Knee / Ankle / Foot

Osteoarthritis Foot

Definition

Osteoarthritis of the foot is a degenerative disorder of the joints related to overload of the foot, age, or systemic diseases, and may be accompanied by inflammation.

Aetiology

The cause of osteoarthritis of the foot is degenerative changes in the joints due to age, infection, trauma, or systemic diseases such as rheumatoid arthritis. Primary idiopathic osteoarthritis of the foot joints is seldom under the age of forty.

Signs and symptoms

The pattern of symptoms is generally characterised by pain during activities. Walking is particularly painful. The foot may also be swollen at times. If other joints are also involved, this is an indication of a systemic condition, such as arthritis.

Diagnostics

Physical Examination

Apart from palpation, on physical examination, passive mutual translation is important for establishing mutual motion restriction of the constituent bones of the foot.

Additional Somatic Diagnostics

  • Standard X-ray ankle.
  • When systemic diseases are suspected, referral to a rheumatologist is indicated.
  • Diabetes must be excluded
  • RAND-36 (quality of life)
  • VAS-Pain (maximal, minimal, actual, average/week)
  • PCS (catastrophising)
  • HADS (fear and depression)

Additional Psycho-cognitive Diagnostics

Multidisciplinary Treatment

Whether or not somatic treatment is indicated is based on the pain diagnosis.  Based on the findings of the pain questionnaires, additional diagnostics and/or multidisciplinary treatment consisting of various non-somatic treatments may be necessary.

Non-somatic Treatment

Somatic Treatment

Pharmacological treatment:

  • Acetaminophen
  • Cyclo-oxygenase-2 (COX-2 blockers)
  • NSAID
  • Topical NSAID

Other Treatments

Interventional Pain Treatment