Arthrosis of the foot: symptoms and treatment

Arthrosis of the foot is one of the most frequent types of pathology, which is localized in the articular apparatus of the distal part of the lower limb.

The unpleasant consequences of a destructive joint disease include chronic pain and loss of motor function. Degenerative damage to the articular tissues occurs after regular heavy loads on the foot, and as a complication after injuries and concomitant diseases. Arthrosis is accompanied by pain and deformity of the foot.

Treatment consists of correcting with orthopedic insoles and relieving symptoms with medication.

What it is?

In simple words, arthrosis of the foot is a severe lesion of the joints of the arch of the foot, associated with gradual degeneration and complete destruction of the cartilage tissue in them. In addition to the intense pain syndrome that accompanies the pathology, it eventually leads to the impossibility of the full functioning of the foot, the loss of its depreciation and other functions and, accordingly, the patient's disability.

Causes of occurrence

The causes of arthrosis of the joints of the foot are mainly poor blood flow, deterioration of the supporting tissues due to injuries or age-related changes. For effective treatment, you need to know what causes arthrosis of the foot.

The main root causes are described below:

1. Too much weight, which puts more pressure on the joints of the legs.
2. Deterioration of bone and cartilage tissue over the years.
3. Genetic predisposition.
4. Walking in tight or oversized shoes.
5. Individual features of the foot: large width, curvature of the toes, flat feet. In addition, different leg lengths may be the cause.
6. Excessive mechanical workload of the limbs, characteristic of people who prefer grueling physical labor or some sports.
7. Traumatic lesions of the legs, muscle sprains.
8. Constant cold action.
9. Wearing high heels.

In addition, the following causes of arthrosis of the foot are distinguished:

• allergies and autoimmune diseases;
• displacement or congenital irregularity of the hip bone;
• hormonal and endocrine disorders in the body;
• lack of useful and vital elements;
• chronic infectious lesions of the limbs.

It is not possible to completely cure such an ailment, but it is quite possible to significantly improve the patient's vital qualities by stopping further degenerative tendencies. In this regard, arthrosis of the foot should be treated after identifying the primary signs of the disease.

What is the danger of arthrosis damage to the foot?

In the absence of competent and timely treatment, arthrosis of the joints of the foot progresses rather quickly, leading to the destruction of cartilage tissue and inflammatory processes in the muscles.

This is accompanied not only by severe pain, but also by deformity of the foot, by the growth of bone tissue in the joints. As a result, mobility is lost to the point that it is completely impossible to move the foot. This leads to disability, inability to move independently, as well as psychological discomfort due to a sense of their own inferiority.

Symptoms of arthrosis of the foot

Arthrosis of the foot is accompanied by different severity of symptoms, the degree of manifestation of which depends on the stage and severity of the lesion. As a rule, the disease begins gradually, and for a long time it may not show external signs.

In addition to fatigue of the legs after a long walk, minor deformation signs appear: the formation of a small bony protrusion in the metatarsophalangeal joint of the big toe, a change in the shape of the fingers. A person may perceive these signs as an unpleasant cosmetic defect and be unaware of the presence of a destructive disease.

The main symptoms of arthrosis of the foot:

1. After waking up, there is stiffness in the joints, they lose mobility, after a short warm-up, flexibility returns to the foot;
2. In the later stages of pathology, the range of motion decreases sharply, the person involuntarily tries to unload the sore leg, due to which the gait is disturbed, and lameness appears;
3. Aching pains as a result of prolonged physical exertion, after a thorough destruction of the joint, pain syndrome is constantly present;
4. Painful aches can appear with a change in the weather or hypothermia of the legs;
5. The affected area periodically swells, with inflammation of the joint, hyperemia appears, the skin becomes hot to the touch;
6. During the movement of the foot, a crunching sound is heard, which is a consequence of a lack of synovial fluid and the presence of bone deformities in the joint;
7. Gradually, the degenerative process spreads to the periarticular tissues, forming dense cysts in the muscles;
8. Calluses appear on the soles of the feet;
9. A person intuitively spares a sore leg, which leads to muscle atrophy and a decrease in blood circulation;
10. Arthrosis of the foot is accompanied by rapid fatigue of the legs after a long standing in one place or a short walk.

The lack of therapeutic measures contributes to the progression of pathological processes. Persistent changes in the structure of the cartilage and the structure of the joint lead to the appearance of a characteristic clinical picture.

