Arthrosis of the foot: symptoms and treatment

Arthrosis of the foot is one of the most common types of pathology, which is located in the joint apparatus of the lower distal extremity.

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. Arthrosis is accompanied by foot pain and deformity.

Treatment consists of correction with orthopedic insoles and symptom relief with medication.

What is it?

In simple words, arthrosis of the foot is a serious injury to the joints in the arch of the foot, associated with gradual degeneration and complete destruction of the cartilage tissue in them. In addition to the intense pain syndrome that accompanies the pathology, it ends up leading to the impossibility of the full functioning of the foot, the loss of its depreciation and other functions and, consequently, the patient's incapacity.

Occurrence causes

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

The main 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 large shoes.
5. Individual foot characteristics: great width, curved toes, flat feet. Also, different leg lengths may be the cause.
6. Excessive mechanical workload on limbs, characteristic of people who prefer strenuous physical work or some sports.
7. Traumatic leg injuries, muscle sprains.
8. Constant cold action.
9. Wearing high heels.

In addition, the following causes of foot arthrosis are distinguished:

• allergies and autoimmune diseases;
• dislocation or congenital irregularity of the hip bone;
• hormonal and endocrine disturbances in the body;
• lack of useful and vital elements;
• chronic infectious lesions of the limbs.

It is not possible to completely cure such a disease, but it is quite possible to significantly improve the vital qualities of the patient by interrupting new degenerative tendencies. In this sense, foot arthrosis should be treated after identifying the primary signs of the disease.

What is the danger of foot osteoarthritis damage?

In the absence of competent and timely treatment, arthrosis of the joints of the foot progresses 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, the growth of bone tissue in the joints. As a result, mobility is lost to the point where it is completely impossible to move the foot. This leads to disability, inability to move independently, as well as psychological discomfort due to the feeling of your own inferiority.

Arthritis of the foot

Arthrosis of the foot is accompanied by different severity of symptoms, whose degree of manifestation depends on the stage and severity of the lesion. As a rule, the disease starts gradually and for a long time may not show any external signs.

In addition to the tiredness of the legs after a long walk, small 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 toes. 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 foot arthrosis:

1. Upon waking up, there is stiffness in the joints, they lose mobility, after a brief warm-up, flexibility returns to the foot;
2. In the later stages of the pathology, the range of motion decreases drastically, the person involuntarily tries to unload the painful leg, due to which the gait is disturbed and lameness appears;
3. Aching pain as a result of prolonged physical exertion, after complete joint destruction, the pain syndrome is constantly present;
4. Painful pain may appear with a change in weather or hypothermia in the legs;
5. The affected area periodically swells, with inflammation of the joint, hyperemia appears, the skin becomes warm to the touch;
6. During foot movement, a popping sound is heard, resulting from 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. Arthrosis of the foot is accompanied by rapid fatigue of the legs after a long stay in one place or a short walk.

The lack of therapeutic measures contributes to the progression of pathological processes. Persistent changes in cartilage structure and joint structure 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 radiographic stages of arthrosis of the foot is used, proposed in 1961 by a doctor in medical sciences, professor, great specialist in the diagnosis of osteoarticular pathologies. Includes three steps:

• Initial, in which the radiogram records a slight narrowing of the interarticular gap, noticeable only when compared to 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 smaller than normal. The destruction of the cartilaginous tissue assumes a pronounced character in places with greater load on the joint;
• The stage of pronounced changes - X-ray shows complete destruction of the cartilage covering of the bone. The interarticular gap 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 clearly 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 undergoes a medical and social examination to establish a disabled group. There is another radiological classification of arthrosis according to Kellgren Lawrence, proposed in 1957.

In addition to radiography, modern methods of instrumental diagnosis of foot arthrosis are used. Ultrasound examination and CT scan of the foot joints provide additional information about the condition of bone, cartilage, and periarticular tissue in the affected area.

Treatment of arthrosis of the foot

It must be said at the outset that therapy should only be performed in consultation with the doctor. Inadequate treatment of foot arthrosis at home, carried out 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, including conservative and surgical techniques. Conservative methods include:

1. Drug treatment - analgesics and anti-inflammatory pills, local and injectable, 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 specific problem is the treatment of arthrosis of the small joints of the foot. Deformation and curvature of the toes with arthrosis of the foot develop very quickly, prevent walking and contribute to the appearance of painful calluses and calluses. Experts recommend changing your shoe to one that is more comfortable to avoid these sagging, 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 deforming arthrosis of the foot, it is too late to take pills and undergo physiotherapy, since at this stage the treatment of arthrosis of the foot with medication is no longer able to give a lasting positive result. First, the cartilaginous membrane is completely destroyed, then the bone tissue in the joint. Furthermore, one of the consequences of foot arthrosis is pathologies of the spine (curvature, herniated intervertebral discs) due to persistent disturbances in posture and gait.

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

lifestyle change

The patient needs to reconsider some of their daily habits, which contribute to and cause the progression of foot arthrosis. Without this, drug treatment will not have the desired effect. Analgesics and anti-inflammatory drugs only eliminate the symptoms of the disease, but the pathological process itself progresses.

The first important point in lifestyle change is to reduce stress on the diseased joint. The load on the joint must first be reduced to prevent disease progression 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;
• walking alternated with rest for 5 minutes;
• don't stay in one place for too long (static load on the affected joint is much worse tolerated than dynamic load);
• frequent descents and climbs of stairs 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, foot arthrosis progresses much faster due to the 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 foot arthrosis with medications

Medication methods for treating foot arthrosis at home are reduced to the use of certain medications. They partially eliminate the symptoms of the disease, help improve joint nutrition. 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 necessary. However, treatment tactics depend on the stage. Before pronounced changes in the joint, the main method is drug treatment.

