Arthritis is an inflammation and swelling of the cartilage and lining of the joints, generally accompanied by an increase in the fluid in the joints. Arthritis is a disabling and occasionally crippling disease afflicting almost 40 million Americans. In some forms, it appears to be hereditary. Although the prevalence of arthritis increases with age, all people from infancy to middle age are potential victims. People over 50 are the primary targets.

If the feet seem more susceptible to arthritis than other parts of the body, it is because each foot has 33 joints that can be afflicted, and there is no way to avoid the pain of the tremendous weight-bearing load on the feet. Arthritic feet can result in loss of mobility and independence. However, early diagnosis and proper medical care can limit or slow the damage.

Symptoms of arthritis in the foot and ankle include:

• Early morning stiffness.
• Limitation in motion of joint.
• Recurring pain or tenderness in any joint.
• Redness or heat in a joint.
• Skin changes, including rashes and growths.
• Swelling in one or more joints.

Forms of Arthritis

Osteoarthritis is the most common form of arthritis. It is frequently called degenerative joint disease or wear and tear arthritis. Aging usually brings on a breakdown in cartilage, and pain gets progressively more severe. Dull, throbbing nighttime pain is characteristic, and may be accompanied by muscle weakness or deterioration. Many of these symptoms can be relieved with rest. Overweight people are particularly susceptible to osteoarthritis. The additional weight contributes to the deterioration of cartilage and the development of bone spurs.

Rheumatoid arthritis is a major crippling disorder and the most serious form of arthritis. It is a complex, chronic inflammatory group of diseases, often affecting more than a dozen smaller joints during its course. In the foot, it frequently affects both ankles and toes.

Arthritis of the foot and ankle can be treated in many ways, including:

• Physical therapy and exercise.
• Anti-inflammatory medication and/or steroid injections into the affected joint. Note: Please consult your physician before taking any medications.
• Orthotics or specially prescribed shoes.

There are many kinds of cancers of the foot. Some take the form of cysts and lesions, while others are more widespread.

Malignant melanoma is a skin cancer that is curable if caught early. Although it makes up only one percent of skin cancers, malignant melanoma accounts for over 60 percent of skin cancer deaths. It is estimated that approximately 30 percent of melanomas occur in the lower extremities, and that 3 percent occur in the feet.

Neoplastic disorders, usually called tumors, are the result of abnormal growth of tissue. Both benign or malignant tumors occur in the foot.

Osteochondromas are benign bone tumors under the toenail. Osteochrondromas account for about half of all benign bone tumors in the foot, occurring mostly in children and young adults. Unless they cause irritation to the surrounding tissue, they are generally not very painful. Sometimes, they can deform the toenail and cause an ingrown toenail. In rare cases, they are removed surgically.

A plantar fibroma is a benign tissue tumor or growth on the plantar, or bottom surface of the foot. Unlike plantar warts, which grow on the skin, these grow deep inside on a thick fibrous band called the plantar fascia. There are a number of nonsurgical measures for treating plantar fibromas, such as orthotics. When these conservative measures fail to provide adequate relief of symptoms, surgical removal is a reasonable option.

Giant cell tumors are benign tumors of the tendon sheath. These masses are generally found on the toes, top of the foot, or sides of the foot. They can also occur deep inside the foot. They are firm irregular masses that are typically painful.

Freiberg's Disease usually begins as a pain in the ball of a child's foot. Its onset is often linked to an injury to the growth plate of one of the long bones behind the toes, called metatarsals. The loss of blood flow to the growth plate causes pain. Freiberg's Disease is most frequently seen in adolescents between the ages of 13 and15. It is three times as likely to occur in females than in males.

Treatment for Frieberg's Disease consists of reducing pressure under the affected bone. This may require the use of crutches and/or prescription of a custom orthotic.

Kaposi's Sarcoma is a cancerous lesion that can occur on the soles of the feet. The disease is usually associated with HIV infection and/or AIDS. The lesion is irregular in shape and has a purplish, reddish, or bluish-black appearance. Kaposi's Sarcoma lesions tend to spread and form large plaques or become nodular. The nodular lesions have a firm, rubbery appearance.

Kohler's Disease is a spontaneous loss of blood supply to a particular bone in the foot.

Treatments may include cast immobilization, reduced activities and foot orthotics or inserts.

Maffucci's Syndrome is a very rare form of enchondromatosis that combines multiple enchondromas in bones anywhere in the body with benign soft tissue tumors (known as hemangiomas), which are associated with blood vessels. This condition tends to appear in the hands and feet, and has a greater tendency toward malignant transformation than Ollier's Disease.

Some form of injury or trauma to the toe results in the formation of this bony irregularity or prominence.

Maffucci's Syndrome only requires treatment in cases where the tumors are aggressive and begin destroying bone tissue. In these cases, surgical removal is recommended.

Ollier's Disease, also known as enchondromatosis, frequently occurs in the small bones in the hands and toes (phalanges) and the long bones behind the phalanges, called metatarsals. This condition is characterized by multiple enchondromas. Some form of injury or trauma to the toe results in the formation of the bony irregularity or prominence.

As with the majority of enchondromas, Ollier's Disease generally requires no treatment. Only in cases where the tumors are aggressive and begin destroying bone tissue do they require further attention, often surgical removal.

Raynaud's Disease is a disorder that affects the hands and feet. It is caused by contraction of the smooth muscles controlling the small arteries supplying circulation into the hands and feet. This contraction, called a vasospasm, makes the arteries so small that they restrict blood flow. Exposure to cold temperature can often bring on a vasospasm.

Raynaud's Disease has no known cause and is most common in young women. Staying warm and exercising regularly to maintain healthy blood circulation throughout the body can help offset the disease.

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