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
- Psychological Treatment
- Depression Treatment
- Cognitive-Behavioural Treatment
- Rehabilitation Treatment
Somatic Treatment
Pharmacological treatment:
- Acetaminophen
- Cyclo-oxygenase-2 (COX-2 blockers)
- NSAID
- Topical NSAID
Other Treatments
- Manual/Musculoskeletal Medicine
- Physiotherapy (only exercises)
Interventional Pain Treatment