What is it?
Osteoarthritis (OA) is the most dominant form of arthritis, affecting 13% of Canadian adults.
In the foot, the most commonly affected sites for OA are the midfoot joints and the first metatarsophalangeal joint. A review of relevant studies has indicated that custom foot orthotics and orthopaedic shoes can be an effective part of a midfoot OA treatment plan.
The Arthritis Society of Canada defines OA as “the result of the body’s failed attempt to repair damaged joint tissue.” This damage can be caused by traumatic injuries or a host of other factors. Anatomically, the ends of our bones are covered with a protective cartilage. That cartilage wears down over time due to mechanical stress, age and other factors. This results in bone-on-bone movement in the joint that can lead to stiffness, discomfort and pain.
Currently, there is no known reason for OA occurrence in some midfoot joints, while other joints in the foot have not degenerated.
In the foot, the most commonly affected sites for OA are the midfoot joints and the first metatarsophalangeal joint. A review of relevant studies has indicated that custom foot orthoses and orthopaedic shoes can be an effective part of a midfoot OA treatment plan.
What do people experience?
Early symptoms can include:
- Joint stiffness
- Joint swelling
- Joint cracking/grinding
- Pain (primarily after activity, although with progression pain can develop with activities of daily living)
Progressive manifestation of symptoms
- Foot pain
- Structural deformities
- Poor balance, resulting in an increased risk of falling
- Slower walking speed
- Difficulty walking across uneven surfaces
- Muscle weakness
- Decreased joint range of motion
- Increased foot pressures
- Difficulty ascending or descending stairs
Unfortunately, osteoarthritis can affect all members of the population, but is found to be more prevalent with certain risk factors. Multiple forms of OA affecting the foot are thought to be linked to multifactorial origins.(5)
Risk factors include:
- Age: your risk factor for developing OA increases as you age
- Female: studies have suggested that OA is more prevalent in females
- Excess weight: excessive weight increases the pressure on the joints of your feet; the mechanical stress increases your risk of developing OA
- Joint injury: repetitive or traumatic injuries may increase the development of OA
Because it may manifest with a multifactorial onset, avoiding OA is difficult. You can reduce symptoms by avoiding risk factors including:
- Ill-fitting footwear
- High impact exercise
- Excessive weight gain
- Activities/actions that increase symptoms of pain
Allowing for ample rehab and physical therapy after an injury and prior to returning to your sport or activity will also help you reduce your risk.
What can you do to feel better today?
The management of your symptoms, your current level of activity, and your range of motion are important to your overall well-being.
- Physical activity and maintenance of muscle strength and joint mobility is an integral part of any treatment plan. If you are not engaged in a current exercise program, consult with your medical professional regarding modifications or restrictions.
- Listen to your body to determine if certain motions increase stress and pain, and adjust techniques to aid in the protection of your affected joint(s).
- Take a look at your current footwear choices—are your shoes comfortable, is it time to replace them? When shopping for new shoes, your pedorthist can provide you with some recommendations to increase your level of comfort and symptom relief and accommodate orthoses (if these are part of your treatment plan).
What are my options for treatment? Who can help?
Treatment goals for individuals with OA include reducing pain and managing debilitating symptoms, while allowing the individual to complete activities of daily living with greater function and mobility. Early treatment intervention is important as it may provide joint stability and slow the progression of the disease.(1)
Conservative treatment options include:
- Custom foot orthoses
- Activity modifications
Prevention / Rehabilitation
As osteoarthritis is a multifactorial disease with different manifestations, there is little information on the prevention of OA. However, there are steps you can take to slow the progression.
- Maintain a healthy body weight
- Select and wear appropriate footwear
- Make activity modifications
- Maintain a regular exercise program, maintain current joint ranges of motion
- Utilize custom foot orthoses
Staying Active with pain
The two main goals of treating osteoarthritis include pain management and increasing your ability to function.
Contrary to previous ideas, maintaining physical activity is key in managing the progression of OA. Although this may seem counterintuitive, maintaining an exercise program retains muscular strength and available joint ranges of motion, which therefore may prevent stiffness.
Ensure that you have appropriate footwear for your activity needs. Your footwear choices may enhance your exercise or inhibit it without you even knowing it.
Always listen to your body and allow for ample rest time when needed. Consult with your physician, physiotherapist or kinesiologist before starting a new exercise program, or if you have any questions regarding your fitness plan.