Arthrosis of the foot
The content of the article:
- Causes and risk factors
- Forms of the disease
- Disease stages
- Symptoms of arthrosis of the foot
- Diagnostics
- Treatment of arthrosis of the foot
- Possible complications and consequences
- Forecast
- Prevention
Arthrosis of the foot is a degenerative-dystrophic process that begins in the cartilage tissue of the joints of the foot, which gradually leads to deformation of the joints and their destruction. Most often, the pathological process affects the joint of the big toe, but it can also occur in the heel and in other parts. Both men and women suffer from arthrosis of the foot, but the latter are more susceptible to it. The risk of developing the disease increases with age, about 85% of people over 55 suffer from arthrosis of the foot. The disease occurs in other age groups, mainly in people involved in active sports.
Cartilage destruction in arthrosis of the foot
The foot is the lower part of the leg. The forefoot is formed by the metatarsus and toes, the hindfoot is made up of the bones of the tarsus. The main functions of the foot are to provide support for the body and the ability to move the body in space. The bone skeleton of the foot is formed by 26 bones. The foot has three points of bone support, two of which are located in the anterior region and one in the posterior. The heel and metatarsal bones bear the main load. In addition to the described anatomical structures, the foot has a complex system of muscles, ligaments, tendons, nerves and blood vessels.
With the development of the pathological process in the articular cartilage, the latter lose their elasticity, dry out and gradually collapse, their cushioning function decreases. As a result, the load on the bone surfaces increases, this leads to a violation of blood microcirculation, the appearance of pathological growths on the surface of the bone tissue (osteophytes). Fibrosclerotic changes occur in the joint capsule and synovium, and also affect the tendons and ligaments of the foot. Due to the development of fibrotic changes in the ligamentous apparatus, its functions are partially lost, as a result of which frequent joint subluxations occur. Deformation of the joint, impaired movement in it leads to changes in nearby muscles.
Causes and risk factors
Primary arthrosis of the foot develops without previous pathology, secondary - against the background of other pathological processes in the musculoskeletal system or directly in the joint (for example, against the background of an inflammatory process).
Risk factors include:
- genetic predisposition;
- metabolic disorders, endocrine diseases;
- a history of inflammation in the joints;
- anemia and other diseases in which the blood supply to tissues is impaired;
- rachiocampsis;
- defects in the formation of the limb (flat feet, shortening of one leg, irregular shape of the legs, wide foot, deformation of the fingers);
- foot injury;
- muscle weakness;
- professional activity, which is associated with prolonged standing, excessive physical exertion;
- intensive classes in some types of physical activity (boxing, wrestling, dancing, ballet, gymnastics, etc. - those where the risk of frequent microtraumas of the joints of the foot is high);
- insufficient physical activity;
- poor nutrition;
- overweight;
- high growth;
- advanced age;
- wearing uncomfortable shoes, as well as shoes with high heels;
- regular hypothermia of the lower extremities.
Overweight creates an additional load on the lower limbs, which is a risk factor for arthrosis of the foot
Arthrosis of the foot often occurs during pregnancy due to an increase in the load on the lower extremities, in particular on the joints of the foot. In children, due to the increased load on the legs, the disease can occur during the period when they begin to walk. In adolescents, the main reason for the development of arthrosis is the X-shaped curvature of the axis of the foot (hallux valgus).
Forms of the disease
Arthrosis of the foot can be primary (idiopathic) and secondary, as well as unilateral and bilateral.
Disease stages
In the clinical picture of arthrosis of the foot, there are three stages:
- Deformation of the joints is not externally noticeable, the first signs of arthrosis are found on the roentgenogram, the disease manifests itself as slight pain in the affected joint during physical exertion.
- X-ray signs of arthrosis are more pronounced: bone hardening, the presence of osteophytes, a decrease in the joint space; movements in the joint are limited, pain occurs not only during exertion, but also at rest, especially when the weather changes.
