Osteoarthritis (OA) is a chronic condition that causes the cartilage in a person’s joints to deteriorate gradually. This leads to joint pain and stiffness. The foot is one of the most common locations for OA to develop because it has more weight-bearing joints than any other part of the body.

Osteoarthritis (OA) is a chronic disease that causes joint cartilage to break down. It usually affects the weight-bearing joints, such as the knees, hips, lower back, and feet, and other joints, such as the hands and neck.

Symptoms typically include pain, joint stiffness, and reduced mobility in the affected area.

There are many ways to manage osteoarthritis, such as using nonsteroidal anti-inflammatory drugs (NSAIDs) or taking over-the-counter (OTC) medications, such as acetaminophen (paracetamol). There are also other treatments that a person can try, such as weight loss, exercise, or surgery if necessary.

This article will review OA of the foot, its symptoms, potential complications, treatments, outlook, and when to seek help.

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Foot OA occurs in the foot or feet. The foot contains 28 bones and more than 30 joints. These work together with muscles, tendons, and ligaments to give a wide range of motion.

Foot OA can occur for many reasons. It can be due to injury or chronic inflammation of the joint, leading to wear and tear of the cartilage covering the joint.

One of the most common injuries that cause foot OA is a sprain to the ligaments supporting the joint or an injury to one of the bones in that area, such as a fracture or broken bone.

Some of the symptoms of foot OA may include:

  • aching
  • decreased range of motion
  • grating or crunching noises when moving
  • pain in the ball of the foot
  • pain in the heel
  • soreness around joints in the foot
  • stiffness, particularly after resting
  • swelling of the joints in the foot
  • bony enlargement at the base of the big toe, or bunion

If a person does not receive treatment for OA in their foot, it can lead to other problems.

Bunions

Bunions are a painful and often debilitating condition. As well as OA, bunions may also be due to a person wearing shoes that are too tight or narrow.

The pressure from the shoe causes the big toe to shift inward, leading to abnormal bone growth at the base of the big toe joint.

Calluses and corns

Calluses are patches of rough, thick skin, and corns are small, hard lumps of skin. Both of these can develop on the feet.

Corns appear due to bone pressure against the skin, whereas calluses form due to repeated friction. Bunions can also cause calluses and corns to form.

Hallux rigidus

OA can also cause hallux rigidus, which is a condition some also refer to as stiff big toe.

When hallux rigidus occurs, the joint at the base of the big toe becomes inflexible and eventually causes pain when walking or standing. The condition is due to cartilage wearing away completely and bones joining together.

There is no cure for OA, so healthcare professionals usually treat the symptoms and advise people on lifestyle changes that they can make to manage the symptoms effectively.

Exercise

Keeping active is important for everyone but particularly for people with OA.

People with OA may think that exercising can cause their symptoms to worsen, but building up muscle and strengthening the joints can help improve symptoms.

Range of motion exercises and foot stretches are good for strengthening foot muscles. Avoid high impact exercises that involve taking both feet off the floor at the same time, such as jumping, as this can put a lot of force on the joints and bones.

The Centers for Disease Control and Prevention (CDC) recommend that people should aim to get at least 150 minutes of moderate-intensity exercise per week.

Podiatry

Podiatrists specialize in conditions affecting the feet. They can give people advice on what treatments would be best for them. This could involve:

  • wearing comfortable, well-fitting shoes – a podiatrist can advise on what to look for in new shoes
  • strapping the feet to limit movement in painful joints
  • wearing supportive insoles or inserts in shoes
  • using padding or shields to reduce pressure or friction in shoes

Diet

Foods containing high amounts of omega-3 fatty acids, vitamin D, and calcium promote healthy joints. A diet rich in these nutrients can help reduce inflammation and joint pain.

Foods that are high in omega-3 fatty acids include:

  • salmon
  • tuna
  • mackerel
  • anchovies
  • sardines
  • walnuts and almonds
  • flax seeds and chia seeds
  • avocados

Foods that contain vitamin D include:

  • liver
  • eggs
  • fortified products, such as milk, plant milk, cereals, and spreads
  • mushrooms

Calcium-rich foods include:

  • dairy products, such as cheese and yogurt
  • green leafy vegetables, such as broccoli and kale
  • sardines canned with bones (which provide calcium)

Maintaining a moderate weight

Excess weight increases the force and pressure on the joints.

According to the Arthritis Foundation, each pound (lb) of weight loss reduces pressure on the lower-body joints by 4 lbs. Maintaining a moderate body weight can help relieve pressure on the foot and reduce OA symptoms.

There is no cure for OA, but there are treatment options to manage the symptoms.

Medication

There is a wide range of medication options available for someone with foot OA.

  • Analgesics: Pain-relieving medications such as acetaminophen can help reduce pain and stiffness. Some analgesics are available over the counter, whereas stronger ones require a prescription.
  • NSAIDs:Nonsteroidal anti-inflammatory drugs such as ibuprofen or naproxen work by reducing inflammation and pain.
  • Counterirritants: Topical treatments, such as those containing capsaicin, menthol, or lidocaine, can change the way the painful area feels, which removes focus from the actual pain. They irritate nerve endings making the area feel cold, warm, or even itchy, which can reduce pain sensations.
  • Corticosteroids: Doctors may recommend injections of anti-inflammatory medication into the affected joint. These are temporary but can help ease symptoms for several months.

Surgery

If nonsurgical treatment has been unsuccessful, doctors may recommend surgery to relieve OA symptoms.

There are several surgical options for foot arthritis:

  • Arthroscopic surgery: This is where the surgeon uses a small camera called an arthroscope to help them perform surgery. The camera allows the surgeon to see what’s going on inside the joint without having to make large incisions. The surgeon will typically remove loose cartilage and bone spurs that may be causing irritation and pain.
  • Fusion surgery (arthrodesis): This is where a surgeon will fuse the bones using pins, plates and screws, or rods to keep the bones in a permanent position. The bones eventually grow together, which eliminates pain by removing the motion of the arthritic joint.
  • Joint replacement surgery: Replacing an entire joint is very rare; surgeons typically use this procedure for the ankle joint.

When to contact a doctor

People should contact their doctor when they notice symptoms of OA.

It is very difficult to self-diagnose any form of arthritis, including OA.

Doctors can refer people to specialists such as an orthopedist or a podiatrist to confirm a diagnosis or a rheumatologist to exclude other causes of foot pain, such as gout or psoriatic arthritis.

This way, a person can begin treatment as quickly as possible to prevent complications.

There is no cure for OA, but people can effectively manage the condition by combining lifestyle changes and medical treatment.

OA typically worsens over time without treatment, so it is important to speak to a doctor as soon as symptoms appear.

The foot is a common place for OA to occur.

Although there is no permanent cure for OA, there are many ways a person can manage and treat OA to prevent it from worsening.

Treatment options include lifestyle and habit changes, medications, and surgery. OA is a degenerative condition, so prompt treatment is essential.