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Painful Foot Joints

Alternate Names

  • metatarsalgia
  • Bones of the foot

Definition

Foot joints can become painful for a number of reasons. The reasons can range from an injury to a specific joint to a condition such as arthritis, an inflammation of the joints, that affects many joints in the body.

What is going on in the body?

Painful foot joints are usually caused by physical stress to the foot. The stress can result from poor bone structure, ill-fitting shoes, being overweight, or from overdoing certain activities. Occasionally, arthritis can cause painful foot joints.
Some of the more common varieties of arthritis that involve the joints of the feet include:
  • gout, a metabolic disease caused by deposits of uric acid in the joints
  • rheumatoid arthritis, a chronic inflammatory disease that affects the joints and surrounding tissues
  • systemic lupus erythematosus, a chronic inflammatory disorder that affects the skin, joints, and internal organs
  • psoriasis, a skin condition characterized by frequent episodes of redness, itching, and thick, dry scales on the skin
  • Reiter's syndrome, a group of symptoms consisting of:
    • arthritis
    • urethritis, which is inflammation of the urethra
    • conjunctivitis, which is inflammation of the lining of the eye
    • lesions of the skin and mucous membranes

Risks

What are the causes and risks of the disease?

The causes are varied as indicated by the various conditions associated with painful foot joints.

Ignoring the symptoms can lead to the symptoms getting worse. It can also lead to permanent damage to the joints.

Prevention

What can be done to prevent the disease?

Joint pain can be prevented by protecting the joint from further damage. This can be done by:
  • selecting shoes that fit comfortably
  • using over-the-counter arch supports
  • having custom-made supports, or orthotics, built in some cases
  • having custom-molded shoes made
  • detecting and treating diseases that affect the whole body, such as arthritis
Individuals should also follow sports safety principles when exercising or participating in sports.

Diagnosed

How is the disease diagnosed?

Joint pain is diagnosed based on the location and type of pain, and when the pain started. Tests such as joint x-rays, magnetic resonance imaging (MRI), and computed tomography (CT scans) can help in the diagnosis.
If arthritis is suspected, the healthcare professional will order additional testing. If gout is suspected, special blood tests can be done or a small sample of fluid from a joint can be analyzed.

Long Term Effects

What are the long-term effects of the disease?

Painful feet and joints can keep a person from performing their usual daily routine. The pain can also keep a person from exercising, even from something as simple as walking.
This may lead to weight gain, loss of bone mass, loss of cardiovascular fitness, and general disability. The long-term effects of arthritis include increasing deformity of the joints and increasing disability.

Treatments

What are the treatments for the disease?

The most important treatment is to protect the affected joint from further injury. This can include:
  • careful shoe selection
  • arch supports
  • custom-made orthotics
  • custom-made shoes
A healthcare professional can identify any underlying causes and treat them with various medications such as steroids. Sometimes a steroid injection into the joint can be helpful. In severe cases, surgery may be necessary to repair or rebuild a damaged joint.

Side Effects

What are the side effects of the treatments?

The side effects of treatment depend on the medications used. Steroid injections give short term relief, but multiple injections could cause long-term damage. The person may overuse the pain-free joint, which can lead to further destruction. Side effects of steroids taken by mouth include thinning of the skin, bruising, osteoporosis, high blood pressure, and elevated blood sugars. Surgery can be complicated by bleeding, infection, or an allergic reaction to the anesthetic.

After Treatment

What happens after treatment for the disease?

A person with custom-made orthotics or shoes should consult the healthcare professional if there is any discomfort. The orthotics or shoes may need to be adjusted after they have been worn for a short while.

Monitor

How is the disease monitored?

Treatment for arthritis and other conditions that affect the whole body must be constantly monitored. The doses of the various medications need to be carefully checked to be sure that the lowest effective dose is being used. Many of these medications have significant side effects which must be monitored closely.

Sources

The Merck Manual of Medical Information, Home edition, 1997

Tierney, Lawrence, editor, "Current Medical Diagnosis and Treatment, 39th edition", 2000

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