Osteoarthritis (OA) is the most common form of arthritis; it affects more Canadians than all others forms of arthritis combined. 1 in 5 Canadians are affected, and these numbers are increasing. OA is a progressive disease and can be described as a result of the bodies failed attempt to repair damaged joint tissue.
Bones come together to form a joint; cartilage at the ends of the bones act to cushion against impact. Gradually, as cartilage breaks down, it becomes rough and frayed and the protective space between the bones decreases. This breakdown of cartilage increases the demand on the bones in the joint and the bones begin to rub against each other and can produce painful osteophytes (or bone spurs), which leads to stiffness, pain and loss of movement in the joint.
In the foot the most common joint affected by OA is the big toe, but it can also affect the midfoot and ankle.
OA affects everyone differently, but common symptoms include:
Joint pain and achiness
Morning stiffness that lasts less than 30-min
Reduced joint range of motion and pain with motion
Tenderness when pressure is applied to the joint
These symptoms may come and go but the intensity generally increases overtime as OA is a progressive disease
Although there is no cure for osteoarthritis, there are many treatment options available to slow the progression and help relive symptoms.
Rheumatoid arthritis (RA) is another type of arthritis commonly affecting the small joints in the foot. RA is a chronic inflammatory disease of the joints, meaning the immune system attacks the tissue (synovium) covering and protecting the joint, causing it to swell. Overtime the synovium covering the joint breaks down causing damage to the cartilage, bone, and supporting ligaments and tendons. RA affects joints symmetrically, meaning it attacks the same joints on both sides of the body.
Gout is a form of arthritis that occurs when excess uric acid, a waste product of the body, circulates in the bloodstream depositing needle-shaped crystals into tissues, including joints. For many people the first symptom of gout is excruciating pain and swelling in the big toe joint. After years of gout, lumps of uric acid may form beneath the skin in different parts of the body including the feet.
How can orthotics and footwear choices help with arthritic pain?
Orthotics can help to redistribute load and relieve pressure from sensitive areas. They can also provide cushioning and shock absorption that reduces stress and biomechanical load on the joint. Orthotic intervention can lead to long-term changes in biomechanics that may slow or prevent arthritic progression. Orthotics cannot only help joints affected in the feet, but also provide relief for structures further up the kinetic chain such as arthritic knees and hips.
Selecting footwear with the right features can help alleviate arthritic pain and improve mobility, look for shoes that have:
A rigid rocker sole (an upwards curve at the toe area of the shoe) this can help decrease stress placed on the ball of the foot and provides a more efficient push-off when walking
Wide, deep, square toe-boxes, with minimum seams help minimize pressure on painful joints and toes.
Heels lower than 1” or 2.5cm
The wrong shoes can exacerbate existing problems in someone with arthritis in their hips, knees, ankles or feet.