Foot health - Arthritic Feet

Arthritis is a disease of the joints which causes them to become inflamed and stiffen.

The three main types which affect the feet are Osteo-arthritis, Rheumatoid arthritis and Gout.

Osteo-arthritis

Osteo (bone) arthritis, the most common type, is known as the 'wear and tear' complaint.  It usually affects one particular joint in areas which are subject to over-use, such as the knees and hips.  It can affect any joints in the feet, but the big toe is the most common one.

Wear and tear at the ends of the bone cause cartilage to erode, and the bone ends may begin to fuse, resulting in stiffness and aching in the joints.

Bunions or other deformities of the big toe are a sign of 'over-use' and osteo-arthritis may result.  It can also follow a bad sprain to the foot, or a break in one of the bones which involves a joint, or where the foot is under stress.

Symptoms

Stiffness and pain in the joint is the first sign of Osteo-arthritis.  Continued use of the joint makes it stiffen-up further until it refuses to move at all.

What you can do

Try to avoid putting the foot under stress in the first place by wearing the correct footwear, which help the foot maintain its correct shape.  Sensible shoes with low heels and lace-up fastening, which keep the heel in place and stop the toes from being pushed into the front of the shoe, are best.  Shoes with a stiff sole may also be of help.

If the arthritis has already developed, and your joint is painful, rest, the use of ice-packs and anti-inflammatory creams, will also help.  Your GP may prescribe anti-inflammatory tablets for you, too.  Continue wearing the right shoes, which should be roomy enough to accommodate any swelling.

Rheumatoid Arthritis

Rheumatoid arthritis is a systematic disease of the whole body, which particularly affects the joints and muscles in the foot, rather than one specific joint, as in the case of Osteo-arthritis.

The insides of the joints become inflamed, swollen and stiff, and as the disease progresses the bones ma move out of their correct positions.  The arch of the foot may slowly collapse and flatten and the toes may draw back into a claw-like shape.  Small joints of the hands and feet are the first to be affected, but eventually all joints may suffer these changes.

Rheumatoid arthritis is a progressive disease which can start in childhood, but is more likely to begin in the middle years.

Twice as many women as men develop this complaint, which is described as auto-immune disease, and can be inherited.  Some authorities auggest it could be the result of a virus.

Signs to look for

The joints become painful, swollen and feel warm.  The soles of the feet are tender and you may feel as though you are 'walking on pebbles'.  Corns, and even ulcers, may develop, and resistance to infection is appreciably diminished, particularly if you have been given a course of steroid therapy.

The stiffness is worse in the morning, after a period of inactivity.

Help yourself

Once again, sensible shoes which are deep enough to accommodate the swelling, and hold the heel in place, will help.  Regular visits to a State Registered Chiropodist is a good idea, so that they can monitor the development of the disease, and stop or reduce the amount of deformity that can occur.  Aspirin may reduce pain and swelling, but your GP will advise, and prescribe, anti-inflammatory drugs.

Drugs

This condition, which is the result of an imbalance of uric acid in the body, affects more men than women.  The main symptom is waking up in the middle of the night with an acute, throbbing pain in the big toe, which is also swollen.  Usually only one of the big toes is affected.

The pain lasts for around three or four hours and will then subside and usually not return for a few months.  It can be controlled by drugs, which your GP will be able to prescribe.  The application of ice or cooling lotions will help during an acute phase.

Chiropody care

All three forms of arthritis can benefit from chiropody care.  State Registered Chiropodists, with the letters SRCh after their names, work in the NHS and in private practice.  They will be able to adapt your existing footwear with orthoses or other appliances, which fit easily into your shoes and help redistribute pressure away from the affected parts.

Made-to-measure shoes can also be prescribed; and State Registered Chiropodists will also be able to advise you on the correct type of shoes to wear, and where to obtain them.

State Registered Chiropodists can also provide protective shields for your toes, or padding to relieve pressure and reduce friction.  Any secondary problems, like ulcers or corns, can also be treated.  They will also refer you to a specialist for further treatment, if they consider it necessary.  Specialist teams of rheumatologists, chiropodists, physiotherapists, and occupational therapists, along with specialised nurses, will provide the most effective care and treatment for arthritic patients, especially those with rheumatoid arthritis.

For the address of your local State Registered Chiropodist, contact:

The Society of Chiropodists and Podiatrists
53 Welbeck Street
London
W1M 7HE

[This is a copy of a leaflet available for free.  It is available in the foyer of Paul
Trickey's clinic, and from the address above.]