- There is a significant deformation of the foot, articular movements are significantly limited or impossible, severe pain syndrome.
Symptoms of arthrosis of the foot
The pathological process is chronic, slowly progressive. The clinical picture depends on the stage of the disease.
At the first stage of arthrosis, the patient periodically experiences pain in the forefoot. Usually, the pain appears after an intense load on the lower limbs, and after rest it goes away.
The initial stage of arthrosis of the foot is characterized by recurrent pain in its front part
In the second stage of the disease, pain is more pronounced, they arise not only after physical exertion, but also spontaneously (especially often when the weather changes), and can also be permanent. Foot mobility is limited.
With arthrosis of the foot of the third degree, the patient has a pronounced deformation of the affected joints, the pain is constant (including at night) and pronounced, foot movements become almost impossible.
One of the characteristic symptoms of arthrosis of the foot in the later stages is a change in gait - when walking, the patient rests on the outer edge of the foot, there is a slight lameness, which is aggravated with the course of the pathological process. The development of lameness occurs as a result of painful sensations in the affected limb, the patient tries to transfer the body weight to the healthy leg. There is increased fatigue of the legs, loss of working capacity. During foot movements, a crunch is heard due to the appearance of irregularities on the articular surfaces. With the progression of the pathological process, the shape of the fingers of the affected lower limb is distorted, painful calluses form in places of increased load. With the defeat of the toes of the foot in patients, rhythmic mechanical pain sensations are noted. In most cases, with arthrosis of the foot, the joint of the big toe of the lower extremity is affected; under its pressure, the second and third toes are deformed. With the localization of the pathological process in the heel, the appearance of a crunch when walking is also noted. Usually, with arthrosis of the foot, several parts of the foot are involved in the pathological process.
Pain in arthrosis of the foot increases in cold and damp weather, when the affected limb comes into contact with cool water. In the morning after waking up and during the day after a period of rest, stiffness of movements is noted, the so-called symptom of morning stiffness. Stiffness and soreness go away in 15-30 minutes. With physical exertion, excessive muscle tension is observed in the area of the affected joint.
When inflammation joins, the skin near the affected joint becomes hyperemic, the affected area swells. In some cases, body temperature may rise to subfebrile values.
Diagnostics
Diagnosis of arthrosis of the foot includes the analysis of data obtained during the collection of anamnesis, examination of the affected limb, laboratory tests and instrumental examination methods.
In order to confirm the diagnosis, as well as to determine the stage of the disease, X-ray examination is used. Radiography makes it possible to detect changes in the cartilage and bone tissue of the joint (decrease in the joint space, unevenness of the articular surface, etc.). In some cases, arthroscopy is used - this method makes it possible to visualize in detail the internal articular surfaces, as well as conduct a biopsy.
Radiography is used to diagnose arthrosis of the foot.
If necessary, a more detailed study is carried out:
- computed tomography (makes it possible to detect joint damage, as well as visualize the structure of the foot);
- magnetic resonance imaging (makes it possible to detect changes in the metatarsal joints, as well as in the small joints of the fingers of the lower limb and determine the degree of their damage);
- bone scintigraphy (allows you to assess the state of the bone by the degree of accumulation of labeled atoms in the bone tissue);
- puncture of the joint followed by laboratory examination of the intra-articular fluid.
The results of a general and biochemical analysis of the patient's blood can indicate the presence of endocrine and metabolic disorders, which is important for determining the etiological factor of foot arthrosis.
Differential diagnosis is carried out with arthritis, gout, heel spurs, flat feet.
Treatment of arthrosis of the foot
Treatment of foot arthrosis begins with the elimination of negative factors that contribute to the progression of the pathological process. It is necessary to reduce the load on the affected area (choosing the right shoes, if necessary, weight loss measures).
The therapy is carried out on an outpatient basis, only in severe cases may require hospitalization in a specialized department of the hospital.
