Arthritis is defined as an inflammation of a joint. There are various causes for this inflammation, some of which are chronic (long term) and others that are acute and not as destructive. Determining the type is essential to provide the treatment required as there are very different treatment methods depending on the type of arthritis.
Rheumatoid & Psoriatic Arthritis
Both rheumatoid (RA) and psoriatic (PA) arthritis are autoimmune diseases that affected the joints. These diseases are chronic and destructive to the joints with the body’s own immune system creating damage to the synovium (lining within the joint) leading to erosion’s of the bones at the joints.
Psoriatic arthritis is linked to psoriasis of the skin and nails which may be the first signs of having the disease with thickened/scaly patches of skin or thickening/ pitting and crumbling of the nails.
Early diagnosis and treatment is key to reducing the progression of the disease and can even create remission but sadly not a complete cure. Recent medical advances have brought about a vast range of medications used to manage the inflammation and slow the progression of damage to the joints. In addition, supporting those joints that are damaged help to reduce pain and deformities that can develop, orthotics, bracings and shoe modifications being the most used methods of treatment with podiatry. Help with callus care over deformities and nail trimming are also care that is provided by podiatrists.
This form of arthritis has long been termed ‘wear and tear’ of the joints. It typically develops with time and occurs when there has been a history of injury or excessive use of a joint. It is also more common who are obese, have poor joint alignment or those who perform repetitive exercises/movements through a joint. Damage and thinning of the cartilage within a joint leads to damage to the bones as they lose their protective spacer between them. Often the body will respond to this by creating ‘lipping’ of the margins of the bones to restrict movement in the joint which is the deformity seen with the swollen joints. Particularly in the feet, this is hazardous because with normal walking there is often a lot of movement that is required in these joints and often, with age, the arch collapses creating even more movement in the joints. As such, stabilising the foot with orthotics and shoes to reduce this excessive movement of the joints in the foot will bring good relief.
Gout is an acute inflammation of a joint due to a build up of uric acid crystals in the area creating an inflammatory response and swelling of the joint. It presents with a classic red, hot, swollen joint which will often come on overnight without any other injury or obvious cause. Relatively self limiting, it will settle down after a few days to a week or two and, with medication to manage the build up of the crystals, it can take a long time before it reoccurs. Damage to the bones and joints as a result of many gout attacks in a joint can lead to deformity and pain and can be managed, like the other forms, with support for the joints or even surgery if possible.