Midfoot osteoarthritis is a type of arthritis in the midfoot joint. The midfoot joint is where two or more of the long bones in the foot are joined by specialized tissue called synovium, cartilage, ligaments or tendons. Midfoot osteoarthritis is a very important condition in the field of rheumatology, which is the branch of medicine that deals with diseases of the muscles, joints and bones. Midfoot arthritis can cause pain, which interferes with the performance of essential tasks of daily living.
There are a number of factors in the development of midfoot osteoarthritis. Age is certainly a factor in the wearing down of cartilage within the joints. Another major factor is obesity. Obesity is a significant factor due to increased load through the joints in the foot. A previous injury to the foot, such as a fracture or a sprain, may also lead to the development of midfoot OA later in life, as confirmed by Thomas et al. (2015).
Those with midfoot osteoarthritis may experience a variety of signs and symptoms. The majority of people who develop midfoot osteoarthritis will report pain that increases when standing and walking. Another common indicator of midfoot osteoarthritis is swelling in the foot. Swelling can cause significant stiffness and limitations in the range of motion of the foot. These limited range of motions can hinder walking long distances or climbing stairs (Kalichman & Hernández-Molina, 2014; Thomas et al., 2015).
The findings from imaging tests are also highly correlated with clinical symptoms. For example, X-rays of the midfoot area can show joint damage or cartilage degeneration. The radiographic findings are often consistent with the degree of clinical symptoms the patient is experiencing such as pain and swelling. Studies have shown that patients with more severe X-ray findings report more severe clinical symptoms (Menz et al., 2010; Lithgow et al., 2020). However, it is also possible for patients to report severe clinical symptoms in the presence of relatively mild radiographic findings. Therefore, it is important to consider both the clinical symptoms and the imaging findings when both are present when diagnosing and treating midfoot osteoarthritis.
It is important to have a good understanding of the causes and symptoms of midfoot osteoarthritis. This will help medical professionals to diagnose and manage the condition more effectively, and will provide individuals withOA a better understanding of how to manage their symptoms and lead a normal lifestyle. Midfoot OA is a degenerative condition causing pain and disability to the midfoot joints. Fortunately, there are several treatment modalities that can be employed to manage the condition effectively. Non-surgical management is also a common way to manage midfoot OA. A physical therapy program that involves strengthening the foot muscles will improve foot strength and function, hence alleviating pain and enhancing the mobility of the foot, thereby allowing optimal performance for daily activities (Paterson & Gates, 2019; Lim et al., 2023).
These may include the use of orthotics which are usually presented in the form of a shoe insert. The shoe insert can help to reduce the load on the joints in the midfoot and can help to position the foot in a more normal alignment which can in turn help to spread the load across the foot more equally. By improving the biomechanical function of the foot the individual may find that they have a significant reduction in their level of disability, with symptoms being improved when moving. Other possible treatments include the prescription of non-steroidal anti-inflammatory drugs, commonly NSAIDs, which are known to reduce inflammation of the tissue surrounding the joints and reduce the joint pain (Paterson & Gates, 2019).
Strengthening muscles that support your joints is an important part of managing midfoot osteoarthritis. Weak foot muscles can cause poor balance and reduced stability, which can be a challenge to patients dealing with long periods of standing and walking (Arnold et al., 2021). Strengthening exercises can not only reduce pain and disability, thus enhancing the ability to carry out daily tasks. Active movement is crucial for physical health and wellbeing, allowing patients to lead more enjoyable and active lifestyles, including participation in social activities, work and leisure. Increased movement and activity can in turn improve a patients’ wellbeing and enable them to do the things they enjoy in life.
Life with midfoot osteoarthritis can impact a person physically and emotionally, and cause disability that can lead to depression, irritability and anxiety (Arnold et al., 2019). Osteoarthritis can impact many aspects of daily life – people may avoid important social events or activities and even withdraw from loved ones because they feel so restricted that they do not feel able to engage in normal social interactions. Managing osteoarthritis as a treatment can only address a portion of the overall issue, as the condition impacts people’s emotional health and personal lives.
