Degenerative foot diseases can significantly impact mobility and quality of life so early diagnosis and appropriate treatment is crucial for managing symptoms and preventing further damage.
“Your feet are the foundation of your body, supporting you through countless steps over a lifetime. However, they can be susceptible to various degenerative conditions that affect the tendons, joints, and bones of the foot and ankle,”
explained Dr. D. Sean Sweeney, D.P.M. of Sweeney Foot & Ankle Specialists.
“Managing degenerative foot diseases is essential to maintain a good quality of life and prevent further complications.”
What Are Degenerative Foot Diseases?
Degenerative foot diseases are conditions that cause the gradual breakdown of structures in the feet, including bones, joints, tendons, and ligaments.
These conditions typically worsen over time, leading to pain, reduced mobility, and decreased quality of life.
According to the American Podiatric Medical Association (APMA), most Americans say they have experienced foot pain (77 percent), but only a third of those would seek expert care from a podiatrist.
Degenerative conditions are particularly common among older adults, with arthritis alone affecting about 1 in 4 adults in the United States (54.4 million people) who report a diagnosis of arthritis, which is a leading cause of disability and a meaningful driver of economic costs, according to the Healthy People 203 arthritis workgroup.
The impact of these diseases extends beyond physical discomfort. They can limit a person's ability to work, exercise, and participate in daily activities.
Understanding these conditions is the first step toward effective management and treatment.
Degenerative Foot Diseases Symptoms and Risk Factors
While specific symptoms can vary depending on the condition, common signs of degenerative foot diseases include:
- Persistent pain, especially during or after activity.
- Stiffness in affected joints.
- Swelling and inflammation.
- Reduced range of motion.
- Changes in foot shape or structure.
- Difficulty walking or bearing weight.
Several factors can increase your risk of developing degenerative foot diseases:
- Age: Risk increases as you get older.
- Genetics: Family history can play a role in some conditions.
- Obesity: Excess weight puts additional stress on foot structures.
- Previous injuries: Trauma to the foot can lead to early-onset degeneration.
- Occupation: Jobs requiring long periods of standing or heavy lifting.
- Medical conditions: Diseases like diabetes or autoimmune disorders increase risk.
“Patients are often surprised about some of the risk factors for degenerative foot diseases which can also include poor diet, unsafe footwear, foot care and hygiene, and even smoking and alcohol use,” said. Dr. Sweeney.
Let’s explore some of the most common degenerative food diseases.
Arthritis
Arthritis is a prevalent degenerative condition affecting the joints in the feet. The two main types are:
- Osteoarthritis (OA): Often called "wear-and-tear" arthritis, OA occurs when the cartilage cushioning the bones breaks down over time. In the feet, it commonly affects the big toe joint (hallux rigidus), midfoot, and ankle. Symptoms include pain, stiffness, and reduced range of motion. As OA progresses, bone spurs may develop, further limiting joint movement.
- Rheumatoid Arthritis (RA): An autoimmune disorder causing inflammation in the joints, RA often affects both feet simultaneously. It typically starts in the smaller joints of the toes before progressing to larger joints. RA can lead to severe deformities over time, including bunions, claw toes, and flat feet. Unlike OA, RA can also affect the skin and nails, potentially causing rheumatoid nodules or skin thinning on the feet.
Tendon-Related Diseases
Tendons can degenerate over time, leading to painful conditions such as:
- Achilles Tendinitis: Achilles tendinitis is inflammation of the Achilles tendon, which connects the calf muscles to the heel bone. It typically results from repetitive stress or overuse, causing pain, stiffness, and swelling along the back of the lower leg near the heel. Common in runners and athletes, it can also affect middle-aged weekend warriors. Symptoms often worsen with activity and improve with rest.
- Plantar Fasciitis: This involves degeneration of the plantar fascia, a band of tissue supporting the arch of the foot. Repetitive stress can cause micro-tears in the fascia, leading to inflammation and pain. Characteristic symptoms include sharp heel pain, especially with the first steps in the morning or after periods of rest.
