Osteoarthritis of the Foot with Mr Bal Dhinsa, Consultant Orthopaedic Surgeon

What is Osteoarthritis and what are the symptoms in the foot?

The bones on either side of the joints in the foot are lined with cartilage. If this lining becomes damaged it can lead to arthritis.


Degenerative changes in the joints of the foot are rarely primary arthritis and usually result from trauma to the area (fractures, dislocations or sprains), from other deformities (such as flat feet) or from inflammatory causes (such as rheumatoid disease).


Patients typically have pain on the top of the foot, which can be worse in the morning and progresses with prolonged weight-bearing. There is associated swelling and with time more obvious deformities in the foot can develop.


What are the 4 stages of Osteoarthritis?

There are generally four stages used to describe osteoarthritis. Stage 1 is described as minor wear and tear changes seen associated with minimal pain. This may progress to having more noticeable bone spurs around the affected joint and more discomfort (stage 2) and then cartilage erosion (stage 3). The final 4th stage typically has very little cartilage present in the joint surfaces (termed bone-on bone) with deformity and pain associated.


What does Osteoarthritis in feet feel like?

It can vary from intermittent pain and swelling to significant pain and restricted movement of the joints involved. The pain can be worse in the morning and progresses with prolonged weight-bearing. The reason for seeking medical attention is often deformity associated with osteoarthritis, which can affect weight-bearing and function.


How is Osteoarthritis treated in feet?

This will depend on the stage of the osteoarthritis. Initial pain relief can be achieved with analgesics, non-steroidal anti-inflammatory medications, modification of footwear and activities, as well as orthotics to off-load the painful area. Depending on the patient, weight loss may help reduce the pressure in this area, as well as physiotherapy to keep the joints supple and surrounding muscles strong.


If these measures fail to resolve the symptoms, a corticosteroid injection into the joint may be of benefit to help control pain and allow activities to continue.


If the arthritis is mild-to-moderate, with the pain resulting from the pressure effect of bone spurs present, it is reasonable to remove these to help with the symptoms. However, if there is rigidity of movements and the arthritis is more advanced, the operative option is to fuse the joints affected to alleviate the pain. For the forefoot there are other surgical options such as joint replacements, however this tends to be reserved for patients who are not very active due to the potential complications from excessive wear of the prosthesis.


What exercises can be done to help osteoarthritis in feet?

People who exercise regularly have less pain, more energy and better function. It is important to try to keep the joints supple. Activities such as yoga and Pilates are very good for the whole body.


For the foot, simple stretching and range of motion exercises are key. It is important to start slow, move gently, stop if your foot starts to hurt (listen to your body) and take appropriate rest.


Can Osteoarthritis in feet be prevented? If so, how? If not, why?

Osteoarthritis cannot be prevented and no cure is known, but early recognition and taking steps to prevent progression of the pain and deformity can help. Factors that can help are:


  • Maintaining a healthy weight
  • Avoiding injury
  • Taking precautions at work
  • Wearing proper-fitting shoes that fit the shape of your foot

Learn more on Mr Bal Dhinsa, why he chose to become an orthopaedic surgeon and what he enjoys most about his job.

Mr Bal Dhinsa, Consultant Orthopaedic Surgeon at One Ashford Hospital in Kent

Bal (Baljinder) Dhinsa is a fellowship trained Consultant Orthopaedic Surgeon, specialising in the treatment of foot and ankle conditions, in particular foot and ankle arthritis (osteoarthritis and inflammatory arthritis), arthroscopy of the ankle for therapeutic management, soft tissue and ligament reconstruction, and sports injuries to the foot and ankle.


To learn more on Mr Dhinsa, click here

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