Renowned psychologist Abraham Maslow coined the quote "I suppose it is tempting, if the only tool you have is a hammer, to treat everything as if it were a nail." Now, we often paraphrase the verbiage into "If the only tool you have is a hammer, every problem looks like a nail" but the spirit is certainly the same.
This particular notion is rather applicable to arthritis—in a good way—because we have more than just a single "hammer" when it comes to potential treatment options for you.
(Don't worry – we never use actual hammers to treat arthritis!)
Arthritis in Your Lower Limbs
Arthritis can be a real challenge no matter where it develops in the body, but arthritic conditions can be especially problematic for your lower limbs.
In part, this is attributable to the fact there are 33 joints in each foot and ankle. Further, your lower appendages are responsible for supporting your entire body and enduring tremendous force loads (up to 3 times your bodyweight) even while simply walking.
Arthritis pain in feet affects millions of people on a daily basis. Why is this? Well, the number of joints in feet and ankles plays a definite role. On top of that, though, is that there are over 100 different kinds of arthritic conditions.
Combining both those factors—number of joints and types of arthritis—it's easy to see why this can be such a big problem in the lower limbs.
There's a decent chance you're surprised at the mention of so many different arthrtitic conditions. After all, most people think arthritis is a single condition.
When they do, it is often on account of the belief arthritis is something that happens as we age. And perhaps they even attribute to the loss of natural lubrication in affected joints.
The fact of the matter is that people aren't completely wrong in thinking along those lines about arthritis. In fact, as you'll see shortly, they're thinking about a specific form of arthritis – for good reason.
Out of all the potential types of arthritis, a handful tend to be most commonly seen in feet and ankles:
- Osteoarthritis. When people think about arthritis, this is usually the condition that comes to mind. Osteoarthritis is the "wear and tear" variety that can happen as we age. The reason people often associate it with arthritis is likely on account of the fact it is the most common form of this medical issue.
- Gout. Whereas osteoarthritis is caused by loss of natural lubrication, gout is an arthritic condition caused by a byproduct of food digestion – uric acid. When the body either creates too much uric acid or does not filter and expel it properly, it settles into joints and begins to crystalize. Urate crystals have sharp points, which press into soft tissues and cause sharp pain at various times (gout attacks). The joint at the base of the big toe is higly susceptible to gout.
- Rheumatoid arthritis. In this autoimmune disorder, the body's immune system starts attacking and breaking down protective joint linings. At this time, it is unknown as to why this happens, but the result is painful and inflamed joints. Treatment is centered on managing symptoms because a cure hasn't been developed yet.
- Post-traumatic arthritis. If you break a bone—and especially at an end (where joints are formed)—an issue that can develop at a later time is post-traumatic arthritis. This can arise months to years following the inciting injury.
To varying degrees, these are all rather different conditions. A major commonality, though, is that they cause joint pain – and this can take away your ability to perform and enjoy favorite activities.
If you have any of these in a foot or ankle, let our team at Sunhein Podiatry Associates create a treatment plan for you!
One of our hopes in helping you to manage arthritic pain is to avoid surgery. Before we look at some of the treatment options that can potentially address the problem without needing surgical intervention, it's important to keep in mind that some cases are best handled with surgical procedures. Sometimes, these procedures are the recommended path to restored foot function and optimal pain relief.
Fortunately, there are nonsurgical options that prove to be effective for some patients!
To determine the appropriate course forward for addressing your arthritis pain—and assessing which options might be best for you—we begin with a careful diagnosis.
In doing so, we will take the time to listen as you tell us what you are experiencing and provide some background on the problem. We will review your medical history and, depending on the circumstances, may order blood tests or X-rays to provide further insight into exactly what is happening.
Once we have gained sufficient insight understanding about your specific circumstances, we will start to discuss possible treatments with you. These could include any of the following:
- MLS Laser therapy. During MLS laser treatment sessions, light energy penetrates deeply into your soft tissue and reaches damaged cells. The energy stimulates natural healing processes by speeding up cellular reproduction and growth. This helps reduce the inflammation and pain associated with arthritis. This a pain free, non-invasive and non-narcotic alternative.
- Exercise or physical therapy. When you have joints that are stiff and painful, it might not seem as though moving around is the best idea. The fact of the matter, however, is that physical activity plays an important role in improving flexibility, range of motion, and muscle strength. All of these can help in relieving joint pain and stiffness.
- Medication. When prescribing or recommending medication to treat arthritis, we consider both the condition and patient. By taking all factors into account, we can best determine which medicinal options are best. Nonsteroidal anti-inflammatory drugs (NSAIDs) and analgescics (medications that treat pain, but not inflammation) might be used to relieve symptoms.
- Cortisone injections. For some patients, we may recommend corticosteroid injections to relieve pain, but this should be done on a limited basis.
- Heating pad. Sometimes, heat can be beneficial for soothing painful joints and muscles.
- Cold compress. At other times, you may need to use cold therapy to reduce inflammation and dull painful sensations.
- Massage. This helps because it relaxes tense muscles, but you should treat yourself to a massage simply because it feels great!
- Dietary choices. If the arthritis in your foot is gout, we will likely recommend a proper diet to lower the amount of uric acid produced by your body. This can be comprised of whole grains, fresh fruit and veggies, low-fat dairy products, legumes, and limited amounts of lean meats.
While our hope is always that we will help you find relief from arthritis pain through conservative (nonsurgical) options, there are cases when surgery is our recommended treatment. This is particularly true for cases whererin arthritis causes severe pain, loss of foot function, and greatly impacts your ability to perform even normal activities (to say nothing of ones you actually want to do).
With regards to arthritis surgery, there are several different procedures we might recommend, including:
- Arthrodesis (fusion). In this operation, we fuse the two bones of the affected joint completely together. This essentially makes one continuous bone from two (or more) bones, which reduces pain via the elimination of any possible joint movement.
- Anthroscopic debridement. In early stages of arthritis, we may elect to use this kind of surgical procedure. Basically, debridement is removal of bone spurs, inflamed synovial tissue, and loose cartilage in and around the arthritic joint. If it helps, you can think of this as a cleanup of the area.
- Total ankle replacement (arthroplasty). As you might expect, this surgical option is a matter of removing damaged bone and cartilage, and then replacing it with new plastic or metal joint surfaces. In doing so, this can restore the affected joint's function while reducing pain at the same time.
As with virtually any medical treatment—or anything in life, actually—there are certain pros and cons to each respective procedure. Accordingly, we will take the time to review these with you beforehand, so you are able to make an informed decision. When we discuss this together, please do not hesitate to ask any questions you might have.
No matter which treatment path or options we prescribe, we will do our best to help with your arthritis pain so you can get back to doing the things you love.
Contact us today for more information or to request your appointment with our Centerville offce by calling (937) 435-7477. If you prefer, take a moment right now and connect with us online.