Understanding is everything
Like any problem, a physical condition needs to be properly understood in order to be improved.
With the wealth of information available online it can be easy to feel confused and overwhelmed about what’s right for you. Here you’ll find not only relevant information regarding Podiatry but also common misconceptions and myths that I’ll set straight. Anything here that you’d like to discuss or find out more about, please don’t hesitate to get in touch.
The body’s joints connect and hold the bones together thanks to capsules and ligaments. The cartilage and the synovial fluid on the extremity of the bones allow the joints to move smoothly while providing the bone with a natural protection against mechanical wear and tear. Arthritis affects the cartilage until the bones end up rubbing on each other, limiting the range of movement in the joint, becoming painful and making standing and moving difficult.
There is a mechanical factor in any arthritis that affects the toes, mid-foot, heel, ankle, knee, hip, and spine. Orthotics are indicated to address the misalignment, unbalance, and postural problem. Additionally, it is essential to address the inflammatory factors and the predisposing factors such as the immune system in degenerative arthritis and joint traumatism, obesity and sometimes the patient’s age.
There are two types of arthritis, OSTEOARTHRITIS and RHEUMATOID. The latter is an autoimmune disease in which the body’s own immune system attacks the body’s joints, whereas osteoarthritis is caused by mechanical wear and tear on joints.
Compared to the mechanical pain, inflammatory pain tends to hurt when you wake up, usually lessening after a few steps, and then reappearing again during the day.
What can help?
Stiffness: Keep the joint moving with some exercises.
Pain: Rest and have your gait and biomechanics analysed. Orthotics can offload an area to some extent whilst also improving the joint mobility by reengaging the bone together.
Swelling: Ice before bed and elevation of the limb by night will relieve the swelling while promoting healing and flexibility.
Deformity: At a foot level, accommodate the deformity with the right footwear (supportive sole, wide toe box, chunky heel under 5cm and ideally materials which give with a minimum of stitches).
Left without any treatment, the joints become stiff and enlarged. However, pain will remain subjective. Biological tests are required, often by a Rheumatologist looking for factors of arthritis in the blood.
Treatments might include; analgesics, steroids, monoclonal antibodies, physiotherapy, custom moulded orthotics, hyaluronic acid injection, surgery… to give just a few examples. Whatever the treatment, it should always be tailored according to the individual needs of each patient and depends on the response and the tolerability of medications. Keep in mind that mechanical disorders can generate osteoarthritis through mechanical wear and tear on joints. In this case it will be essential to make the body work better.