Secrets of foot pain: Arthritis is PROGRESSIVE

The patient above was seen initially in this office back in 2011, and those images are on the right hand side. The left side images show 2013 radiographs. This demonstrates the progressive nature of the arthritic condition in the first toe joint. The left shows a joint space of 0.6mm versus 1.92 mm joint space on the right, and this implies cartilage thinning, a mainstay of osteoarthritis. On the side views, we see increased calcifications and spurring on top of the joint which is outlined with a red circle to the image on the left.

This can progress slowly, but whenever we see this sort of progression in 2 years time, we can be certain this patient may require surgical intervention. I always strive to treat with nonsurgical care, but in circumstances such as this, often times an arthrodesis or total joint replacement can be undertaken depending on nature of symptoms and activity level of the patient.

Joint supplementation, such as chondroiten sulfate,  along with flavanoids for anti oxidant nonsteroidal anti inflammatory relief may benefit for osteoarthritis pain as well.

Sometimes even cortisone injections (maximum of 3 in a 12 month period) may be useful for pain relief, along with orthosis with rigid first ray advancement.

Dr Timm

Diplomate American Board of Podiatric Surgery