Arthritis and your feet

ARTHRITIS AND YOUR FEET

The American Podiatric Medical Association

Arthritis: Overview

• Chances are you or someone you know has arthritis. In fact, arthritis affects an estimated 42.7 million Americans – nearly one of every six people. Although this prevalence is already high, it is expected to increase even more as the U.S. population ages. By the year 2020, an estimated 60 million people will have arthritis.

Arthritis: Overview

• Arthritis and other rheumatic conditions are among the most chronic conditions and the leading cause of disability in the United States. These conditions frequently lead to limitations in work, recreation, and daily/normal activities, including basic self-care.

Arthritis: Overview

• Approximately seven million people named arthritis as a major or contributing cause of activity limitation at work. And just like the number of people who are afflicted by arthritis, the prevalence of arthritis-related disability is also expected to rise to an estimated 12 million people by the year 2020.

Arthritis: Overview

• Compounding this picture are the enormous costs that our nation bears for treating arthritis, its complications, and the disability that results from uncontrolled disease. The total cost is nearly $65 billion dollars a year.

What is Arthritis?

• Arthritis is inflammation and swelling of the cartilage and lining of the joints, generally accompanied by an increase in the fluid in the joints. It causes pain, stiffness, and sometimes swelling in or around joints which can lead to limitation of movements, redness, and a burning (hotness) sensation around the joints.

What is Arthritis?

• Arthritis encompasses more than 100 diseases and conditions affecting joints, the surrounding tissues, and other connective tissues. These diseases and conditions include osteoarthritis, rheumatoid arthritis, lupus, juvenile rheumatoid arthritis, gout, fibromyalgia, bursitis, rheumatic fever, and Lyme disease.

Most Common Forms of Arthritis

• The three most common forms of arthritis are:

• Osteoarthritis

• Rheumatoid Arthritis

• Fibromyalgia

What is Osteoarthritis?

• Osteoarthritis or degenerative joint disease, is the most common type of arthritis, affecting nearly 21 million Americans, mostly after age 45. Osteoarthritis often affects the hip, knee, foot and hand. Degeneration of joint cartilage and changes in underlying bone and supporting tissues lead to pain, stiffness movement problems, and activity limitations.

What is Rheumatoid Arthritis?

• Rheumatoid arthritis is characterized by chronic inflammation of the joint lining. It typically affects more than one joint and tends to be symmetrical. Symptoms include pain, stiffness, and swelling of multiple joints. The inflammation may extend to other joint tissues and cause bone and cartilage erosion, joint deformities, movement problems, and activity limitations.

What is Rheumatoid Arthritis?

• Rheumatoid arthritis can also affect connective tissue and blood vessels throughout the body, triggering inflammation in a variety of organs, including the lungs and heart, and increasing a person’s risk of dying of respiratory and infectious diseases. Onset is usually after age 45, but often occurs in the 20s and 30s. Approximately 2.1 million Americans have rheumatoid arthritis.

What is Fibromyalgia?

• Fibromyalgia is a pain syndrome involving muscle and muscle attachment areas. Common symptoms include widespread pain throughout the muscles of the body, sleep disorders, fatigue, headaches, and irritable bowel syndrome. Approximately four million people have fibromyalgia.

What Causes Arthritis?

• Arthritis has multiple causes. Joint inflammation and arthritis are associated with many different illnesses. There are more than 100 different types of arthritis and the cause of most types is unknown.

Causes

• Scientists are currently studying what roles three major factors play in certain types of arthritis. These include the genetic factors you inherit from your parents, what happens to you during your life and how you live. The importance of these factors varies for every type of arthritis.

Some Known Causes

• Besides heredity, arthritic symptoms may arise in a number of ways:• Through Injuries

• Through Bacterial and Viral Infections

• Through the Use of Drugs

• As part of a Congenital Autoimmune Disease Syndrome

• In conjunction with Bowel Disorders

Arthritis and the Feet

• The feet are more susceptible to arthritis than other parts of the body. Each foot has 33 joints that can be afflicted and there is no way to avoid the pain of the tremendous weight-bearing load on the feet.

