This type of arthritis usually takes a longer time to develop and for this reason it usually is found in the older person. Nevertheless it can lead to crippling arthritis and foot pain.
Reasons for foot osteoarthritis
It is important to realize that foot osteoarthritis affects first mainly the first metatarsophalangeal joint (bunion or hallux valgus), second the forefoot (mid tarsal osteoarthritis) or third the ankle (subtalar osteoarthritis). Specifically, inappropriate footwear (high heels in women), trauma (soccer players), weight gain and diabetes mellitus are all risk factors. More details about diagnostic tests and treatment regarding “osteoarthritis” can be found on this page. Notably there is some indication that osteoarthritis may have a link to many years of exposure to high insulin levels (metabolic syndrome). Certainly, this has some implications regarding possible dietary modifications. Particularly, avoidance of starchy foods and of sugar (low carb diet) may have a preventative and healing influence regarding osteoarthritis in general (for literature see the metabolic syndrome link).
Remedies against foot pain
Heat rubs and capsaicin work in a similar fashion as heat. Corticosteroids help via the anti-inflammatory effect and often last 6 to 9 months. Voltaren gel is usually well tolerated and helps through the anti-inflammatory effect. Hyaluronic acid (brand name: Synvisc) is usually given as a set of three injection 1 or two weeks apart. The effect, if it works, will last several months up to a year and can then be repeated again. Glucosamine sulfate has truly been a folk remedy for the past 15 to 20 years and has been well researched.
Treatment of foot osteoarthritis
With this in mind, many studies found glucosamine to be almost as powerful as the traditional anti-inflammatory medications, but without the stomach irritating side-effects. In contrast to these studies, which unfortunately were not always well controlled a well controlled study regarding glucosamine and arthritis could not find any significant effect over the placebo effect. Moreover, there likely will be newer agents developed in future. What would be needed is an injectable agent that is similar to synovial fluid, which is missing in the affected joint fluid, based on joint fluid analysis. Research in this area has been slow in the past, but one of the products that has come out of it is Synvisc. Perhaps there may be more effective similar medications in future with continued research. For one thing, such alternative over-the-counter method is the use of supplemental collagen, available in health food stores.
References
1. ABC of rheumatology, second edition, edited by Michael L. Snaith , M.D., BMJ Books, 1999. Chapter 5.
2. The Merck Manual, 7th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapter 270.
3. Wheeless’ Textbook of Orthopaedics: http://www.wheelessonline.com/
4. The Merck Manual, 7th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapter 60, p.487.
5. Goldman: Cecil Textbook of Medicine, 21st ed.(©2000)W.B.Saunders
6. Ferri: Ferri’s Clinical Advisor: Instant Diagnosis and Treatment, 2004 ed., Copyright © 2004 Mosby, Inc.
7. Rakel: Conn’s Current Therapy 2004, 56th ed., Copyright © 2004 Elsevier
8. Suzanne Somers: “Breakthrough” Eight Steps to Wellness– Life-altering Secrets from Today’s Cutting-edge Doctors”, Crown Publishers, 2008
