Arthritis of the Foot and Ankle, Part I

By John M. Sigle, DPM, FACFAS, Foot & Ankle Center of Illinois

Pain caused by arthritis of the foot and ankle is one of the most common complaints that I get from patients in my office.  Most patients live with it for years before seeking treatment by a physician.  That is unfortunate because early detection and treatment can help to slow its progression.  If you are suffering from this condition, you are not alone.  In fact, over forty million Americans suffer from some form of arthritis.  The first part of this article will help you understand what arthritis is and what causes osteoarthritis. The second part of the article will explain what arthritis feels like, how it is diagnosed, and how it is treated.

WHAT IS ARTHRITIS
Arthritis is a condition that affects and causes pain in joints of the human body. Arthritis causes inflammation of the joint lining and loss of the cartilage covering on the bone. Cartilage functions to cushion and protect bone during movements.  Loss of this protective covering can cause bone-on-bone contact, limited motion and pain. It can affect any one joint or multiple joints at the same time.  Arthritis can present itself at any age.  There are over one hundred different disorders that can manifest in painful arthritis.  The most common type is osteoarthritis. Osteoarthritis, also known as degenerative arthritis, is a “wear and tear” form of arthritis. It usually presents in patients over the age of 45 and often is a part of the aging process.  When cartilage loss is significant, its symptoms can be painful enough to prevent one from performing even routine daily activities.  In some cases it can be crippling.  The foot and ankle can be particularly vulnerable to this type of arthritis. 

There are thirty-three joints in each foot and ankle that can be afflicted.  What a complex structure it is!  The first x-ray is a top view of great toe joint osteoarthritis. The second x-ray is a side view of great toe joint osteoarthritis. Notice the free floating bone fragment at the top of the joint.

WHAT CAUSES OSTEOARTHRITIS
One common cause of this type of arthritis is overuse and repetitive stress in the affected joint.  Athletes and industrial workers commonly overuse and stress the joints of the foot and ankle. The third x-ray is an example of ankle joint arthritis.
Weight is a big factor.  The United States, in particular, has a large population of overweight people.  What most people do not realize is that each step we take, with gravity figured in, our foot joints take on four times our body weight!  Naturally, our feet will break down with time and added weight.  The ligament structures surrounding the joints eventually fail and give way to gravity.  This causes the joint alignment to change and cartilage breakdown ensues.  So, being overweight is another significant cause of this disease.

Other factors that can cause joints to become arthritic are abnormal foot structures such as flat feet or excessively high arches.  Flat feet tend to have unstable or hyper mobile joints that lead to erosion of the cartilage.  High arches often are rigid and do not have enough motion and result in constant jamming of the joints.  Both can be very painful.

Injuries can also lead to arthritic joints, especially if they are ignored.  Fractures that enter joints often leave incongruent cartilage that will lead to joint breakdown.  Sprains or ligament tears can also leave joints unstable and cause gradual erosion of the cartilage.

Next month, part 2 of this article will explain what arthritis feels like, how it is diagnosed, how it is treated, and surgical intervention.

Dr. Sigle is the owner of the Foot & Ankle Center Of Illinois located at 2921 Montvale Drive, Springfield, Illinois. Dr. Sigle received a Bachelor of Science degree in Liberal Arts and Sciences from the University of Illinois Urbana-Champaign, graduated from Dr. William M. Scholl College of Podiatric Medicine in Chicago, and completed his Podiatric Medicine and Surgical Residency at Botsford General Hospital in Farmington Hills, Michigan. He went on to complete Advanced Reconstructive Ankle and Foot Surgery/Trauma at Kaiser Hospital in San Francisco. Dr. Sigle is board certified through the American Board of Foot Surgery and in Reconstructive Rearfoot and Ankle Surgery. He is currently on the physicians’ panel for Memorial Medical Center’s Wound Healing Center. For more information, Dr. Sigle may be reached at (217)787-2700.