Midfoot Arthritis Introduction

Patients with midfoot arthritis usually suffer pain and swelling, with a change in the shape of the foot developing later.

Midfoot Arthritis Symptoms

Symptoms arise particularly when walking or taking part in sport. The pain may be sharp or burning. Midfoot arthritis can result in problems finding suitable and comfortable footwear.

Causes of Midfoot Arthritis

There are two main causes of midfoot arthritis.

  1. A specific injury, sometimes relatively minor, can lead to joint damage and osteoarthritis. This same process can occur over years if the middle part of the foot is under strain because of, for example, a long-standing bunion.
  2. Rheumatoid arthritis and other inflammatory joint conditions may also affect the midfoot.

Midfoot Arthritis Diagnosis

Midfoot arthritis is sometimes overlooked by non-specialists because there are so many small joints in the midfoot. A careful clinical assessment needs to be supplemented with special x-ray views. Scans may be required as well and to be certain which joint(s) are involved, selective injections are helpful.

Midfoot Arthritis Treatment

Non-surgical treatment

Painkillers and anti-inflammatory medication help to reduce discomfort. Limiting activities that aggravate the symptoms is also sensible. Shoes should be stiff, rather than soft. An extreme example would be walking boots; MBT trainers are a more modern alternative. The stiff soles protect the painful joints, which bend less and therefore hurt less.

Orthotics can be useful to either correct abnormal foot biomechanics or to help stiffen existing shoes (see above).

Surgical treatment

In selected cases, where localised arthritic spurs have developed, they can be removed using a relatively small operation.

If the arthritis is severe, and all non-operative treatments have been tried, fusion of the arthritic joints may be considered. By fusing together the joints using screw plates and/or staples, pain is much reduced.

Prior to surgery, scans and/or injections are needed to decide which small joints to fuse. This sort of surgery for metatarsalgia (forefoot pain) takes many months to recover from and is very much a last resort.

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