Patient Education

Joint Pain in the Foot

Description

Life is good when everything in your body is moving smoothly: ligaments and muscles pulling easily without tears or weakness, bones supporting the motion, cartilage and joint fluid doing their part to lubricate things nicely. It’s like the best sort of party: everyone’s getting along. Unfortunately, just like all parts of the body, joints are susceptible to wear and tear over time, not to mention infection, inflammation, and trauma. When your joint experiences damage or other problems, it means less smooth motion for you, and also more pain.

In a way, it’s hardly surprising that joints can become painful. They’re often under a lot of stress, particularly the joints in your foot. (You have more than thirty of them there.) Any one of them may decide to be a party pooper and start causing you trouble.

Joint pain has many different causes. Arthritis, itself caused by many things, is the most common source of joint pain. Other causes of pain in or around a joint include injury, infection in the joint, problems with the structure of the foot, bone bruises, ligament damage, stress fractures, joint dislocation, inflammation, foreign objects (like a needle or piece of glass) in the joint, and bursitis (inflammation of the bursa, a fluid-filled sac near joints).

Let’s discuss arthritis for a bit. Some of the most common kinds that can affect the foot include the following:

  • Osteoarthritis – Caused by wear and tear on the cartilage in the joint, usually over a period of time (although it can also be brought on by trauma), this type of arthritis is the most common. Being overweight can increase your risk of developing osteoarthritis.
  • Rheumatoid arthritis – This type of arthritis is actually an autoimmune disease in which the body’s immune system attacks the joints. It usually shows up in a mirror-image pattern, so, for instance, both big toe joints would be affected at the same time. Those with this disease often experience periods of remission in between flare-ups. Women are much more likely than men to develop RA.
  • Gout – When uric acid crystals build up in the blood, they may form crystals in a joint, usually the big toe joint. This condition is extremely painful, and is much more likely to affect men than women.

Symptoms

Pain in the joint may be accompanied by different symptoms, depending on the cause of your discomfort. For instance, osteoarthritis usually develops slowly and manifests as stiffness upon arising, whereas rheumatoid arthritis usually has a more acute (sudden) onset and may be accompanied by chest and abdominal pains, loss of weight, and a rash. Fevers might show up with infection in a joint.

However, with most joint problems, you’ll probably experience swelling, warmth and redness in the joint, as well as restrictions in motion. You may also notice that the shape of your foot has changed a bit.

Diagnosis

Unfortunately, your podiatrist doesn’t have a podiatric superchip to immediately determine the cause of your joint pain (although science is probably working on it right now), so he or she will need to do some detective work to find the source. Be prepared to talk about a history of your symptoms, including how long you’ve had them, how quickly they developed, how bad they are, and so on. Your podiatrist may also want to watch your feet in motion, so he or she might have you walk around. The foot doctor will probably also do a physical examination of the foot, and may manipulate it to see what your range of motion is in the painful joint.

X-rays and other imaging technology are good ways for your podiatrist to look at what’s happening with your bones and other tissues inside your foot. They’ll help your doctor spot damage to the joint and may aid in the diagnosis of your condition. However, you should be aware that all joints tend to show wear over time, and the wear on the painful joint may or may not be the cause of your discomfort. Joint taps may be used to retrieve some of the fluid from the joint. Joint fluid should be clear and somewhat viscous (like syrup), but things like infections or gout often cause it to look cloudy. Your podiatrist may also check for uric acid crystals if gout is suspected, or may determine the number of white blood cells in the fluid.

Treatment

Treating painful joints usually revolves around getting them to stop freaking out (i.e. trying to reduce or eliminate the inflammation). Your podiatrist is likely to suggest you stay off your feet as much as possible and elevate your foot to reduce swelling and pain. Ice is often helpful (you’ll want to apply it for 20 minutes over a thin towel, and then wait at least 40 minutes before applying it again).

Medication is also often used to reduce joint pain. Your doctor might suggest non-steroidal anti-inflammatory medication, such as ibuprofen, or other pain medications such as acetaminophen or aspirin. In some cases, your podiatrist may try a cortisone injection into the joint to reduce your pain.

Because joint pain may be associated with weakened muscles, your podiatrist may suggest physical therapy to strengthen the muscles that interact with your joint. Orthotics (or prescription shoe inserts) are also often used to correct the function of the foot and provide relief from pain.

On occasion, depending on the cause of your joint pain, and how it responds to conservative treatment (or doesn’t respond), your podiatrist may determine that surgery is the best option for getting your joints to be pain-free. Be sure to thoroughly discuss all treatment options with your foot doctor.

While damage to your joint may be permanent, there’s no reason why you should have to live a life of pain. With proper treatment and regular checkups, you should be able to get your joint to work together with the rest of your body again, and quit being such a spoilsport.