Arthritis is a painful, often debilitating disease, all the more so when it affects what you rely on for everyday movement: your feet! The following article discusses arthritis in general, how this disease can affect you, and to what you can do to alleviate the pain felt in your toes, heels, foot, and ankle.
The prefix “Arth-“ means joint.
The suffix “-itis” means inflammation.
So, arthritis is inflammation of a joint and this can be caused by several things.
There are four “-ors” of inflammation:
- “Tumor” which mean swelling of the area in question.
- “Rubor” means redness
- “Calor” means heat: the area gets warm to the touch compared to its surrounding,
- “Dolor” when means that the area is painful.
Taken together Tumor, Rubor, Calor, Dolor equal inflammation. Any area of inflammation will have these four components.
Inflammation can be caused by many things: infection, trauma, disease processes and more. This article will focus on the inflammation associated with arthritis.
A joint is made up of cartilage, the supporting structures around it such as capsule, ligaments and tendons, and the lining of the joint called the synovium.
Cartilage is the white, shiny, hard, and incredibly smooth and perfectly made substance at the ends of most bones. These bone ends fit together so perfectly that man still cannot duplicate this type of perfection.
The capsule, ligaments and tendons are there to keep the cartilage surfaces in proper alignment to each other. They are very, very tough! They do not stretch easily. If a joint is not properly aligned it can quickly break down. More on this below.
The synovium is very important. It lines the inside of a joint and produces synovial fluid, which is the most perfect lubricant ever, far surpassing the best motor oils ever made by man. Synovial fluid lubricates the cartilage surfaces in a manner similar to what happens between two metal surfaces: put a drop of oil between them and they slide against one another with little resistance. Remove the oil and rub the metal surfaces again and soon they begin to grind each other to dust. The same goes for the protection and function offered by synovial fluid to cartilage.
Types of Arthritis
There are three basic types of arthritis:
1. Osteoarthritis—Osteoarthritis happens when your body’s joints begin to wear down. The joints that are used the most or that are under the most pressure experience this sooner and to a larger degree. In this type of arthritis cartilage wears down and causes an inflammatory reaction because the worn off flecks of cartilage inside the joint irritate it. . This alone hurts. Over time the supporting tissues around the joint react to the inflammation caused by bone grinding on bone and the flecks of cartilage by producing new bone around the joint to attempt to reduce the painful motion of the joint. On x-ray and when seen in surgery, this extra bone accumulation looks similar to a head of cauliflower. This painful disease affects a large portion of us as we grow older. All of us will experience this type of arthritis as we get older and older to greater or lesser degrees. We may think of this type of arthritis as basically a mechanically caused type of arthritis.
2. Rheumatoid Arthritis—Unlike osteoarthritis, which typically affects joints that have been heavily used over an extended period of time, rheumatoid arthritis is caused by your body’s immune system attacking and destroying cartilage and the supporting structures of a joint. It’s a chemical dissolving and weakening of the cartilage, surrounding structures and synovium of the joint as opposed to a mechanical breaking down process as seen in osteoarthritis. There is a mechanical component to the process also: as the supporting structures around the joint are weakened, the joint loosens and the perfect alignment of the cartilage surfaces is lost. Then they grind and an osteoarthritic process compounds the joint destructive disease process. Together the two processes can create a crippling and painful condition. But the primary force in this case is the chemical process that started first. The disease can be localized to only a few joints, or, it can attack many joints in a more general distribution over the body. Commonly affected joints in Rheumatoid arthritis are: hands, feet, and knees, but the disease can affect any joint. There are other medical problems associated with this arthritis as well.
3. Post-Traumatic Arthritis—Post-traumatic arthritis affects those who have had an injury to a joint.
; It is a type of osteoarthritis. For example: a broken bone that healed with the bones in a slight degree of misalignment will, over time, cause excessive pressure to be placed on part of the cartilage inside the joint. Over time this excess pressure will break down the cartilage in this area which will cause inflammation and a process not unlike that described above for osteoarthritis results. This condition is called post-traumatic arthritis because it is the result of trauma to the joint. Like osteoarthritis, its symptoms may take several years to show up.
Symptoms of Arthritis
The symptoms of arthritis include all the findings of inflammation with swelling, redness, pain and tenderness, and warmth of the area plus stiffness, and reduced range of motion of the affected joint(s). “Morning stiffness” is a common complaint of arthritis sufferers. Many say they know when its about to rain as their diseased joints are sensitive to changes in barometric (air) pressure. In severe cases the pain can be so severe that severe nausea occurs.
The treatment for arthritis of the foot and ankle varies based on its type, location, and severity. While some cases are less debilitating and require only pain medication and customized shoe inserts (“orthotics”), others may find that a cane or brace is necessary to help them get around. Physical therapy can be of great help to some, as is weight loss to reduce the amount of stress placed on the affected joint(s).
Those who find that their quality of life is so drastically compromised by arthritis may benefit from surgical treatment. The most common procedures include removal of excess bone accumulation, joint fusion, and joint replacement.
For more information on the treatment of hammertoes, bunions and fungal infections, contact the Family Foot Center. For over 23 years Dr. Stanley J. Zawada and the rest of the Family Foot Center staff have provided expert care, diagnosis and treatment of foot disorders for children, adults and seniors in the New York City area. Visit us online or call us at (718) 767-5555 to learn more about our services or to make an appointment.
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