Osteoarthritis of the foot: symptoms and treatment.

Osteoarthritis of the foot is one of the most common types of pathology, which is located 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 illnesses. Osteoarthritis is accompanied by pain and deformity of the foot.

Treatment consists of correcting with orthotics and relieving symptoms with medication.

What it is?

In simple words, 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 in them. In addition to the severe pain syndrome that accompanies the pathology, it eventually leads to the impossibility of the full functioning of the foot, the loss of its depreciation and other functions, and, consequently, the disability of the patient.

Causes of occurrence

The causes of osteoarthritis of the foot joints are mainly poor blood flow, deterioration of supporting tissues due to injury or age-related 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 tissue over the years.
3. Genetic predisposition.
4. Walking in tight or oversized shoes.
5. Individual foot characteristics: great width, curvature of the toes, flat feet. Also, different leg lengths can be the cause.
6. Excessive mechanical workload on the extremities, characteristic of people who prefer strenuous 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 extremities.

It is not possible to completely cure such an ailment, but it is quite possible to significantly improve the vital qualities of the patient by stopping new 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 quite rapidly, leading to the destruction of cartilage tissue and inflammatory processes in the muscles.

This is accompanied not only by severe pain, but also by foot deformity, due to 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 a sense of one's own inferiority.

Symptoms of osteoarthritis of the foot.

Osteoarthritis of the foot is accompanied by different symptoms of severity, the degree of manifestation of which depends on the stage and severity of the injury. As a rule, the disease begins gradually and for a long time it may not show external signs.

In addition to fatigue of the legs after a long walk, minor signs of deformation appear: the formation of a small bony protrusion at 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 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 sore leg, as a result of which gait is disturbed and lameness appears;
3. Painful pains as a result of prolonged physical exertion, after complete destruction of the joint, the pain syndrome is constantly present;
4. The painful pains can appear with a change in the climate or hypothermia of the legs;
5. The affected area periodically swells, with inflammation of the joint, hyperemia appears, the skin becomes warm to the touch;
6. During the movement of the foot, a crunch is heard, which is a consequence of the lack of synovial fluid and the presence of bone deformities in the joint;
7. Little by little, 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 avoids a pain in the leg, which leads to muscle atrophy and a decrease in blood circulation;
10. Osteoarthritis of the foot is accompanied by rapid leg fatigue after prolonged standing in one place or after a short walk.

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

Diagnosis

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

• Initial, in which the radiograph shows a slight narrowing of the interarticular space, perceptible 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 inter-joint gap is clearly visible, as it becomes two or more times smaller than the norm. The destruction of the cartilaginous tissue acquires a pronounced character in the places of greatest load in the joint;
• The stage of pronounced changes - the radiograph shows the complete destruction of the cartilaginous covering of the bone. The inter-articular gap is practically absent, the bone tissues of the joints are in contact with each other, completely coincide, their surfaces are deformed, bone growths are acutely expressed. This stage is called deforming osteoarthritis of the foot, in which the motor functions of the foot joints are severely affected.

This technique is still used when a person undergoes 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 X-rays, modern methods of instrumental diagnosis of osteoarthritis of the foot are used. Ultrasound examination and computed tomography of the foot joints provide additional information on the state of the bone, cartilage, and periarticular tissue in the affected area.

Treatment of osteoarthritis of the foot.

It should be said immediately that therapy should be carried out only in consultation with the doctor. Improper treatment of osteoarthritis of the foot at home, which is performed by some careless 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, which include conservative and surgical techniques. Conservative methods include:

1. Pharmacological treatment: analgesics and anti-inflammatories 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. The deformation and curvature of the fingers with osteoarthritis of the foot develop very quickly, make walking difficult and contribute to the appearance of painful corns and calluses. Experts recommend changing your shoes for more comfortable ones to avoid such curvatures, as well as contacting an orthopedist who will help you choose orthopedic insoles and special splints that keep the toes in the correct position.

In the third stage of deforming osteoarthritis of the foot, it is too late to take pills and apply physical therapy, since at this stage the treatment of osteoarthritis of the foot with drugs can no longer give a lasting positive result. First, the cartilaginous membrane is completely destroyed, and then the bone tissue of the joint. In addition, one of the consequences of osteoarthritis of the foot is spinal pathologies (curvature, herniated intervertebral discs) due to the persistent alteration of posture and gait.

To restore the 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 and prevent further destruction of the bone, partial replacement of the joint tissue with an artificial one. A radical treatment method involves a complete replacement of the joint with a stent. But all these manipulations are carried out with only one large joint - the ankle.

Lifestyle change

The patient must reconsider some of their 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. Pain relievers and anti-inflammatory drugs will only eliminate the symptoms of the disease, but the disease 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, 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 to reduce the load on the foot are the following:

• avoid long walks;
• alternate walking with rest for 5 minutes;
• do not stand in one place for a long time (static load on the affected joint is much worse tolerated than dynamic);
• Frequent stair descents and ascents 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 increased stress 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 medications.

