Arthritis & the Feet in Sugar Land
Arthritis is a frequent component of complex disease processes that may
involve more than 100 identifiable disorders. It is characterized by inflammation
of the cartilage and lining of the body's joints.
If the feet seem more susceptible to arthritis than other parts of the
body, it is because each foot has 33 joints which can be afflicted, and
there is no way to avoid the pain of the tremendous weight-bearing load
on the feet. Arthritis may be a disabling and occasionally crippling disease;
it afflicts almost 40 million Americans. In some forms, it appears to
have hereditary tendencies. While the prevalence of arthritis increases
with age, all people from infancy to middle age are potential victims.
People over 50 are the primary targets. Arthritic feet can result in loss
of mobility and independence. With early diagnosis and proper medical
care this may be avoided.
What is Arthritis?
Arthritis, in general terms, is inflammation and swelling of the cartilage
and lining of the joints, generally accompanied by an increase in the
fluid in the joints. There are multiple causes; just as a sore throat
may have its origin in a variety of diseases, so joint inflammation and
arthritis are associated with many different illnesses. Besides heredity,
arthritic symptoms may have their source in a number of phenomena:
- They can be traumatic, having their origins in injuries, notably in athletes
and industrial workers, especially if the injuries have been ignored (which
injuries of the feet tend to be).
- Bacterial and viral infections can strike the joints. The same organisms
that are present in pneumonia, gonorrhea, staph infections, and Lyme disease
cause the inflammations.
- Arthritis can develop in conjunction with bowel disorders such as colitis
and ileitis, frequently in the joints of the ankles and toes. Such inflammatory
bowel diseases seem distant from arthritis, but their control can relieve
- Drugs, both prescription drugs and illegal street drugs, can induce arthritis.
- Arthritis can be part of a congenital autoimmune disease syndrome, of undetermined
origin. Recent research has suggested, for instance, that a defective
gene may play a role in osteoarthritis.
Because arthritis can affect the structure and function of the feet it
is important to see a doctor of podiatric medicine if any of the following
symptoms occur in the feet:
- Swelling in one or more joints
- Recurring pain or tenderness in any joint
- Redness or heat in a joint
- Limitation in motion of a joint
- Early morning stiffness
- Skin changes, including rashes and growths
Some Forms of Arthritis
Although it can be relieved with rest. Dull, throbbing nighttime pain is
characteristic, and it may be accompanied by muscle weakness or deterioration.
Gait patterns (normal walking) may grow erratic. It is a particular problem
for the feet when people are overweight, simply because there are so many
joints in each foot. The additional weight contributes to the deterioration
of cartilage and the development of bone spurs. Rheumatoid Arthritis (RA)
is a major crippling disorder, and perhaps the most serious form of arthritis.
It is a complex, chronic inflammatory system of disease, often affecting
more than a dozen smaller joints during the course of the disease, frequently
in a symmetrical pattern -- both ankles, or the index fingers of both
hands, for example. It is often accompanied by constitutional signs and
symptoms -- lengthy morning stiffness, fatigue, and weight loss -- and
it may affect various systems of the body, such as the eyes, lungs, heart,
and nervous system. Women are three or four times more likely than men
to suffer RA, indicating a linkage to heredity. RA has a much more acute
onset than osteoarthritis. It is characterized by alternating periods
of remission, during which symptoms disappear, and exacerbation, marked
by the return of inflammation, stiffness, and pain. Serious joint deformity,
and loss of motion, frequently result from acute rheumatoid arthritis.
However, the disease system has been known to be active for months, or
years, then abate, sometimes permanently. Gout (gouty arthritis) is a
condition caused by a build-up of the salts of uric acid -- a normal byproduct
of the diet -- in the joints. A single big toe joint is commonly the locus,
possibly because it is subject to so much pressure in walking; attacks
of gouty arthritis are extremely painful, perhaps more so than any other
form of arthritis. Men are much more likely to be afflicted than premenopausal
women, an indication that heredity may play a role. While a rich diet
that contains red meat, rich sauces, and brandy is popularly associated
with gout, there are other protein compounds in such foods as lentils
and beans which may also play a role.
Different forms of arthritis affect the body in different ways; many have
distinct systemic affects that are not common to other forms. Early diagnosis
is important to effective treatment of any form. Destruction of cartilage
is not reversible, and if the inflammation of arthritic disease isn't
treated, both cartilage and bone can be damaged, which makes the joints
increasingly difficult to move. Most forms of arthritis cannot be cured,
but can be controlled or brought into remission; perhaps only five percent
of the most serious cases, usually of rheumatoid arthritis, result in
such severe crippling that walking aids or wheelchairs are required.
The objectives in the treatment of arthritis are controlling inflammation,
preserving joint function (or restoring it if it has been lost) and curing
the disease if possible. Because the foot is a frequent early warning
sign, the doctor of podiatric medicine is often the first physician to
encounter some of the complaints -- inflammation, pain, stiffness, excessive
warmth, injuries. Even bunions can be manifestations of arthritis. Arthritis
may be treated with several modalities. Patient education is important.
Physical therapy and exercise may be indicated, accompanied by medication.
In such a complex disease system, it's no wonder that a wide variety
of drugs have been used effectively to treat it; likewise, a given treatment
may be very effective in one patient and almost no help at all to another.
Aspirin is still the first-line drug of choice for most forms of arthritis,
and the benchmark against which the efficacy of a host of therapies is
measured. The control of foot functions with shoe inserts called orthoses,
or with braces or specially prescribed shoes, may be indicated. Surgical
intervention is a last resort in arthritis, as it is with most disease
conditions; the replacement of damaged joints with artificial joints is
a possible surgical solution.