Foot arthrosis: Symptoms and Treatment

Foot arthrosis is one of the most common types of pathology localized in the articular system of the distal lower limb.

Unpleasant consequences of destructive joint disease include chronic pain and loss of motor function. Degenerative damage to joint tissue occurs after regular heavy exertion of the foot and as a complication of injuries and comorbidities. Arthrosis is accompanied by pain and deformity of the foot.

Treatment consists of orthopedic insole correction and alleviation of medication symptoms.

Which?

In simple words, arthrosis of the foot is a severe damage to the joints of the arch of the foot, accompanied by a gradual degeneration and complete destruction of the cartilage tissue within them. In addition to the intense pain syndrome that accompanies the pathology, it eventually leads to the impossibility of complete functioning of the foot, loss of value, and other functions, and, accordingly, disability of the patient.

Causes of occurrence

Arthrosis of the joints of the foot is mainly caused by poor blood flow, damage to the supporting tissues, or age-related changes. For effective treatment, you need to know what causes foot arthrosis.

The main 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. Walk in tight or oversized shoes.
5. Individual characteristics of the foot: large width, curvature of the toes, flat foot. In addition, different leg lengths may be the reason.
6. Excessive mechanical strain on the limbs, which is common in people who enjoy strenuous physical work or some form of sport.
7. Traumatic lesions of the legs, muscle spasms.
8. Constant cold action.
9. She is wearing high heels.

In addition, the following causes of leg arthrosis can be distinguished:

• allergies and autoimmune diseases;
• dislocation 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.

Such a disease cannot be completely cured, but by stopping further degenerative tendencies, the vital characteristics of the patient can be significantly improved. In this regard, leg arthrosis should be treated after identifying the primary signs of the disease.

What is the risk of foot arthrosis?

In the absence of proper and timely treatment, arthrosis of the joints of the foot develops fairly rapidly, 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, an increase in the bone tissue in the joints. As a result, mobility is lost to such an extent that it is completely impossible to move the foot. This leads to disability, self-immobility, and psychological discomfort due to their own sense of inferiority.

Symptoms of leg arthrosis

Leg arthrosis is accompanied by symptoms of varying severity, the degree of manifestation of which depends on the stage and severity of the lesion. The disease usually begins gradually and may show no external signs for a long time.

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

The main symptoms of leg arthrosis are:

1. After awakening, there is stiffness in the joints, they lose their mobility, after a short warm-up the flexibility of the foot returns;
2. In the later stages of the pathology, the range of motion is sharply reduced, the person involuntarily tries to relieve the painful leg, causing the gait to become disturbed, limp appearing;
3. Painful pains due to prolonged physical exertion, after thorough destruction of the joint, pain syndrome is constantly present;
4. Painful pain may occur with changes in weather or hypothermia of the legs;
5. The affected area occasionally swells, with arthritis, hyperemia, and the skin becomes hot to the touch;
6. A crackling sound is heard during the movement of the foot, which is a consequence of the lack of joint fluid and joint deformity of 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. One intuitively spares a sore leg, leading to muscle atrophy and decreased blood circulation;
10. Leg arthrosis is accompanied by rapid fatigue of the legs after a long standing or short walk.

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

Diagnostics

X-ray technology is crucial in the field of diagnostics. In medicine, the classification of the X-ray stages of leg arthrosis is used, which was proposed in 1961 by a doctor of medicine, a professor and a leading specialist in the diagnosis of osteoarticular pathologies. It consists of three stages:

• Initial, in which the roentgenogram records a slight narrowing of the gap between the joints, which can only be detected in comparison with a healthy joint, and a weak expression of the articular cartilage;
• The stage of pronounced changes - the narrowing of the interarticular gap is clearly visible as it will be twice or more smaller than normal. The destruction of cartilage tissue takes on a pronounced character in the places of greatest load on the joint;
• Phase of Expressed Changes - X-ray shows complete destruction of the cartilaginous covering of the bone. The gap between the joints is practically absent, the bone tissues of the joints are in contact with each other, they completely coincide, their surface is deformed, and the bone growth is sharply expressed. This stage is called deforming osteoarthritis of the foot, in which the motor functions of the joints of the foot are severely impaired.

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

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

Treatment of foot arthrosis

It should be stated immediately that therapy should only be performed in consultation with a physician. Improper treatment of foot arthrosis at home by some careless patients only exacerbates the course of the disease and delays recovery.

A complex of procedures, including conservative and surgical techniques, are used to treat leg arthrosis. Conservative methods include:

1. Medication - painkillers and anti-inflammatory drugs in tablet, topical and injectable forms, chondroprotectors injected into the joint;
2. Physiotherapy - ultraviolet radiation, treatment with high frequency currents, shock wave therapy, therapeutic exercises and massage, mud packs, mineral baths;
3. Spa treatment.

