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Arthritis is a frequent component of complex disease processes that may involve more than 100 identifiable disorders.
Arthritis, in general terms, is inflammation and swelling of the cartilage and lining of the joints, generally accompanied by an increase in the fluid in the joints. Arthritis has multiple causes. The feet seem more susceptible to arthritis than other parts of the body, because each foot has
many joints which can be affected by arthritis, and because the feet support the body's weight, there is no relief from the constant use these joints endure.
Arthritis can be a disabling and occasionally crippling disease; it afflicts almost 40 million Americans. In some forms, it appears to have hereditary tendencies. The incidence of arthritis increases with age, but all people from infancy to middle age are potential victims. People over 50 are the primary targets of arthritis.
Arthritic feet can result in the loss of mobility and independence. With early diagnosis and proper medical care the effects of arthritis can be minimized.
Causes
Besides heredity, causes of arthritis include:
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Trauma - Arthritis may begin after injury to a joint. Athletes and industrial workers are prone to arthritis induced by a joint injury. Many sports and work-related injuries are ignored and medical treatment is not sought in a timely manner, worsening the effects of the injury and the resulting arthritic
symptoms
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Bacterial and Viral Infections - These infections can strike the joints. The same organisms that are present in pneumonia, gonorrhea, staph infections, and Lyme disease cause inflammation in the joints.
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Chronic Diseases - Arthritis can develop in conjunction with bowel disorders such as colitis and ileitis, frequently in the joints of the ankles and toes. Such inflammatory bowel diseases seem distant from arthritis, but their control can relieve arthritic pain. Arthritis can be part of a congenital autoimmune disease syndrome, of undetermined origin. Recent research has suggested, for instance, that a defective gene may play a role in osteoarthritis.
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Drugs - both prescription drugs and illegal street drugs can induce arthritis.
Symptoms
Because arthritis can affect the structure and function of the feet it is important to see a doctor of podiatric medicine if any of the following symptoms occur in the feet:
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Swelling in one or more joints
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Recurring pain or tenderness in any joint
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Redness or heat in a joint
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Limitation in motion of a joint
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Early morning stiffness
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Skin changes, including rashes and growths
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Forms of Arthritis
 Osteoarthritis
is the most common form of arthritis. It is often called degenerative joint disease or "wear and tear" arthritis. It can be brought on suddenly by an injury, but its onset is usually gradual; aging brings on a breakdown in cartilage, and pain gets progressively more severe, although it can be relieved with rest. Dull, throbbing nighttime pain is characteristic, and it may be accompanied by muscle weakness or deterioration. Gait patterns,
normal walking, may become erratic. It is a particular problem for the feet when people are overweight, simply because there are so many joints in each
foot and the additional weight contributes to the deterioration of cartilage and the development of bone spurs.
Rheumatoid arthritis (RA) is a major crippling disorder, and perhaps the most serious form of arthritis. It is a complex, chronic inflammatory system of diseases, often affecting more than a dozen smaller joints during the course of the disease, frequently in a symmetrical pattern,
both ankles, or the index fingers of both hands, for example. It is often accompanied by constitutional signs and symptoms
__ lengthy morning stiffness, fatigue, and weight loss
__ and it may affect various systems of the body, such as the eyes, lungs, heart, and nervous system.
Women are three or four times more likely than men to suffer RA, indicating a linkage to heredity. RA has a much more rapid onset than
osteoarthritis. It is characterized by alternating periods of remission, during which symptoms disappear, and exacerbation, marked by the return of inflammation, stiffness, and pain. Serious joint deformity, and loss of motion, frequently result from acute rheumatoid arthritis. However, the disease system has been known to be active for months, or years, then abate, sometimes permanently.
Gout (gouty arthritis) is a condition caused by a build-up of uric acid, a normal
by-product of the diet, in the joints. A single big toe joint is commonly the target, possibly because it is subject to so much pressure in walking; attacks of gouty arthritis are extremely painful, perhaps more so than any other form of arthritis. Men are much more likely to be afflicted than premenstrual women, an indication that heredity may play a role in the disease. While a rich diet that contains lots of red meat, rich sauces, and brandy is popularly associated with gout, there are other protein compounds in such foods as lentils and beans which may play a role.
Different forms of arthritis affect the body in different ways; many have distinct systemic affects that are not common to other forms. Early diagnosis is important to effective treatment of any form. Destruction of cartilage is not reversible, and if the inflammation of arthritic disease isn't treated, both cartilage and bone can be damaged, which makes the joints increasingly difficult to move. Most forms of arthritis cannot be cured, but can be controlled or brought into remission; perhaps only five percent of the most serious cases, usually of rheumatoid arthritis, result in such severe crippling that walking aids or wheelchairs are required.
Treatment
The objectives in the treatment of arthritis are controlling inflammation, preserving joint function (or restoring it if it has been lost), and curing the disease if that is possible.
Because the foot is such a frequent target, the doctor of podiatric medicine is often the first physician to encounter some of the complaints
of arthritis including: inflammation, pain, stiffness, excessive warmth, injuries. Even bunions can be manifestations of arthritis.
Arthritis may be treated in many ways. Patient education is important. Physical therapy and exercise may be indicated, accompanied by medication. In such a complex disease, it's no wonder that a wide variety of drugs have been used effectively to treat it; likewise, a given treatment may be very effective in one patient and almost no help at all to another. Aspirin is still the first-line drug of choice for most forms of arthritis, and the benchmark against which the efficacy of a host of therapies is measured.
The control of foot functions with shoe inserts called orthothotics, or with braces or specially prescribed shoes, may be indicated. Surgical intervention is a last resort in arthritis, as it is with most disease conditions; the replacement of damaged joints with artificial joints is a possible surgical procedure.
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