Diagnostics

The X-ray technique is of decisive importance in the issue of diagnostics. In medicine, the classification of X-ray stages of foot arthrosis is used, proposed in 1961 by a doctor of medical sciences, professor, a leading specialist in the diagnosis of osteoarticular pathologies. It includes three stages:

• Initial, in which the roentgenogram records a slight narrowing of the inter-articular gap, noticeable only when compared with a healthy joint, and a weakly expressed lesion of the articular cartilage;
• The stage of pronounced changes - the narrowing of the inter-articular gap is clearly visible, since it becomes two or more times less than the norm. The destruction of the cartilaginous tissue takes on a pronounced character in the places of the greatest load on the joint;
• The stage of pronounced changes - the X-ray shows the complete destruction of the cartilaginous covering of the bone. The inter-articular gap is practically absent, the bone tissues of the joints are in contact with each other, they completely coincide, their surfaces are deformed, bone growths are sharply expressed. This stage is called deforming osteoarthritis of the foot, in which the motor functions of the joints of the foot are sharply impaired.

This technique is still used when a person undergoes a medical and social examination in order to establish a disability group. There is another radiological classification of arthrosis according to Kellgren Lawrence, proposed in 1957.

In addition to X-ray, modern methods of instrumental diagnostics of foot arthrosis are used. Ultrasound examination and computed tomography of the joints of the foot provide additional information about the condition of the bone, cartilage and periarticular tissue in the affected area.

Treatment of arthrosis of the foot

It must be said right away that therapy should be carried out only in consultation with the doctor. Improper treatment of arthrosis of the foot at home, which is carried out by some careless patients, only aggravates the course of the disease and delays recovery.

In the treatment of arthrosis of the feet, a complex of procedures is used, including conservative and surgical techniques. Conservative methods include:

1. Drug treatment - pain relievers and anti-inflammatory drugs in tableted, local and injectable forms, chondroprotectors injected into the joint;
2. Physiotherapy - ultraviolet irradiation, treatment with high frequency currents, shock wave therapy, therapeutic exercises and massage, mud applications, mineral baths;
3. Spa treatment.

A particular problem is the treatment of arthrosis of the small joints of the foot. Deformation and curvature of the fingers with arthrosis of the foot develop very quickly, impede walking and contributes to the appearance of painful corns and calluses. Experts recommend changing shoes for more comfortable ones to prevent such curvatures, as well as contact an orthopedist who will help you choose orthopedic insoles and special splints that hold the toes in the correct position.

At the third stage of deforming arthrosis of the foot, it is too late to drink pills and apply physiotherapy, since at this stage the treatment of arthrosis of the foot with medication is no longer able to give a lasting positive result. First, the cartilaginous membrane is completely destroyed, and then the bone tissue of the joint. Also, one of the consequences of arthrosis of the foot are pathologies of the spine (curvature, herniated intervertebral discs) due to persistent disturbance of posture and gait.

To restore the normal motor functions of the joint, surgical methods of treatment are used. This can be an operation to remove the remnants of cartilage, artificially close the joint in order to immobilize it to prevent further destruction of the bone, partial replacement of the articular tissue with an artificial one. A radical method of treatment involves a complete replacement of the joint with an endoprosthesis. But all these manipulations are carried out only with a large joint - the ankle.

Lifestyle change

The patient needs to reconsider a number of his habits in everyday life, which contribute to and provoke the progression of arthrosis of the foot. Without this, drug treatment will not have the desired effect. Painkillers and anti-inflammatory drugs will only eliminate the symptoms of the disease, but the pathological process itself will progress.

The first important point in changing your lifestyle is to reduce the stress on the diseased joint. The load on the joint, first of all, must be reduced to prevent the progression of the disease and stabilize the process. This can be achieved by changing certain habits and lifestyle.

The most important rules for reducing the load on the foot are as follows:

• avoid long walking;
• alternate walking with rest for 5 minutes;
• do not stand for a long time in one place (the static load on the affected joint is much worse tolerated than the dynamic one);
• frequent descents and ascents of stairs are not recommended; if possible, you should use the elevator more often;
• do not carry weights;
• use a cane.

Another important point is weight loss. As noted above, in obese patients, arthrosis of the foot progresses much faster due to the greater stress on the joints when walking. For treatment, it is important to determine the so-called body mass index (BMI) and try to normalize this indicator.