Prescribing medications can cause the development of gastropathies, which are manifested by erosions and ulcers in the stomach and duodenum. Risk factors for the development of complications are advanced age, the presence of peptic ulcer and chronic gastritis in the past, simultaneous administration of 2 to 3 medications from this group at once.

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

• Proton pump inhibitors.
• Histamine H2 receptor blockers.

To improve joint function, chondroprotectors are used. They are drugs that improve the metabolism of articular cartilage, which slows down and prevents its destruction. The main components of these drugs are glycosaminoglycans and sodium chondroitin sulfate. All chondroprotectors are used in long courses - from 1 to six months. After an interval of 2 to 3 months, the treatment must be repeated.

In addition to pills, capsules and injections, which have a systemic effect (all over the body), local therapy is also used. It all comes down to using ointments and creams. Also, some drugs 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 of ointments (gels, creams) to the affected joint area, based on non-steroidal anti-inflammatory drugs.

Physiotherapy

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

1. Pulse Magnetotherapy - Inductors are placed on either side 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 these procedures, the temperature of the tissues exposed to the action increases. Cartilage metabolism is activated, its regeneration is stimulated. Peat mud applications at temperatures up to 40 degrees, paraffin and ozokerite at temperatures up to 55 degrees are used. These procedures are performed in 10-15 for a 20 minute course each.
3. Electrophoresis - lidocaine, analgin, sodium salicylate. The exposure duration 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 - lasting 5 to 8 minutes into the painful joint daily for 10 days.

Fitness

In the acute period of arthrosis of the feet of the lower limbs, the legs are at rest. However, as soon as the pain subsides, it is necessary to start exercise therapy.

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

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

If the patient has arthrosis of the small joints of the foot, treatment with movements (kinesiotherapy) is considered essential. In the beginning it is best to study with an instructor - he will show you what and how things should be done

wearing special shoes

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

Specially designed instep supports and insoles support the foot in the intended position and add shock absorption when walking, while additional straps and inserts secure the ankle, preventing further articular cartilage deformation and the development of arthrosis of the toes. .

folk remedies

The following folk remedies are most effective for treating and preventing osteoarthritis:

• Potato compresses. They are primarily used to relieve swelling and pain in the affected joint area. Potatoes are well washed and chopped without peeling. It is then 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 is needed. The fabric is placed in a bowl of hot water and allowed to cool down to a temperature of 30-40 degrees. Afterwards, footbaths are performed for 10 to 15 minutes. In this case, the bag is not removed.
• Fir oil. Fir oil is completely rubbed into the affected joint area twice a day. For best effect, it is advisable to apply a warming compress before rubbing the ointment.
• Garlic juice. Some new garlic cloves are ground until pasty vegetable oil is added. The resulting mixture is applied in a thin layer to the painful joint before going to bed and a bandage is applied.
• Conifer balm. This tool helps to improve metabolism in cartilage tissue, delaying joint deformation. To prepare the balm, 50 g of young needles are placed in 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, rosehip puree and finely chopped licorice root. The broth is infused in a thermos for 18 to 20 hours. It is then filtered through gauze, cooled in the refrigerator and drunk from 0. 5 to 1 liter a day for a week.
• Hops and St. John's Wort Ointment. To prepare the ointment, carefully mash 10 g of washed St. John's wort and hops. To the resulting paste, add 50 g of petroleum jelly and mix well until you get a homogeneous mass. 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. Firstly, these are patients suffering from rheumatoid arthritis and other inflammatory joint diseases. As a preventive measure, these prescriptions can also be used by the elderly, athletes, patients after ankle joint fractures or sprains.

Surgery

Arthrosis 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 medication. To eliminate deformities, severe pain, restore the ability to walk, only surgical methods are used. The rest of the 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: separable cartilage particles, bones or blood clots. Manipulation reduces the intensity of the pain but provides only temporary relief. Pain returns within 6-12 months. It is mostly used in young people;
2. Arthrodesis. During the operation, the remaining cartilage is removed, the joint is fixed in position. Gradually, the bones fuse in a certain position, thus giving rise to ankylosis. 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. The method consists of implanting the implant. Its shelf life reaches 10-15 years, depending on the type of material used. The endoprosthesis allows you to completely restore the quality of life.

Is it possible to completely cure arthrosis of the foot?

It is believed that it is impossible to completely deal with arthrosis of the foot. Destroyed cartilage no longer grows. All therapy aims to maintain the current state of the joint and preserve it in the way the patient went 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 the person feel discomfort in the legs.

Prevention and complications

To exclude the appearance of an unpleasant illness, you must follow simple rules. One is a healthy lifestyle. For the prevention of arthrosis 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 arthrosis include:

• avoiding injuries to the lower extremities;
• exclusion of hypothermia of the legs;
• sole self-massage;
• wearing comfortable shoes with flexible soles, orthopedic insole;
• elimination of high heels;
• performing gymnastics for the joints of the feet;
• walk 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. Arthrosis of the foot leads to deformation of the toes, in the neglected state it becomes the reason for the immobilization of the foot and the patient's disability.

Forecast

With the timely diagnosis of foot arthrosis and the treatment properly selected in the early stages, the prognosis is favorable. Although cartilage destruction is irreversible, the progression of the pathology with joint destruction can be prevented. Arthrosis in the later stages has an unfavorable prognosis, the functions of the foot are lost, the deficiency can only be avoided by replacing the destroyed joint with an artificial one.