Arthritis and the Feet: Symptoms

• Arthritic feet can result in loss of mobility and independence, but that may be avoided with early diagnosis and proper medical care. And because arthritis can affect the structure and function of the feet it is important to see a doctor of podiatric medicine if any of the following symptoms occur in the feet:

Symptoms

• Swelling in one or more joints• Recurring pain or tenderness in any

joint• Redness or heat in a joint • Limitation in motion of joint• Early morning stiffness• Skin changes, including rashes and

growths

Arthritis and the Feet: What is Gout?

• Gout is a condition caused by buildup of the salts of uric acid in the joints. A single big toe joint is commonly the affected area, possibly because it is subject to so much pressure when/during walking. Men are much more likely to be afflicted than women. Attacks of gouty arthritis are extremely painful, perhaps more so than any other form of arthritis.

Podiatric Physicians Role in Treating Arthritis

• The objectives in the treatment of arthritis are controlling inflammation, preserving joint function, and curing the disease if possible. Because the foot is such a frequent target, podiatrists are often the first to encounter the complaints – inflammation, pain, stiffness, excessive warmth, injuries. Even bunions can be manifestations of arthritis.

Podiatric Physicians Role in Treating Arthritis

• Arthritis may be treated in many ways. Patient education is important. Physical therapy and exercise may be indicated, accompanied by medication.

• The control of foot functions with shoe inserts called orthoses, or with braces or specially prescribed shoes, may be recommended. Surgical intervention to replace damaged joints with artificial joints may also be a possible course of action.

Podiatric Physicians Role in Treating Arthritis

• Weight control can be achieved through preventive foot care by allowing individuals to stay active.

• Job-related injuries can be reduced by receiving appropriate foot care, exercising regularly, and using the proper footwear when walking on specific floor surfaces.

• Proper footwear and stretching exercises will assist in the prevention of sports-related injuries.

Common Myths about Arthritis

• Arthritis is an old person’s disease. Although arthritis affects one of every two people over age 65, most people with arthritis – nearly three out of five – are younger than 65. People of all ages ages are affected, including children and teens. Juvenile rheumatoid arthritis is one of the most common chronic illnesses of childhood.

Common Myths about Arthritis

• Arthritis is just a normal part of aging. If this were true, most older adults – and no children would have arthritis.

• There is no cure for most forms of arthritis. Although no “magic bullet” for all types of arthritis exists, research shows that early diagnosis and appropriate management can help reduce the consequences associated with many types of arthritis.

Who is at risk for Arthritis?

• Certain factors are known to be associated with a greater risk of arthritis. Three of these factors are nonmodifiable: female sex, older age, and genetic predisposition. Although these factors cannot be changed, knowledge of their presence helps identify groups at higher risk for arthritis so that intervention efforts can be targeted accordingly.

Who is at risk for Arthritis?

• Women aged 15 years and older account for 60% of arthritis cases. Almost 27 million women have arthritis. It is the leading chronic condition among women, and by the year 2020, an estimated 36 million women will be affected. Furthermore, approximately 5 million women report arthritis as a major or contributing cause of activity limitation.

Who is at risk for Arthritis?

• Age is also associated with increased risk of arthritis. Half of the elderly population is affected by arthritis, and risk increases with age.

• Genetic predisposition to arthritis is a third nonmodifiable risk factor. Certain genes are known to be associated with a higher risk of some types of arthritis.

Who is at risk for Arthritis?

• Some demographic factors, such as lower levels of education and lower income, are associated with arthritis. In addition, a few modifiable risk factors are also associated with increased risk of arthritis. These include:

• Obesity

• Joint Injuries

• Infections

• Certain occupations (e.g., farming, heavy industry, and occupations with repetitive joint stress such as knee-bending, hip-bending, and or ankle bending).

Arthritis Prevention

• While there is no guarantee that anything you do will prevent osteoarthritis, here are some steps you can take to keep your cartilage as healthy as possible:

• KEEP MOVING – Flexing joints lubricates and protects them, so exercise regularly. But avoid high-stress activities that pound on knees or hips.

• STAY SLIM – Carrying too much weight puts extraordinary stress on the knees, hips, and ankles. Shed excess pounds to take a load of the joints.

• BUILD MUSCLE – Joints need a strong support system; maintaining muscle tone will help stabilize knees, hips, and shoulders.

More information about Arthritis

• To receive a free brochure about arthritis or to locate a podiatric physician near you contact the American Podiatric Medical Association (APMA) at 1-800-FOOTCARE and or visit us at www.apma.org to learn more about foot health.