Drug therapy for arthrosis of the foot is mainly local - drugs are prescribed in the form of ointments, creams or gels with anti-inflammatory and analgesic effects. With severe pain syndrome, non-steroidal anti-inflammatory drugs are prescribed for a short course. If this is not enough (especially often in the presence of severe secondary synovitis), they resort to intra-articular administration of corticosteroid hormonal drugs.
Sometimes, in order to prevent further destruction of cartilage and deformation of the joint at the initial stages of the disease, drugs from the group of chondroprotectors are prescribed, however, since their therapeutic effect has not been confirmed, most experts consider this inappropriate.
Of the physiotherapeutic methods for arthrosis of the foot, phonophoresis and electrophoresis of drugs, ultra-high-frequency therapy, magnetic and laser therapy, as well as radon baths and applications of therapeutic mud are effective. Sanatorium treatment is shown.
Patients with arthrosis of the foot are prescribed a diet with a predominance of fruits, vegetables, cereals, legumes, dairy products and low-fat meats. The diet is limited to animal fats, spicy, spicy foods, alcohol. If you need to lose weight, you should stop eating sugar, confectionery, fatty, fried foods.
Radon baths are one of the physiotherapeutic methods for treating arthrosis of the foot
Medical gymnastics is highly effective in treating arthrosis of the foot. The set of exercises is selected by the doctor, taking into account the stage of the disease, the individual characteristics of the patient and possible contraindications. Exercises for arthrosis of the foot are aimed at stretching the big toe, stretching the Achilles tendon, developing and strengthening the toes.
As an additional method of treating arthrosis of the foot, massage is used, which helps to normalize blood microcirculation and prevents muscle atrophy in the affected area. Massage can be combined with warming up with ozokerite or paraffin, which increases its effectiveness.
The main treatment can be supplemented by herbal medicine. For arthrosis of the foot, foot baths are used from decoctions of medicinal herbs (mint, St. John's wort, thyme, juniper, oregano, violet tricolor) with the addition of honey, sea salt. A good therapeutic effect is provided by bee sting therapy and hirudotherapy (treatment with medicinal leeches).
In the absence of a positive effect from conservative therapy, surgical treatment is indicated:
- arthroplasty is a minimally invasive method of treating arthrosis of the foot, it can be used in patients of all age groups. During the operation, the damaged surfaces are removed, new articular surfaces are modeled with a spacer between them from the patient's own tissues;
- arthroplasty - replacement of the affected joint with an implant. It is used in the later stages of the disease, when the destroyed joint loses its functions and becomes the cause of disability.
Possible complications and consequences
The disease can be complicated by pathologies such as arthritis, foot bursitis, inflammation of the periarticular bursa.
Arthrosis of the foot leads to deformation of the toes, in a neglected state it becomes the cause of immobilization of the foot and the patient's disability.
Forecast
With timely diagnosis of arthrosis of the foot and properly selected treatment in the early stages, the prognosis is favorable. Despite the fact that the destruction of cartilage is irreversible, further progression of the pathology with the destruction of the joint can be prevented. Arthrosis in the later stages has a poor prognosis, the functions of the foot are lost, disability can be avoided only by replacing the destroyed joint with an artificial one.
Prevention
In order to prevent arthrosis of the foot, as well as to prevent the development of complications, it is recommended:
- timely treatment of pathologies that can cause the development of arthrosis of the foot;
- weight correction;
- prevention of lower extremity injuries;
- sufficient physical activity;
- rejection of activities associated with constant overload and / or microtrauma of the joints of the feet;
- balanced diet;
- rejection of bad habits;
- selection of comfortable and high-quality shoes that do not impede the movement of the lower extremities.
Anna Aksenova Medical journalist About the author
Education: 2004-2007 "First Kiev Medical College" specialty "Laboratory Diagnostics".
The information is generalized and provided for informational purposes only. At the first sign of illness, see your doctor. Self-medication is hazardous to health!
