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Osteoarthritis of the feet

Foot osteoarthritis is an abnormality of the cartilage which lines bones in the joints in the middle part (top) of the foot and the toes. There normally is a very smooth covering of cartilage over the bones that allows normal, smooth and painless motion.

In the case of osteoarthritis of the feet, the smooth cartilage lining the ends of the bones becomes damaged, rough or thin. Usually the top part of the foot (the area under the shoelaces), and the toes are affected.

Aching pain and stiffness is very common in osteoarthritis. There may be some bony swelling, tenderness and occasionally a knobby appearance. Usually there is not a large amount of redness in a joint with osteoarthritis. If the arthritis is not too bad, the stiffness often will improve after some ‘loosening up’ of the foot with walking. There may be some extra stiffness in the morning or after a period of rest, but if the stiffness lasts more than one or two hours it may not be osteoarthritis, but a form of inflammatory arthritis (such as psoriatic arthritis, rheumatoid arthritis or gout).

Osteoarthritis of the feet is sometimes called ‘wear and tear’ arthritis. It may be caused by previous overuse or abnormal use, or due to an injury in the past which damaged the cartilage. Over months or years the damage to the cartilage worsens, and symptoms start.

Routine x-rays usually show narrowing between the bones where the cartilage has worn. Extra bone may build up around the joint, causing the formation of bony spurs called osteophytes. Sometimes osteoarthritis may be present with other forms of arthritis such as gout or rheumatoid arthritis, and x-rays and blood tests may be needed to clarify the diagnosis.

The treatment of foot osteoarthritis depends upon the severity of the pain. If the osteoarthritis limits walking, custom orthotics provided by podiatrists provide relief. For more severe pain, oral or rub-on (topical) medications may be recommended. These may include over the counter medications such as Tylenol (generic = acetaminophen) Aleve (generic = naproxen), Motrin (generic = ibuprofen) or aspirin. In addition, prescription strength medications called non-steroidal anti-inflammatory medications (NSAIDs for short) may be recommended. Some of the more commonly prescribed of these include medications such as Ibuprofen, Naprosyn and Celebrex. More recently, a medication of a different class called Cymbalta has been approved to treat the pain from osteoarthritis.

For severe pain injections of cortisone-like medication may provide temporary relief. If the pain resistant to other treatments, and foot function is very limited, surgery to limit movement in the painful joints of the feet may be considered

Additional Resources:
Osteoarthritis NSAID information
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