The management of midfoot osteoarthritis requires a multi-disciplinary approach. As well as focusing on physical and pharmacological therapy it is equally important to address the psychological and emotional issues of having a chronic condition such as midfoot osteoarthritis (Iagnocco et al., 2013). Health care professionals can play an important role in the management of the condition and may be able to offer considerable psychological support. Patients may therefore lead a better quality of life as a result of a more holistic approach.
Citations:
Thomas, M.J., Peat, G., Rathod, T., Marshall, M., Moore, A., Menz, H.B. and Roddy, E., 2015. The epidemiology of symptomatic midfoot osteoarthritis in community-dwelling older adults: cross-sectional findings from the Clinical Assessment Study of the Foot. Arthritis research & therapy, 17(1), p.178. https://link.springer.com/article/10.1186/s13075-015-0693-3
Kalichman, L. and Hernández-Molina, G., 2014. Midfoot and forefoot osteoarthritis. The Foot, 24(3), pp.128-134. https://www.sciencedirect.com/science/article/pii/S0958259214000546
Thomas, M.J., Roddy, E., Rathod, T., Marshall, M., Moore, A., Menz, H.B. and Peat, G., 2015. Clinical diagnosis of symptomatic midfoot osteoarthritis: cross-sectional findings from the Clinical Assessment Study of the Foot. Osteoarthritis and Cartilage, 23(12), pp.2094-2101. https://www.sciencedirect.com/science/article/pii/S1063458415012182
Paterson, K.L. and Gates, L., 2019. Clinical assessment and management of foot and ankle osteoarthritis: a review of current evidence and focus on pharmacological treatment. Drugs and Aging, pp.1-9. https://eprints.soton.ac.uk/430008/
Menz, H.B., Munteanu, S.E., Zammit, G.V. and Landorf, K.B., 2010. Foot structure and function in older people with radiographic osteoarthritis of the medial midfoot. Osteoarthritis and cartilage, 18(3), pp.317-322. https://www.sciencedirect.com/science/article/pii/S1063458409003057
Lithgow, M.J., Munteanu, S.E., Buldt, A.K., Arnold, J.B., Kelly, L.A. and Menz, H.B., 2020. Foot structure and lower limb function in individuals with midfoot osteoarthritis: a systematic review. Osteoarthritis and Cartilage, 28(12), pp.1514-1524. https://www.sciencedirect.com/science/article/pii/S1063458420311225
Lim, P.Q., Lithgow, M.J., Kaminski, M.R., Landorf, K.B., Menz, H.B. and Munteanu, S.E., 2023. Efficacy of non-surgical interventions for midfoot osteoarthritis: a systematic review. Rheumatology International, 43(8), pp.1409-1422. https://link.springer.com/article/10.1007/s00296-023-05324-3
Iagnocco, A., Rizzo, C., Gattamelata, A., Vavala, C., Ceccarelli, F., Cravotto, E. and Valesini, G., 2013. Osteoarthritis of the foot: a review of the current state of knowledge. Medical ultrasonography, 15(1), pp.35-40. http://www.medultrason.ro/medultrason/index.php/medultrason/article/view/442
Arnold, J.B., Halstead, J., Grainger, A.J., Keenan, A.M., Hill, C.L. and Redmond, A.C., 2021. Foot and leg muscle weakness in people with midfoot osteoarthritis. Arthritis Care & Research, 73(6), pp.772-780. https://acrjournals.onlinelibrary.wiley.com/doi/abs/10.1002/acr.24182
Arnold, J.B., Marshall, M., Thomas, M.J., Redmond, A.C., Menz, H.B. and Roddy, E., 2019. Midfoot osteoarthritis: potential phenotypes and their associations with demographic, symptomatic and clinical characteristics. Osteoarthritis and cartilage, 27(4), pp.659-666. https://www.sciencedirect.com/science/article/pii/S1063458419300214
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