Medication methods for treating osteoarthritis of the foot at home boil down to taking certain medications. 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 of the time, for a complete correction, surgical intervention is still required. However, treatment tactics depend on the setting. Before pronounced changes in the joint, the main method is precisely drug treatment.

The prescription of drugs can lead to 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 to 3 drugs from this group at a time.

For the prevention of exacerbations, the following are prescribed in parallel:

• Proton-pump inhibitor.
• Histamine H2 receptor blockers.

To improve joint function, chondroprotectors are used. 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 to 3 months, the treatment should be repeated.

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

Physiotherapy

In the treatment of patients with osteoarthritis 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 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 to the action increases. Cartilage metabolism is activated, its regeneration is stimulated. Peat mud applications are used with temperatures up to 40 degrees, paraffin and ozokerite with temperatures up to 55 degrees. Such procedures are carried out in 10-15 for a course of 20 minutes each.
3. Electrophoresis: lidocaine, analgin, sodium salicylate. The duration of the exposure is 20 minutes daily. The course consists of 15 procedures.
4. Ultraphonophoresis - hydrocortisone, analgin. Duration 5 minutes per affected joint. The course of treatment consists of 10 procedures.
5. Infrared radiation: lasts 5 to 8 minutes on the sore joint daily for 10 days.

Gymnastics

In the acute period of osteoarthritis of the feet of the lower extremities, the legs are shown 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 feet at home:

• alternatively, pull the socks out and towards you;
• make circular movements with your thumb;
• squeeze your toes as hard as possible, and also loosen strongly;
• try to lift small objects off the ground 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 better 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 wearing of special shoes. It's easy to find orthopedic boots, shoes, and even slippers to wear at home on sale now.

Specially designed instep supports and insoles hold the foot in the desired position and add cushioning when walking, while additional braces and inserts secure the ankle, preventing further deformation of the articular cartilage and the development of osteoarthritis of the fingers. .

Home remedies

The following home remedies are the most effective for the treatment and prevention of osteoarthritis:

• Potato compresses. They are used primarily to relieve swelling and pain in the affected joint area. The potatoes are thoroughly washed and cut without peeling. Then it is poured into warm 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. The angelica root is crushed and wrapped in a cloth (gauze folded several times). For 5 liters of water, 250 - 300 g of root are required. The fabric is placed in a container with hot water and wait until the water cools to a temperature of 30-40 degrees. After that, foot baths are done for 10 to 15 minutes. In this case, the bag is not removed.
• Fir oil. Fir oil is rubbed thoroughly into the affected joint area twice a day. For the best effect, it is advisable to apply a warm compress before rubbing in the ointment.
• Garlic juiceA few tender garlic cloves are ground until soft and vegetable oil is added. The resulting mixture is applied in a thin layer on the sore joint before going to bed and a bandage is applied.
• Coniferous balsam. This tool helps to improve the metabolism in the cartilage tissue, delaying the deformation of the joint. To prepare the balsam, 50 g of young needles are poured into 2 liters of boiling water. The mixture is boiled for 15 to 20 minutes over low heat. In this case, you can add a teaspoon of garlic juice, rose hips puree, finely chopped licorice root. The broth is infused in a thermos for 18 to 20 hours. After that, it is filtered through cheesecloth, chilled in the refrigerator and drunk from 0. 5 to 1 liter per day for a week.
• Hop and St. John's wort ointment. To prepare the ointment, thoroughly grind 10 g of washed herb, St. John's wort and hops. To the resulting suspension, add 50 g of Vaseline oil and stir 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 osteoarthritis 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

Osteoarthritis of the foot refers to chronic pathologies that gradually progress and aggravate degenerative processes. In the third stage of the disease, the disorders 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. All 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 only provides temporary relief. The pain returns in 6-12 months. It is used mainly in young people;
2. Arthrodesis During the operation, the remaining cartilage is removed, the joint is fixed in one position. Little by little, the bones fuse in a certain position, which is why ankylosis appears. The joint is completely removed, this leads to immobility of the foot, but the elimination of pain, inflammation and the ability to walk, although the quality of movement is still 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 of implanting the implant. Its useful life reaches 10-15 years, depending on the type of material used. The 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 fully cope with arthrosis of the foot. The destroyed cartilage no longer grows. All therapy aims to maintain the current state of the joint and preserve it in the way 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 cause a person to feel discomfort 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 is required:

• 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 injury to the lower extremities;
• exclusion of hypothermia of the legs;
• sole massage;
• wearing comfortable shoes with flexible soles, orthopedic insoles;
• removal of high heels;
• perform gymnastics for the joints of the foot;
• walking barefoot on grass, 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 the 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 a timely diagnosis of osteoarthritis of the foot and properly selected treatment in the early stages, the prognosis is favorable. Although the destruction of cartilage is irreversible, further progression of the pathology can be prevented with the destruction of the joint. Osteoarthritis in the later stages has an unfavorable prognosis, the functions of the foot are lost, disability can only be avoided by replacing the destroyed joint with an artificial one.