Foot Arthritis

What is Foot Arthritis?

Foot arthritis is degeneration of the foot joints causing pain, swelling and stiffness.

Causes of Foot Arthritis

Foot arthritis is often due to previous injury or long-term deformity.

The foot can also be affected by:
  • primary osteoarthritis
  • rheumatoid arthritis
  • sero-negative inflammatory arthritis
  • crystal arthropathy (gout/pseudo-gout)
  • haemophilic arthropathy
  • Charcot neuroarthropathy.
Foot arthritis is common.

Which Foot Joints are Commonly Affected by Arthritis?

The foot joints most commonly affected by arthritis are the:
  • joint at the base of the big toe (1st metatarsophalangeal/MTP)
  • midfoot joints (tarsometatarsal and naviculocuneiform)
  • hindfoot joints (subtalar, talonavicular and calcaneocuboid).
Please see Foot - Anatomy and Imaging for more information on where these are.

Symptoms of Foot Arthritis

Symptoms of foot arthritis vary in severity but often get worse over time. They include:
  • pain is usually with/after activity. Pain also present at night suggests severe arthritis.
  • swelling
  • stiffness
  • altered foot shape.

Diagnosis of Foot Arthritis

The diagnosis of foot arthritis is made following:
  • medical history
  • physical examination
  • weight-bearing X-rays of the foot.
Other investigations (CT, MRI, etc) may be needed if X-rays do not fully explain the pain or if surgery is planned.

Treatment of Foot Arthritis

Non-surgical treatment

Non-surgical treatment is always important and involves:

 

  • pain relief and occasional anti-inflammatory medications
  • activity modification and weight loss
  • orthotics (insoles) and braces
  • supportive +/- rocker sole shoes.

 

Hyaluronic acid (Euflexxa, Synvisc, Durolane, etc) viscosupplementation injections may help in early ankle and hindfoot arthritis. Evidence is stronger in knee arthritis.


Cortisone injections do not cure foot arthritis but are used for temporary relief of symptoms prior to holidays and other events. They should not be repeated more than twice unless in unusual situations.

Surgical treatment of foot arthritis

Surgery is only recommended when non-surgical treatment has not controlled pain or deformity, and activity is significantly impaired.


Big toe arthritis can be treated by "clean-out" or 1st MTP fusion.


Midfoot and hindfoot arthritis - there are two surgical options:

 

  • "clean-out" - removal of large spurs and inflammation
  • fusion - permanently stiffening arthritic joints together with plates, screws and staples.

 

There are no joint replacements available for the midfoot and hindfoot joints. 

 

Please see Big Toe (1st MTP) Fusion and  Midfoot and Hindfoot Fusion under the TREATMENTS menu for more information.