Treatment of arthrosis of the foot with drugs

Medication methods for treating arthrosis of the foot at home are reduced to taking certain medications. They partially eliminate the symptoms of the disease, help to improve the nutrition of the joint. The problem is that cartilage and bone deformities are very difficult to repair. Most often, for a complete correction, surgical intervention is still required. However, treatment tactics depend on the stage. Before pronounced changes in the joint, the main method is precisely drug treatment.

Prescribing drugs can provoke the development of gastropathies, which are manifested by erosions and ulcers of the stomach and duodenum. Risk factors for the development of complications are old age, the presence of peptic ulcer disease and chronic gastritis in the past, the simultaneous administration of 2 - 3 drugs from this group at once.

For the prevention of exacerbations, the following are prescribed in parallel:

• Proton pump inhibitors.
• H2 histamine receptor blockers.

To improve the function of the joint, chondroprotectors are used. These are drugs that improve the metabolism of the articular cartilage, which slows down and prevents its destruction. The main components of such drugs are glycosaminoglycans and sodium chondroitin sulfate. All chondroprotectors are used for long courses - from 1 month to six months. After a break of 2 - 3 months, the treatment should be repeated.

In addition to tablets, capsules and injections, which have a systemic effect (on the whole body), local therapy is also used. It comes down to the use of ointments and creams. In addition, some drugs are injected directly into or near the ankle. This treatment usually gives a faster and more stable effect.

For local therapy, the following methods can be used:

• intraarticular and periarticular administration of glucocorticoids;
• intra-articular administration of hyaluronic acid preparations;
• local application to the area of the affected joint of ointments (gels, creams), based on non-steroidal anti-inflammatory drugs.

Physiotherapy

In the treatment of patients with arthrosis of the feet, the following physiotherapeutic procedures are used:

1. Pulse magnetotherapy - inductors are placed on both sides on the affected joint and slowly moved for 5 to 10 minutes. The course consists of 10 procedures.
2. Application of heat transfer fluids - with such procedures, the temperature of the tissues that are exposed to the action rises. Cartilage metabolism is activated, its regeneration is stimulated. Applications of peat mud with temperatures up to 40 degrees, paraffin and ozokerite with temperatures up to 55 degrees are used. Such procedures are carried out in 10 - 15 for one course of 20 minutes each.
3. Electrophoresis - lidocaine, analgin, sodium salicylate. The duration of exposure is 20 minutes daily. The course consists of 15 procedures.
4. Ultraphonophoresis - hydrocortisone, analgin. Duration 5 minutes per affected joint. The course of treatment consists of 10 procedures.
5. Infrared radiation - lasting 5 - 8 minutes on the sore joint daily for 10 days.

Gymnastics

In the acute period of arthrosis of the feet of the lower extremities, the legs are shown to be at rest. However, as soon as the pain decreases, it is necessary to begin exercise therapy.

Exercises that can be performed for arthrosis of the feet at home:

• alternately pull the socks away from you and towards you;
• make circular movements with your thumb;
• squeeze the toes as tightly as possible and also strongly unclench;
• try to pick up small objects from the floor with your toes.

If the patient has arthrosis of the small joints of the foot, treatment with movements (kinesitherapy) is considered fundamental. At first, it is better to study with an instructor - he will show what and how things should be done

Wearing special shoes

With the complex treatment of arthrosis of the foot, doctors prescribe the constant wearing of special shoes. It is easy to find orthopedic boots, shoes and even slippers for use at home on sale now.

Specially designed instep supports and insoles support the foot in the desired position and add shock absorption when walking, while braces and additional inserts fix the ankle, preventing further deformation of the articular cartilage and the development of arthrosis of the toes.

Folk remedies

The following folk remedies are most effective for the treatment and prevention of arthrosis:

• Potato compresses. They are mainly used to relieve swelling and soreness in the area of the affected joint. Potatoes are thoroughly washed and chopped without peeling. Then it is thrown into warm water (40-50 degrees) and soaked for several minutes. The resulting mass is wrapped in cloth and applied to the affected joint twice a day.
• Angelica root baths. Angelica root is crushed and wrapped in a cloth (gauze folded several times). For 5 liters of water, 250 - 300 g of root are required. The fabric is placed in a bowl of hot water and waited until the water cools down to a temperature of 30-40 degrees. After that, foot baths are made for 10 to 15 minutes. In this case, the pouch is not removed.
• Fir oil. Fir oil is thoroughly rubbed into the area of the affected joint twice a day. For the best effect, it is advisable to apply a warming compress before rubbing in the ointment.
• Garlic juice. A few cloves of young garlic are ground until mushy and vegetable oil is added. The resulting mixture is applied in a thin layer to the sore joint before going to bed and a bandage is applied.
• Coniferous balm. This tool helps to improve the metabolism in the cartilage tissue, delaying the deformation of the joint. To prepare the balsam, 50 g of young needles are poured into 2 liters of boiling water. The mixture is boiled for 15 to 20 minutes over low heat. In this case, you can add a teaspoon of garlic juice, mashed rose hips, finely chopped licorice root. The broth is infused in a thermos for 18 - 20 hours. After that, it is filtered through cheesecloth, cooled in the refrigerator and drunk 0. 5 - 1 liter per day for a week.
• Ointment from hops and St. John's wort. To prepare the ointment, thoroughly grind 10 g of washed herb St. John's wort and hops. To the resulting slurry, add 50 g of vaseline oil and stir well until a homogeneous mass is obtained. The ointment is applied to the joint area twice a day.

The above means are recommended for people at risk of developing arthrosis of the feet. First of all, these are patients suffering from rheumatoid arthritis and other inflammatory diseases of the joints. As a prophylactic agent, these recipes can also be used by the elderly, athletes, patients after fractures or sprains of the ankle joint.

Surgery

Arthrosis of the foot refers to chronic pathologies that gradually progress and aggravate degenerative processes. At the 3rd stage of the disease, the disorders are so pronounced that the cartilage tissue is completely destroyed and cannot be restored with medications. To eliminate deformation, severe pain, restore the ability to walk, only surgical methods are used. The rest of the treatments are ineffective.

Modern types of surgical intervention:

1. Arthroscopy. An arthroscope is inserted into the intra-articular cavity - this is a special device that allows you to examine the joint from the inside. The doctor removes all foreign elements from the synovial fluid: breakaway cartilage particles, bones or blood clots. Manipulation reduces the severity of pain, but only provides temporary relief. The pain returns within 6-12 months. It is mainly used in young people;
2. Arthrodesis. During the operation, the remaining cartilage is removed, the joint is fixed in one position. Gradually, the bones are fused in a given position, so ankylosis appears. The joint is completely eliminated, this leads to immobility of the foot, but the elimination of pain, inflammation and the ability to walk, although the quality of movement still remains low. The technique is rarely used;
3. Endoprosthetics. It is used exclusively at stage 3 of the disease, when there is practically no cartilage left. The method consists in the implantation of the implant. Its service life reaches 10-15 years, depending on the type of material used. Endoprosthetics allows you to completely restore the quality of life.

Is it possible to completely cure arthrosis of the foot?

It is believed that it is impossible to completely cope with arthrosis of the foot. The destroyed cartilage no longer grows. All therapy is aimed at maintaining the current state of the joint and preserving it in the form in which the patient came to the doctor.

The doctor can only stop the process, but not restore the tissue. If the recommendations are followed, the patient will not feel restrictions on movement, and only negative external factors or ignoring the doctor's advice can again make a person feel discomfort in the legs.

Prevention and complications

To exclude the appearance of an unpleasant ailment, you must follow simple rules. One of them is a healthy lifestyle. For the prevention of arthrosis requires:

• reduce the amount of salt you eat;
• organize proper nutrition;
• limit excessive physical activity;
• get rid of excess weight;
• strengthen immunity to exclude inflammatory, infectious diseases.

Preventive methods for the development of arthrosis include:

• avoiding injuries to the lower extremities;
• exclusion of hypothermia of the legs;
• self-massage of the sole;
• use of comfortable shoes with flexible soles, orthopedic insoles;
• elimination of high heels;
• performing gymnastics for the joints of the foot;
• walking barefoot on the grass, sand;
• timely treatment of inflammatory diseases.

The disease can be complicated by pathologies such as arthritis, foot bursitis, inflammation of the periarticular bursa. Arthrosis of the foot leads to deformation of the toes, in a neglected state it becomes the reason for the immobilization of the foot and the patient's disability.

Forecast

With timely diagnosis of arthrosis of the foot and properly selected treatment in the early stages, the prognosis is favorable. Despite the fact that the destruction of cartilage is irreversible, further progression of the pathology with the destruction of the joint can be prevented. Arthrosis in the later stages has an unfavorable prognosis, the functions of the foot are lost, disability can be avoided only by replacing the destroyed joint with an artificial one.