Flat Foot Conditions
The arch of the foot can collapse over time, resulting in:
- Acquired Flat Foot: Acquired flat foot, also known as adult-acquired flatfoot deformity (AAFD) or posterior tibial tendon dysfunction, is a progressive condition where the arch of the foot collapses in adulthood. It primarily results from the weakening or damage of the posterior tibial tendon, which supports the foot's arch. Symptoms include pain along the inside of the ankle, flattening of the arch, and an outward tilt of the heel. As it progresses, it can lead to difficulty walking, swelling, and arthritis.
- Flexible Flat Feet: In this condition, the arch disappears when standing but reappears when sitting or on tiptoe. While often present from childhood, it can worsen with age. Symptoms may include pain in the feet, ankles, knees, hips, or lower back, especially after long periods of standing or physical activity.
Joint and Bone Conditions
These conditions affect the bones and joints in the feet and ankles:
- Ankle Impingement: This occurs when bone spurs or soft tissue inflammation restricts ankle motion. There are two types: anterior impingement (front of the ankle) and posterior impingement (back of the ankle). Symptoms include pain and reduced range of motion, particularly when pointing the toes up (anterior) or down (posterior).
- Os Trigonum Syndrome: This condition involves pain caused by an extra bone (os trigonum) at the back of the ankle. The os trigonum is present in about 10% of the population and is usually asymptomatic. However, it can become painful when repeatedly compressed, especially during activities that involve pointing the toes downward, such as ballet or soccer.
Deformities
Over time, various deformities can develop in the feet:
- Hallux Rigidus: This condition causes stiffness and eventual immobility of the big toe joint. It's a form of degenerative arthritis that can be caused by faulty foot mechanics or injury. As it progresses, bone spurs develop, further limiting motion and causing pain.
- Hallux Valgus (Bunion): Hallux valgus, commonly known as a bunion, is a progressive deformity of the first metatarsophalangeal joint of the big toe. It involves lateral deviation of the big toe and medial deviation of the first metatarsal, creating a prominent bump on the inside of the foot. This condition is more prevalent in women and older adults, often causing pain, difficulty with footwear, and altered gait.
- Hammer Toe: This deformity causes the toe to bend or curl downward instead of pointing forward. It most commonly affects the second toe but can occur in other toes as well. Over time, the affected toe can become rigid and painful, making it difficult to wear shoes comfortably.
Other Conditions
Other degenerative foot conditions can include:
- Gout: A form of arthritis caused by uric acid buildup; gout often affects the big toe joint. Gout can cause pain (sometimes sudden), redness, and tenderness. Over time, repeated gout attacks can lead to gouty arthritis, a degenerative form of arthritis.
- Charcot Foot: This condition causes weakening of the bones in the foot, often associated with diabetic neuropathy. In its early stages, the foot becomes red, warm, and swollen. As it progresses, the joints collapse, and the foot becomes deformed. This can lead to serious complications, including ulcers and, in severe cases, the need for amputation.
Diagnosis and Treatment Options
At Sweeney Foot & Ankle Specialists, we employ a comprehensive approach to diagnose and treat degenerative foot diseases. Our diagnostic methods may include physical examinations, imaging studies (X-rays, MRI, CT scans), and specialized tests like nerve conduction studies.
Once we've accurately diagnosed your condition, we develop a personalized treatment plan. Our approach typically begins with conservative measures and progresses to more advanced treatments if necessary.
Conservative treatments may include:
- Custom orthotics and bracing.
- Physical therapy and targeted exercises.
- Medications for pain management and inflammation reduction.
- Lifestyle modifications, including weight management.
For more advanced cases, we offer cutting-edge treatments:
- Regenerative medicine techniques, such as platelet-rich plasma (PRP) therapy.
- Minimally invasive surgical procedures.
- Advanced wound care for diabetic foot conditions.
Degenerative foot diseases can be challenging, but with proper care and treatment, you can manage symptoms and maintain an active lifestyle.
If you're experiencing symptoms of a degenerative foot condition or have concerns about your foot health reach out to Sweeney Foot & Ankle Specialists today for a consultation.