Arthritis is an umbrella term for conditions causing inflammation and pain in the joints. Osteoarthritis is the most common type of arthritis. It causes degeneration of the cartilage lining and surrounding tissues of the joint and most often affects weight-bearing joints like the foot, ankle, hip and knee. This type of arthritis is often associated with “wear and tear” as a person ages. Other types of arthritis with different underlying causes exist as well. Arthritic conditions can typically be classified as degenerative, inflammatory, infectious or metabolic. Rheumatoid arthritis, juvenile arthritis, psoriatic arthritis, lupus and gout are examples of other types of arthritis

Your foot consists of many different joints. There are joints between the bones of the toes, joints between the toes and the long bones of the foot (metatarsals), joints between the bones of the midfoot just in front of the ankle as well as the joint created by the talus and calcaneus (heel bone) just below the ankle in the hindfoot. Each of these joints is lined by cartilage which cushions and preserves the joint. Arthritis can affect any of the joints in the foot but it is most commonly found in the big toe, the midfoot and the hindfoot. Arthritis can have a genetic component but can also occur in a previously- injured area or in someone who has a long history of participation in high-impact activity.

Pain is a common complaint among those living with arthritis. As arthritis progresses, the congruency of the joint surfaces (meaning how well the joint surfaces align with one another) decreases which can further exacerbate pain and result in a need to change the way you stand, walk or move. If you have arthritis, you are probably familiar with the creative ways people often adapt to arthritis pain.

Though the symptoms of arthritis differ slightly based on the type, in general, foot arthritis includes the following symptoms:

• Foot or toe joint pain
• Swelling
• Stiffness
• Decreased range of motion
• Pain with standing, walking, running, etc.
• Joint pain and swelling that worsens with activity and improves with rest (though symptoms can occur at rest or after a period of rest in more advanced cases of arthritis)

If you decide to work with a physical therapist to help correct your foot arthritis, your entire treatment plan could consist of around 8-20+ different physical therapy sessions that will each last 60-90 minutes. Once you complete your customized physical therapy treatment plan, you will be able to continue to do the prescribed stretches and exercises utilized during your PT sessions yet in the comfort of your own home.

PHYSICAL THERAPY TREATMENT OF FOOT ARTHRITIS

While physical therapy cannot reverse the effects of arthritis on joint tissues, research shows that physical therapy is an effective tool to reduce pain and improve function. Though it may seem counterintuitive, significantly decreasing your level of movement and activity is often not the answer to arthritis pain, and in some cases, can worsen it. This is where a physical therapist can help. After interviewing and examining your foot, and watching you walk and move, your PT at Evolve will work with you to understand your goals and develop a plan to help you get there. Your physical therapist may use the following treatments to achieve several goals important to the management of foot arthritis:

• Manual therapy such as joint mobilizations, soft tissue mobilization, dry needling, myofascial release and IASTM to reduce pain, improve foot mechanics and optimize nearby muscle function
• Modalities like ice, heat, ultrasound, laser therapy or electrical stimulation to manage pain, facilitate tissue healing and improve local blood flow
• Therapeutic exercises to address impairments in foot muscle strength and endurance or muscle length which can improve foot mechanics and improve support around the foot joints
• Neuromuscular re-education to retrain the muscles how to move
• Gait training to restore normal gait mechanics or help you learn how to use an assistive device like a cane or walker

Physical therapists use the above treatments to achieve these outcomes:

Pain Reduction: Foot joint pain from arthritis may be mild, moderate or severe but physical therapy can help to address your pain symptoms.

Restore Joint Motion: Foot and toe stiffness and loss of range of motion are common with arthritis. Restoring normal joint motion is an important step in getting you back to your favorite activities.

Address Biomechanical Impairments: While the surfaces of the joint may no longer be pristine, how the joint moves and how much stress is applied across an arthritic joint can play a large role in how much pain you experience and how much you have to limit your activities. Proper strength, flexibility and control in the muscles surrounding the foot and toes can optimize its motion and may reduce some of the rubbing that occurs between uneven joint surfaces.

Getting Back to Activities

The ultimate goal of a physical therapy program for foot arthritis is to help you get back to the activities you love and need to do throughout your life. At Evolve, your PT will help you get back to activities in the safest, most effective and quickest way possible. They will always strive to help get you back to these activities but in cases where that is not possible without some modification, your PT is there to advise you on adaptations you can make to help control your symptoms.

If you are living with foot arthritis, don’t lose hope, there is still a lot that can be done to manage your symptoms. Call Evolve Physical Therapy today to set up an initial evaluation and begin working with one of our skilled physical therapists.