Arthritis, a condition characterized by damage and stiffness of the joints, may affect any of the more than 30 joints in the foot and ankle. The joints that connect the bones of the foot and ankle provide the body with the balance and stability required to stand, walk, and pursue other physical activities.
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As arthritis advances, it may damage cartilage, the smooth material lining the ends of bones in the joints. Cartilage allows the foot and ankle bones to move against each other without friction. If cartilage erodes, the bones may begin to rub directly against each other, causing further joint damage and a deep, aching pain, particularly during movement. Bones that rub together may also cause bony growths to develop, which may interfere with joint motion and worsen pain. Over time, joint damage may also lead to stiffness and deformity in the foot and ankle and make walking and other movements difficult.
There are many types of arthritis, but arthritis in the foot and ankle is usually one of three types: osteoarthritis, rheumatoid arthritis, or post-traumatic arthritis.
Osteoarthritis, often called “wear and tear” arthritis, develops most often in people over age 50. As cartilage gets worn down with use over time, it can result in pain and stiffness in the joint. Osteoarthritis may develop in an isolated joint or area—for example, in one foot and not the other.
Rheumatoid arthritis is an autoimmune disorder, which means that the body mistakenly attacks its own tissues. This immune response targets soft tissue in the joints called the synovium, resulting in warmth, redness, swelling, stiffness, and pain of the foot and ankle. Unlike osteoarthritis, rheumatoid arthritis generally develops symmetrically, meaning both feet are affected at the same time.
Post-traumatic arthritis develops in the foot or ankle as a result of injury, even one that occurred long ago. For example, a sprain, fracture, or dislocation in the foot or ankle may damage cartilage, leading to premature deterioration of the joint. Symptoms may appear within a few years, or it may take decades for joint damage to cause pain or limit function.
Four areas of the foot are most frequently affected by arthritis: the big toe, the midfoot, the hindfoot, and the ankle.
Arthritis in the big toe—also called hallux rigidus—is common. It typically affects the first metatarsophalangeal joint, which is located at the base of the big toe and connects the toe to the rest of the foot. Every time you take a step, this joint bears your body weight; arthritis in this joint can increasingly limit your ability to walk without pain.
The midfoot joints, called tarsometatarsal joints, are located almost halfway between the ankle and the toes, slightly closer to the ankle. These joints connect the long bones that form the arch of the foot to the bony part of the foot in front of the ankle. Arthritis that develops in the midfoot can affect one or more of these joints, causing pain when walking or climbing stairs.
Arthritis in the hindfoot affects the three joints below the ankle and above the heel: the subtalar joint, the talonavicular joint, and the calcaneocuboid joint. Together, these joints allow the foot to have side-to-side movement, as well as other motions, and aid in bearing the weight of the body. Arthritis in these joints can cause pain and swelling in the feet and ankles.
The ankle joint connects the foot to the leg and allows the foot to flex and point. Arthritis in the ankle can limit range of motion and affect standing, walking, and jumping.
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