Pain and stiffness in the feet can happen to anyone. But when symptoms become more frequent and affect your level of physical activity, you may have arthritis. This is a condition that affects more than 50 million adults. Besides pain and stiffness, arthritis causes:
- Inflammation (swelling)
- Limited motion
- Redness
- Deformity
Arthritis of the foot commonly affects patients over age 60. In fact, nearly half of the population will have some level of foot arthritis, though they may not have symptoms. It can also affect athletes and younger people.
Feet, particularly the big toe joint, are prone to osteoarthritis
The most common form of foot arthritis is osteoarthritis. This occurs when the flexible, connective tissue (cartilage) around the joint breaks down. Without cartilage, the bones rub against each other, causing arthritis symptoms. This wear and tear often affects the foot and its 28 bones (both feet contain a quarter of the total bones in the entire body). The complex foot structure also has:
- 20 muscles that control movement
- 33 joints (where two or more bones meet)
- Tendons and ligaments that attach to the muscles to support mobility and the foot’s arch
Osteoarthritis mostly affects the big toe, but it can also affect the middle of the foot. Along with usual arthritis symptoms, patients may have a bump on the big toe. To diagnose arthritis of the foot, your doctor will perform a physical exam. They will also ask questions like:
- What symptoms do you have?
- When did your symptoms begin and under what circumstances?
- Do any family members have arthritis or foot problems?
- Are your symptoms better or worse during specific activities?
Depending on the results of the exam and your medical history, your doctor may order extra tests. For example, your doctor may collect blood or joint fluid samples to rule out:
- Lupus (an inflammatory disease where the immune system attacks the body)
- Rheumatoid arthritis (a disease that causes inflammation of the joints)
- Gout (excess uric acid in the body can lead to inflamed, painful joints)
- Infection
Your doctor may also order imaging tests, such as X-rays or CT scans, to better understand the physical structure of your foot. Imaging tests can identify:
- Narrowing of spaces between bones
- Bone spurs (overgrowth of bone at the joint, common with osteoarthritis)
- Broken bones or stress fractures (tiny cracks in the bone)
- Swelling or injury to cartilage, tendons and ligaments
A range of treatment options provide relief
Depending on the diagnosis, there are a range of available treatment options. Conservative options like medications provide pain relief and reduce swelling or inflammation. These may include:
- Nonsteroidal anti-inflammatory drugs (NSAIDs) to limit both pain and inflammation
- Analgesics for patients who cannot tolerate NSAIDs
- Cortisone injections to decrease swelling at a specific joint
- Antirheumatic drugs for conditions caused by forms of arthritis other than osteoarthritis (these lessen the impact of the disease over time)
- Bone-building medications to make bones stronger and less prone to fractures
For more complex conditions, your doctor may recommend surgery.
- Arthroscopic surgery uses small incisions and a camera to see inside the joint. Using tiny instruments, the surgeon can remove bone spurs or inflamed tissue.
- Joint fusion combines the ends of two joints and secures them with pins or screws so they fuse together. This procedure can ease pain but can also limit range of motion.
- Toe joint replacement may decrease pain and retain motion. This procedure replaces the metatarsophalangeal joint, which connects the toe bones to the foot bones, with an implant.
Whether your symptoms are mild or advanced, UCLA Health has treatments to help you stay active and healthy. We offer 10 convenient rheumatology clinic locations. Contact us or fill out our online form to request information.
