortable shoes with flexible soles, orthopedic insoles;
• elimination of high heels;
• perform gymnastics for the joints of the foot;
• walking barefoot on the grass, on the sand;
• timely treatment of inflammatory diseases.

The disease can be complicated by pathologies such as arthritis, foot bursitis, inflammation of the periarticular bursa. Osteoarthritis of the foot leads to deformation of the toes, in a neglected state it becomes the reason for the immobilization of the foot and the disability of 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, it is possible to prevent further progression of the pathology with the destruction of the joint. Arthrosis in the later stages has a poor prognosis, the functions of the foot are lost, disability can be avoided only by replacing the destroyed joint with an artificial one.