There are three types of arthritis that commonly affect the body; Osteoarthritis (OA), Rheumatoid Arthritis (RA) and Gout.
OA is also known as wear and tear. This is simply because it occurs when the cartilage that lies between the bones and joints starts to wear away through daily usage. In some people the cartilage rebuilds itself and they have no symptoms. However, in most people when the cartilage deteriorates, the bone underneath can thicken, causing pain, stiffness and swelling. The joints most affected are the knees, hips, hands and big toes.
OA is uncommon before the age of 40 and is more common in women than men. Though the exact cause of OA is unknown, it is probably due to the fact that as we age, we tend to put on weight and thereby put more pressure on our joints, so our muscles become weaker and our body loses its ability to heal itself. When OA occurs in younger people, it is usually because the joint cartilage has been damaged through injury (such as a sprain or fracture), a bacterial or viral infection or even through overuse of a particular joint as is common in farmers (hips), plumbers (knees) and footballers (knees and ankles). Arthritis Research UK estimates that 8 million people in the UK are affected by OA but only 1 million seek treatment.
RA is a chronic inflammatory condition that affects the synovial membranes within the joints. The synovial joint lubricates the joints and because of this we have thousands of them all over our body. Therefore, any joint can be affected but RA particularly affects the hands, feet, wrists, ankles and knees… and tends to occur symmetrically. RA tends to affect the smaller joints such as the fingers and toes first, so feet are often one of the first places to be affected. Symptoms usually strike the toes first and may then affect the back of the feet and the ankles. The joints may enlarge and even freeze in one position so they can’t extend fully.
Unfortunately, RA is the more aggressive type of arthritis, as the immune system is essentially attacking the joints for no reason. RA often results in more severe deformity of both the hands and feet. However, the lungs, heart and liver can also be affected.
A full Biomechanical Assessment allows the Podiatrist to assess the manner, functionality and alignment of the lower limb and foot. It is specifically beneficial to those who have pain which has not been diagnosed or pain which has failed to respond to medication. The examination is done with the patient in a weight bearing (standing) and non-weight bearing (lying) position. The podiatrist will concentrate on examining the range, direction and quality of motion within the hip, knee, lower limb and foot. We ask that when you come for the assessment, if your happy to, that you bring a pair of shorts to change into. This makes it much easier for the Podiatrist to examine your hip and knee joints. It also helps when the Podiatrist watches the way you walk (gait cycle) as it allows us to see how the whole leg is functioning rather than just the foot itself.
This assessment usually identifies the need for correction which is done through the use of orthotics, also known as insoles. The orthotics, which are custom designed to your feet, provide support and work with the lower limb and feet. In order to provide you with the most suitable insole, we ask that on the day of your appointment, you bring your regular shoes with you. This will allow the Podiatrist to gain an insight into what style you prefer and will give us a better understanding of what type of insole we should provide you with.
However, sometimes the problem lies within the actual muscles. If this is the case then the Podiatrist will be happy to prepare a stretching and strengthening exercise program specifically for your problem.
If the Biomechanical Assessement fails to identify any problems then the Podiatrist may still be able to suggest further areas of investigation that can be done in order to reach a diagnosis. We understand that the worst thing about pain is not knowing the source and reason of it, so everything possible will be done to help you.