Arthritis and Podiatric Medicine: Walking Hand-in-Hand

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Arthritis and Podiatric Medicine Walking
Hand-in-Hand

• David J. Sands, DPM
• 560 Northern Blvd., Suite 206
• Great Neck, NY 11021
• Diplomate, American Board of Podiatric Surgery

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Arthritis Facts

• Arthritis in one form or another afflicts 66
  million Americans or nearly 1 in 3 adults
• 42.7 million Americans have doctor-diagnosed
  arthritis and 23.2 million others live with
  chronic joint symptoms but have not been
  diagnosed by a doctor
• Doctors of podiatric medicine are often the first
  to diagnose arthritis because the feet have 33
  joints that can be affected, and there is often
  pain associated with weight-bearing

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Arthritis Facts

• Arthritis is one of the most prevalent chronic
  health problems and the nations leading cause of
  disability among Americans over age 15.
• Arthritis is second only to heart disease as a
  cause of work disability.
• Arthritis limits everyday activities such as
  walking, dressing and bathing for more than 7
  million Americans.

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Arthritis Facts

• Arthritis results in 39 million physician visits
  and more than a half million hospitalizations.
• Costs to the U.S. economy total more than 86.2
  billion annually.
• Arthritis affects people in all age groups
  including nearly 300,000 children.
• Baby boomers are now at prime risk. More than
  half those affected are under age 65.

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Definition of Arthritis

• Arthritis is inflammation and swelling of the
  cartilage and lining of the joints, generally
  accompanied by an increase of fluid in the
  joints.
• Often arthritis is a component of complex
  diseases that may involve more than 100
  identifiable disorders.

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Causes of Arthritis

• Hereditary tendencies
• Age (arthritis often targets those over 50)
• Trauma or injury (athletes and industrial workers
  at higher risk)
• Bacterial or viral infections that strike joints
• In conjunction with inflammatory bowel diseases
• Use of prescription or illegal street drugs
• Possible congenital autoimmune association

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Types of Arthritis - Osteoarthritis

• Osteoarthritis is the most common form of
  arthritis
• Often called degenerative joint disease or wear
  and tear arthritis
• Onset is generally gradual (i.e., the aging
  process causes a breakdown in cartilage)
• Pain usually progresses, but rest can relieve
  pain
• Characterized by dull, throbbing nighttime pain
  with accompanied muscle weakness or deterioration
• Particularly seen in the feet when patients are
  overweight due to the deterioration of cartilage
  and development of bone spurs

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Types of Arthritis Rheumatoid (RA)

• Rheumatoid arthritis is the most serious and
  crippling
• Complex, chronic inflammatory system of diseases,
  often affecting more than a dozen smaller joints,
  usually in a symmetrical fashion
• Characterized by lengthy morning stiffness,
  fatigue and weight loss

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Types of Arthritis Rheumatoid (RA)

• Can affect eyes, lungs, heart and nervous system
• Women are 3-4 times more likely than men to
  suffer
• More acute onset than osteoarthritis
• Intermittent periods of remission and
  exacerbation
• Resultant joint deformity and loss of motion

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Types of Arthritis - Gout

• Gout is caused by a buildup of the salts of uric
  acid (a normal byproduct of the diet) in the
  joints. It can also be caused by metabolic
  disorders in the kidney
• Most commonly affects the great toe joint in the
  foot but can affect any joint in the foot
  including the ankle
• Extreme acute onset of intense pain without
  injury
• Men are much more likely to be afflicted than
  women
• Perhaps hereditary, but usually due to a diet
  rich in red meat, sauces, shellfish, liquor and
  fatty foods

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Symptoms of Arthritis

• You should visit your podiatrist if you have one
  or more of the following
• Swelling in one or more joints
• Recurring pain or tenderness in any joint
• Redness or heat in a joint
• Limitation of motion in joint
• Early morning stiffness
• Skin changes, including rashes and growths

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Diagnosis of Arthritis

• Early diagnosis is important since destruction of
  cartilage is not reversible
• Your podiatrist or primary care physician can
  diagnose arthritis by
• History and clinical exam
• When suspected, the doctor can administer blood
  tests

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Treatment of Arthritis

• While there is no cure, the management of
  inflammation is the key
• Patient education
• Physical therapy and exercise
• Medication
• Control of foot function with orthotics or braces
  
• Prescription shoes for those with fit issues
• Surgical intervention with possible joint
  replacement as a last resort

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Treatment of Arthritis

• Because the foot is where arthritis often
  manifests, the DPM is often the first physician
  to encounter some of the typical complaints
• Since arthritic feet can result in loss of
  mobility and independence, frequent visits to the
  podiatrist can help avoid this with early
  diagnosis and proper medical care

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Arthritis is manageable

• By working with your podiatric physician and your
  primary care doctor, you can treat and manage
  arthritis. The key is to seek care and follow up
  periodically to manage your care with all your
  doctors.
• David J. Sands, DPM
• [phone]