Definition Joints can become painful for a number of reasons. The reasons can range from an injury to a specific joint to an overall condition, such as arthritis, that affects many joints in the body.
What is going on in the body? Painful foot joints are usually caused by physical stress to the foot. The stress can result from poor bone structure, ill-fitting shoes, being overweight, and overdoing certain activities.
Occasionally, arthritis can cause painful foot joints. Some of the more common conditions caused by arthritis that involve the joints of the feet include:
gout, a metabolic disease caused by deposits of uric acid in the joints
rheumatoid arthritis, a chronic inflammatory disease that affects the joints and surrounding tissues
systemic lupus erythematosus, a chronic inflammatory disorder that affects the skin, joints, and internal organs
psoriasis, a skin condition characterised by frequent episodes of redness, itching, and thick, dry scales on the skin
venereal disease, or sexually transmitted disease
Reiter's syndrome, a group of symptoms consisting of:
arthritis, which is inflammation of the joints
urethritis, which is inflammation of the urethra
conjunctivitis, which is inflammation of the lining of the eye
lesions of the skin and mucous membranes
What are the signs and symptoms of the disease? Symptoms usually consist of pain in one or more joints of the foot. These include:
the joint at the base of each toe
the joints of the toes themselves
the joints of the midfoot
the ankle
The pain can be dull and achy or it can be quite sharp and unbearable.
What are the causes and risks of the disease? Ignoring the symptoms can lead to the symptoms getting worse. It can also lead to permanent damage to the joints.
What can be done to prevent the disease? Joint pain can be prevented by protecting the joint from further damage. This can be done by:
selecting shoes that fit comfortably
using over-the-counter arch supports
having custom-made supports, or orthotics, built in some cases
having custom-moulded shoes made
detecting and treating diseases that affect the whole body, such as arthritis
Individuals should also follow sports safety principles when exercising or participating in sports.
How is the disease diagnosed? Joint pain is diagnosed based on the location and type of pain, and when the pain started. Tests such as joint x-rays, magnetic resonance imaging (MRI), and computed tomography (CT scans) can help in the diagnosis. If arthritis is suspected, the doctor will order additional testing. If gout is suspected, a small sample of fluid from a joint can be analysed.
What are the long-term effects of the disease? The long-term effects of painful feet and joints can keep a person from performing their usual daily routine. It can also keep them from exercising, even from something as simple as walking. This may lead to weight gain, loss of bone mass, loss of cardiovascular fitness, and general disability. The long-term effects of arthritis include increasing deformity of the joints and increasing disability.
What are the treatments for the disease? The most important treatment is to protect the affected joint from further injury. This can include:
careful shoe selection
arch supports
custom-made orthotics
custom-made shoes
A doctor can identify any underlying causes and treat them with various medications such as steroids. A steroid injection into the joint can be helpful. In severe cases, surgery may be necessary to repair or rebuild a damaged joint.
What are the side effects of the treatments? The side effects of treatment depend on the medications used. Steroid injections give short term relief, but can contribute to long-term damage. The person may overuse the pain free joint, which can lead to further destruction. Side effects of steroids taken by mouth include thinning of the skin, bruising, osteoporosis, high blood pressure, and elevated blood sugars. There are complications with any surgery or anaesthesia. These include bleeding, infection, and reactions to the anaesthesia medications.
What happens after treatment for the disease? A person with custom-made orthotics or shoes should consult the doctor or podiatrist if there is any discomfort. The orthotics or shoes may need to be adjusted after they have been worn for a short while.
How is the disease monitored? Treatment for arthritis and other conditions that affect the whole body must be constantly monitored. The doses of the various medications need to be carefully checked to be sure that the lowest effective dose is being used. Many of these medications have significant side effects. The side effects need to be monitored closely.
Author: Bill O'Halloran, DPM Reviewer: HealthAnswers Australia Medical Review Panel Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia Last Updated: 1/10/2001 Contributors Potential conflict of interest information for reviewers available on request
