Foot arthrosis: symptoms, causes and treatment
Arthrosis of the feet is a chronic condition responsible for a cartilaginous degenerative process that can affect one of the joints that make up the foot
Articular cartilage is an elastic tissue with considerable resistance to pressure and traction (it is a specialised connective tissue with a supporting function).
It is pearly white in colour and lines the ends of the joint bones, protecting them from friction.
When cartilage is affected by arthrosis, it becomes progressively thinner.
They then flake off and expose the underlying bone ends, which thus come into direct contact with each other.
Movement becomes difficult, restricted and often the pain in the feet is very intense.
The severity of arthrosis varies depending on the degree of cartilage impairment.
Foot arthrosis is one of the most common sources of painful disorders and affects about 10% of the general adult population
Age and disease onset
50% of people over 60 years of age.
The joints of the ankle, metatarsus-first phalanx of the first toe, tarsometatarsus are most affected.
Arthrosis of the foot, generally associated with old age, can be
- primary, i.e. due to genetic factors or idiopathic
- secondary due to trauma, surgery or biomechanical factors or septic problems
- localised (monoarticular)
- generalised (multi-articular)
Do not confuse arthrosis of the feet with arthritis.
Both are rheumatic diseases, i.e. affecting the joints.
They may have some symptoms in common, such as pain, stiffness and difficulty in movement.
For these reasons, they are often mistakenly confused even though they are fundamentally different diseases.
Arthrosis is degenerative, arthritis is autoimmune
So one occurs with age while the other is not related to ageing.
Again, arthrosis corresponds to cartilage wear, while arthritis to inflammation of a membrane.
Both can lead to bone deformation but in different ways and to different degrees.
Arthrosis is much more widespread and common than arthritis.
In fact, it accounts for more than 70% of rheumatic forms.
The development of the two diseases is also different, although there is a vague similarity in symptoms.
Arthrosis is manifested by pain that appears when using the joint.
The sensation of stiffness experienced is modest and usually lasts only a few minutes.
Arthrosis can also be recognised by the characteristic noise that the joint sometimes makes, a kind of creaking noise.
With rest, arthrosis in the feet improves
Arthritis, on the other hand, behaves in the opposite way.
The pain arises mainly at rest, more frequently at night.
It subsides with movement.
The feeling of stiffness usually lasts more than 30 minutes.
Swelling and redness of the affected joint also appear.
It can sometimes happen that arthritis leads to arthrosis.
Arthritis and arthrosis are in fact two different diseases but one can generate the other
The inflammatory process of arthritis may go away, but leave marks on the cartilage.
These will make the cartilage more susceptible to wear and tear and thus lead to arthrosis.
Symptoms of arthrosis in the foot
The main clinical manifestation of arthrosis of the foot is certainly pain, which in some cases can become almost unbearable, especially at an advanced stage of the disease.
In this case it can become constant and occur during the night, disturbing proper rest.
Other symptoms may be
- consequent difficulty in walking
- swelling and redness in the affected foot
- rubbing noise (similar to a crackling) of the joint
- joint stiffness
The cause of arthrosis of the foot is unknown to date, although a number of important predisposing factors can be identified:
- congenital skeletal malformations that favour improper use of the joints of the foot, such as flat foot, hallux valgus, varus knee (opposing legs) or valgus knee (X-legs)
- trauma
- obesity
- incorrect walking posture
- wearing incorrect shoes or too high heels
- sports and strenuous work
- dysmetabolic diseases such as gout or hyperuricemia (in which excess uric acid in the blood causes crystals to be deposited inside the joint, causing inflammation).
This degenerative disease usually affects the elderly and if left untreated can become very disabling.
It can sometimes also occur in young people who have suffered trauma or have malformations.
From a diagnostic point of view, on X-rays at the beginning of the disease, no changes are found, but as the disease progresses, one observes
- reduction of the joint space
- alteration of the profile of the articular end of the bone
- formation of osteophytes (small growths) at the joint margins or at the insertion point of tendons
- cystic areas in the bone immediately below the cartilage.
The radiologically demonstrable degree of change does not always correlate with the extent of the symptoms.
Treatment of arthrosis of the foot
First and foremost, it is necessary to take preventive action against the onset of the pathology.
Thus, for example:
- those suffering from obesity should try to follow a diet to achieve a better weight
- those who always wear narrow or high-heeled shoes should reduce their wearing time as much as possible
- those who suffer from postural problems should contact a specialist to take appropriate action.
As far as treatment is concerned, there are several possible types of intervention.
Drug therapy is one of them.
The goal is to halt the degenerative effect of the disease on the joint and restore joint function as far as possible.
The drugs used to preserve and restore cartilage are known as chondroprotectants.
One medicine of this type that has proven effective is glucosamine.
Infiltrations of hyaluronic acid or the newer PRP can also be used, which seem to have a dual function for arthrosis in the feet.
They induce remission of inflammation and simultaneously have a chondroprotective action. PRP – Platelet Rich Plasma – is a blood-derived product for non-transfusion use.
The PRP remedy
PRP is an autologous platelet concentrate obtained by centrifuging blood and characterised by a high concentration of growth factors.
Its ability to activate tissue regeneration makes it the foundation of numerous techniques in the medical field.
Another effective therapy is a low-calorie, balanced diet.
In overweight people, losing kilos has proven useful in reducing pain and increasing function, as well as reducing stiffness and fatigue (also reducing the use of drug treatment).
In most osteoarthritis sufferers, moderate motor activity also allows increased joint function and reduced pain, especially in gonarthrosis.
Several scientific evidences demonstrate the usefulness of physiotherapy in decreasing pain and increasing function.
Some sources claim that manipulation may be more effective than exercise in treating hip arthrosis.
Surgery is the last available therapy when others have proven ineffective.
In severe cases that do not respond to drug therapy, causing disability, surgery is necessary.
The surgical procedure for arthrosis in the feet is called arthrodesis.
This operation is also called joint fusion as it serves to ‘fuse’ the bone elements so as to avoid rubbing and friction, resulting in less pain.
Another name for it is surgical ankylosis.
This type of surgery allows patients with severe arthrosis of the feet to return to as normal a life as possible.
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