Midfoot arthritis is joint inflammation that impacts the middle of the foot. It can cause stiffness and pain. For some, it may cause difficulty walking.

People can develop midfoot arthritis for various reasons. It may occur due to osteoarthritis, which is the result of wear and tear. Other conditions, such as rheumatoid arthritis (RA), may also cause it. RA occurs when the immune system mistakenly attacks healthy tissue in the joints.

Midfoot arthritis does not impact the toes or the ankle. However, people can have arthritis in more than one location at the same time.

This article discusses what midfoot arthritis is, its symptoms, causes, diagnosis, treatment, and outlook for people with this symptom.

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Midfoot arthritis is joint pain and inflammation that impacts the bones that make up the middle part of the foot. This includes the tarso-metatarsal (TMT) joints and naviculo-cuneiform joints (NCJ).

The TMT joints connect the tarsals and the metatarsals. The tarsals are the five bones that make up the arch of the foot. The metatarsals connect these five bones to the phalanges, or bones of the toes. The naviculo-cuneiform joints are the connection between two tarsal bones, the navicular and cuneiform bones.

The bones, ligaments, and joints of the midfoot help stabilize the arch of the foot. When walking or running, these joints help transfer force generated by the calf to the front of the foot. The midfoot also helps connect the hindfoot (heal and ankle) to the front part of the foot.

People with midfoot arthritis can experience a range of symptoms, depending on the specific type of arthritis they have. These include:

  • pain when the bones move, such as walking or even standing
  • pain that worsens with intense activity
  • swelling, pain, or warmth
  • trouble walking
  • tenderness or pain when pressure is applied to the midfoot

Over time, midfoot arthritis may weaken the ligaments that support the arch and cause it to collapse. Once the arch collapses, the foot appear flat.

Midfoot arthritis can be the result of several types of arthritis. They include:

  • Osteoarthritis: This form of arthritis occurs when the cartilage in joints wears down, allowing bones to rub directly against each other. This leads to inflammation and pain.
  • Posttraumatic arthritis: Injuries that damage the joint surface can cause cartilage to wear away, resulting in similar symptoms to osteoarthritis.
  • RA: This type of arthritis is an autoimmune condition, where the body’s immune system mistakenly attacks healthy joints. The feet are a common place for RA to start. Usually, RA is symmetrical, meaning a person with this condition would likely have midfoot arthritis in both feet.
  • Psoriatic arthritis (PsA): PsA is another autoimmune condition that typically occurs in a portion of people with the skin condition psoriasis. It can affect multiple joints and tendons in the feet. However, unlike RA, it can be asymmetrical.

Of the above types, osteoarthritis and posttraumatic arthritis are the most common causes of midfoot arthritis.

To diagnose midfoot arthritis, a doctor will ask questions about a person’s symptoms and medical history, including if they have had injuries to the area and if so, what treatment they received. They will also perform a physical examination of the foot and ankle, and may apply pressure to certain places to see if it causes symptoms.

A doctor may ask questions about when the symptoms began, if they affect one or both feet, when the pain gets worse, and whether it worsens with physical activity.

Next, the doctor will try to identify the cause of the symptoms. They may order:

  • X-rays
  • CT or MRI scans
  • gait analysis tests
  • blood tests for inflammation or markers of autoimmune disease

There is no cure for arthritis. However, treatment can reduce the symptoms, improve mobility, and quality of life. What treatment entails will depend on the type of arthritis a person has.

It may involve:

  • Lifestyle modifications: This could include limiting activities that worsen symptoms, maintaining a healthy weight, or replacing high-impact exercise such as jogging or running with lower-impact exercise, such as swimming or cycling.
  • Cold therapy: This entails applying cold compresses or ice packs to the area to reduce pain and swelling. Avoiding hot showers or baths may also help.
  • Physical therapy: During physical therapy, a person learns exercises that can improve their flexibility, strength, and range of motion.
  • Assistive devices: Foot braces, orthopedic shoe inserts, or custom-made shoes that accommodate swelling and reduce pressure on the feet may help with mobility.
  • Over-the-counter (OTC) medications: Drugs such as nonsteroidal anti-inflammatory drugs (NSAIDs) may reduce pain and swelling.
  • Prescription medications: For people with RA or PsA, disease-modifying antirheumatic agents (DMARDs) may help control symptoms. Cortisone injections can also reduce inflammation.

If none of the above treatments or therapies reduce symptoms sufficiently, surgery may be an option. The types of surgery doctors can use for midfoot arthritis include:

  • Arthroscopic surgery: This removes inflamed joint tissues, bone spurs, or loose cartilage. During the procedure, a surgeon inserts a very small camera into the foot to guide miniature surgical instruments inserted in small cuts.
  • Arthrodesis: This surgery fuses the joint bones together to create one continuous piece of bone, removing impacted joints.
  • Arthroplasty: During this procedure, a surgeon removes impacted bones and replaces them with plastic or metal joint surfaces.

Midfoot arthritis can make walking and other physical activities painful. However, exercise is important for health, and helps people maintain a moderate weight. This, in turn, can reduce pressure on the feet, easing symptoms.

As a result, it is beneficial to try and find ways to stay active without aggravating symptoms. People can try forms of exercise that place less pressure on the feet, such as:

  • swimming
  • water aerobics
  • cycling
  • elliptical machines

Using cold therapy after exercise may help to prevent a flare-up of pain by decreasing blood flow to the area.

If walking and mobility prove difficult, it may help to change footwear. Shoes with extra cushioning and a wide toe box can help to give the feet enough room, while also protecting against impact from the ground.

The exact outlook for midfoot arthritis will depend on the type of arthritis a person has, and how severe their symptoms are.

For example, a person with mild osteoarthritis may find that simply making adjustments to their lifestyle and footwear are enough to reduce pain. For others, managing arthritis requires a multidimensional approach, involving a combination of medications, therapies, and lifestyle changes.

Some types of arthritis, such as RA, can be progressive and affect multiple joints. For this reason, it is important to seek medical advice as soon as possible if the symptoms develop. Beginning a treatment plan early may slow the progression of the disease.

Midfoot arthritis is joint inflammation that impacts the middle of the foot – specifically, the TMT and NCJ. Symptoms may include pain, swelling, and tenderness.

Several types of arthritis can affect the midfoot, so it is important to speak with a doctor if a person has pain here. Seeking treatment may help a person regain mobility, have less pain when walking, and improve quality of life.

Additionally, for some forms of arthritis, early treatment can help slow the progression of symptoms.