If you listen closely each morning and pay full attention, the city erupts with the sound of stiff and creaky joints waking from their slumber.
“Ooohh”, “Eeekkk”, “Aaahhh” is the chorus repeated by many during their morning routine.
This morning in particular, many would be out of touch to reach for the glucosamine or anti-inflammatories to help manage their osteoarthritis, as yesterday new guidelines on the management of hip and knee osteoarthritis were introduced.
The Royal Australian College of General Practitioners now endorse the increase of physical activity and weight loss in the long-term management of osteoarthritis, and recommend that medication and surgery be used as a last resort.
But what does this mean for our feet?
Osteoarthritis is a significant cause of foot pain, particularly in older people and has a major impact on our health including reduce mobility, reduced balance, increased risk of falling and reduced quality of life.
In the clinic each day, I hear repeatedly the impact foot osteoarthritis has on my patient’s lifestyle and their ability to do the things they enjoy.
There are two primary types of Osteoarthritis in the foot, Midfoot and 1st MTP Joint (Big toe) and both require slightly different forms of management.
Certainly, the above recommendations of increasing physical activity and weight loss also ring true for your feet as they are naturally mobile and bear your body weight on top of them. But what else can be done?
Intra-articular Corticosteroid Injections produce short-to-moderate term improvements in pain but no lasting improvements in physical function. Given we like to take a long-term approach to foot osteoarthritis we don’t often recommend them.
Physical and Manual Therapies
These can include joint mobilisation, manipulation, calf stretching and arch/big toe strengthening exercises. We believe they are a simple, easy and cost-effective way of maintaining mobility and strength around the joint and are absolutely helpful in the management of foot osteoarthritis.
Most sufferers of foot osteoarthritis will report a difference in symptoms depending on what’s underneath their foot. Shoe modifications or even choosing shoes based on certain characteristics related to their condition is important when managing foot osteoarthritis. For example, 1st MTP joint arthritis doesn’t appreciate a shoe that has a large toe break and is really flexible through the forefoot as this will compress the joint under body-weight during the propulsive phase of gait.
Carbon Spring Plate
This is a flat, thin, shoe insert that extends the entire length of the shoe. These are most commonly dispensed to those suffering 1st MTP joint osteoarthritis, with the aim being to reduce the dorsiflexion during the propulsive phase of gait, helping to minimize joint compression. Clinically, we have found these to be great for those suffering 1st MTP joint osteoarthritis and there is current research being conducted to help validate their effect.
It has been shown that those with midfoot osteoarthritis often exhibit higher loads under the midfoot and have more “pronated” feet. Semi-rigid, contoured foot orthoses aim to reduce excessive rearfoot pronation and help to support the medial longitudinal arch. Foot orthoses are quite often therapeutically beneficial for patients with midfoot osteoarthritis and a validated conservative treatment.
Surgical intervention is often indicated in those with severe osteoarthritis and those who have had poor results with conservative management. Surgery most commonly involves arthrodesis (fusion) of the affected joints, with research indicating good clinical outcomes, however obviously involves an increased risk of complications and infection due to surgery.
We hope this article assists you in better understanding and managing your foot osteoarthritis.
It is advised you take a long-term and multi-faceted approach, with a management plan that addresses a range of factors related to your condition.
If you would like to discuss your foot pain further please feel free to book an appointment online, or call us on 9939 3339.