A particular problem is the treatment of arthrosis of the small joints of the foot. Deformity and curvature of the toes with arthrosis of the foot develops very quickly, impeding walking and contributing to the appearance of painful corneal and calluses. Experts recommend changing shoes to make them more comfortable and to consult an orthopedist to help you choose orthopedic insoles and special splints that keep your toes in place.

In the third stage of deforming arthrosis of the foot, it is too late to drink tablets and use physiotherapy, because at this stage the drug treatment of arthrosis of the foot can no longer give a lasting positive result. First, the cartilage membrane is completely destroyed, and then the bone tissue of the joint. One of the consequences of leg arthrosis is spinal pathologies (curvature, intervertebral disc herniation) due to permanent posture and gait disturbances.

Surgical treatment methods are used to restore normal motor functions of the joint. It can be a surgery to remove cartilage remnants, artificially seal the joint, immobilize it to prevent further bone destruction, and partially replace the joint tissue with an artificial one. The radical treatment method involves the complete replacement of the joint with an endoprosthesis. But all of these manipulations are performed only with a large joint - the ankle.

Lifestyle change

The patient needs to rethink many of the habits in their daily lives that contribute to and trigger the progression of leg arthrosis. Without this, the medication will not achieve the desired effect. Painkillers and anti-inflammatory drugs only eliminate the symptoms of the disease, but the pathological process itself progresses.

The first important point in lifestyle change is to reduce stress on the patient’s joint. Above all, the load on the joint should be reduced to prevent disease progression and stabilize the process. This can be achieved by changing certain habits and lifestyles.

The most important rules for reducing foot strain are:

• avoid long walks;
• alternately walking with rest for 5 minutes;
• do not stand in one place for a long time (the static load on the affected joint is much less tolerable than the dynamic one);
• frequent descent and stairs are not recommended, use the elevator more often if possible;
• do not carry weights;
• use a stick.

Another important point is weight loss. As noted above, in obese patients, leg arthrosis develops much more rapidly during walking due to the increased strain on the joints. For treatment, it is important to determine the so-called body mass index (BMI) and try to normalize this index.

Treatment of foot arthrosis with medication

Medicinal methods for treating foot arthrosis at home are limited 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. In most cases, complete correction is still required for surgery. However, treatment tactics depend on the stage. Prior to pronounced changes in the joint, the main method is precisely medication.

Prescribing medications can cause the development of gastropathies, which are manifested by erosion and ulcers of the stomach and duodenum. Risk factors for the development of complications include old age, the presence of peptic ulcer disease and chronic gastritis, concomitant use of 2-3 drugs from this group.

In order to prevent exacerbations, the following are prescribed in parallel:

• Proton pump inhibitors.
• H2 histamine receptor blockers.

Chondroprotectors are used to improve joint function. These are drugs that improve the metabolism of articular cartilage, which slows it down and prevents it from dying. 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, treatment should be repeated.

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

The following methods can be used during topical therapy:

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

Physiotherapy

The following physiotherapy procedures are used to treat patients with leg arthrosis:

1. Pulse Magnetic Therapy - Inductors are placed on either side of the affected joint and moved slowly for 5-10 minutes. The course consists of 10 procedures.
2. Use of heat transfer fluids - such procedures increase the temperature of the exposed tissues. Cartilage metabolism is activated, it stimulates its regeneration. Peat sludge up to 40 degrees, paraffin and ozokerite up to 55 degrees are used. Such procedures are performed every 10 to 15 minutes in a 20-minute course.
3. Electrophoresis - lidocaine, analgin, sodium salicylate. The duration of exposure is 20 minutes per day. The course consists of 15 procedures.
4. Ultraphophoresis - hydrocortisone, analgin. Duration 5 minutes per affected joint. The treatment process consists of 10 procedures.
5. Infrared radiation - lasts for 5-8 minutes on a sore joint for 10 days a day.

Gymnastics

In the acute period of leg arthrosis of the lower extremities, the legs are at rest. However, as soon as the pain subsides, practical therapy should be started.

Home exercises for foot arthrosis:

• take turns pulling the socks away from you and towards yourself;
• make circular movements with your thumb;
• squeeze your toes as tightly as possible and also open firmly;
• try to pick up small objects from the floor with your toes.

If the patient has arthrosis of the small joints of the foot, movement therapy (kinesitherapy) is considered essential. At first, it is better to study with an instructor - he will show you what and how to do it

Wear special shoes

With the complex treatment of foot arthrosis, doctors require the constant wearing of special shoes. From now on, you can easily find special orthopedic boots, shoes and even slippers for home use.

Specially designed insoles and insoles support the foot in the desired position and provide shock absorption while walking, while stiffeners and accessory inserts secure the ankle, preventing further deformation of the articular cartilage and the development of toe arthrosis.

Folk remedies

The following folk remedies are most effective in treating and preventing arthrosis:

• Potato wrap. It is mainly used to relieve swelling and pain in the affected joint area. Wash the potatoes thoroughly and chop without peeling. Then throw in warm water (40-50 degrees) and soak for a few minutes. The resulting mass is wrapped in a cloth and applied to the affected joint twice a day.
• Angelica root baths. The angelic root is crushed and wrapped in cloth (the gauze is folded several times). 5 liters of water require 250-300 g of roots. Place the material in a bowl of hot water and wait for the water to cool to 30-40 degrees. After that, foot baths are made for 10-15 minutes. In this case, the sachet is not removed.
• Pine oil. Pine oil is thoroughly rubbed into the affected joint area twice a day. For best results, a warming compress is recommended before rubbing with the ointment.
• Garlic juice. Grind a few cloves of young garlic until pureed and add vegetable oil. The resulting mixture is applied to the sore joint in a thin layer before going to bed and a bandage is applied.
• Coniferous balm. This device helps to improve the metabolism in the cartilage tissue, delays the deformation of the joint. To make the balm, pour 50 g of young needles into 2 liters of boiling water. The mixture is boiled on low heat for 15-20 minutes. In this case, you can add a teaspoon of garlic juice, mashed rosehips, finely chopped licorice. The broth is infused in a thermos for 18-20 hours. It is then filtered through a cheese cloth, cooled in a refrigerator and consumed 0. 5-1 liters per day for a week.
• Ointment from hops and St. John's wort. Thoroughly grind 10 g of washed St. John's wort and hops to make the ointment. To the resulting suspension add 50 g of petrolatum oil and mix thoroughly until a homogeneous mass is obtained. The ointment is applied to the joint area twice a day.

The above devices are recommended for those at risk of foot arthrosis. First, these patients suffer from rheumatoid arthritis and other arthritic diseases. As a preventative measure, these recipes can also be used by the elderly, athletes, after an ankle fracture or sprain.

Surgery

Leg arthrosis refers to chronic pathologies that progressively progress and exacerbate degenerative processes. In stage 3 of the disease, the disorders are so pronounced that the cartilage tissue is completely destroyed and cannot be repaired with medication. Only surgical methods are used to eliminate deformity, severe pain, and restore gait. Other treatments are ineffective.

Modern types of surgery:

1. Arthroscopy. An arthroscope is inserted into the intraarticular cavity - a special device that allows the joint to be examined from the inside. The doctor removes all foreign elements from the joint fluid: torn cartilage particles, bones, or blood clots. Manipulation reduces the severity of pain, but provides only temporary relief. The pain returns within 6-12 months. It is mainly used in young people;
2. Arthrodesis. During surgery, the remaining cartilage is removed and the joint is fixed in one position. Gradually, the bones merge in a given position, causing ankylosis to appear. The joint is completely eliminated, this leads to immobility of the foot, but pain, inflammation and inability to walk are eliminated, although the quality of the movement remains low. The technique is rarely used;
3. Endoprosthesis. It is used only in stage 3 of the disease when there is virtually no cartilage. The method consists of implant placement. Its service life is 10-15 years, depending on the type of material used. Endoprosthetics allow for a complete restoration of quality of life.

Is it possible to completely cure foot arthrosis?

It is believed that it is impossible to completely cope with arthrosis of the foot. The destroyed cartilage no longer grows. The goal of all therapies is to maintain and preserve the current condition of the joint in the form in which the patient sought medical attention.

The doctor can only stop the process, but not restore the tissue. If the recommendations are followed, the patient will not feel restricted and only ignoring negative external factors or the advice of a doctor can cause discomfort in the leg again.

Prevention and complications

You need to follow simple rules to rule out an unpleasant illness. One of them is a healthy lifestyle. To prevent arthrosis, you need:

• reduce the amount of salt consumed;
• organizing proper nutrition;
• limits excessive physical activity;
• get rid of excess weight;
• strengthens immunity to rule out inflammatory, infectious diseases.

Methods to prevent the development of arthrosis include:

• avoid injuries to the lower extremities;
• exclusion of foot hypothermia;
• self-massage of the sole;
• use of comfortable, flexible soles, orthopedic insoles;
• removal of high heels;
• performing exercises for the joints of the feet;
• barefoot walking on the grass, sand;
• timely treatment of inflammatory diseases.

The disease can be complicated by pathologies such as arthritis, bursitis of the foot, inflammation of the periarticular bursa. Foot arthrosis leads to deformity of the toes, a cause of foot immobilization and disability in a neglected state.

Forecast

The prognosis is favorable with timely diagnosis of leg arthrosis and appropriate treatment at an early stage. Although cartilage destruction is irreversible, further progression of the pathology can be prevented by joint destruction. Arthrosis has an unfavorable prognosis in the later stages, the functions of the foot are lost, and the disability can only be avoided by artificial replacement of the ruined joint.