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Osteoarthritis

Diabetic Foot Care Northern Michigan

Osteoarthritis is the normal wear and tear of a joint over time in which the smooth, low friction cartilage between two bones wears away. This occurs as we age. It can also be caused after an injury, such as a broken bone (also called a fracture). If the broken bone heals incorrectly, or the break extends into an adjacent joint and into the cartilage, this will lead to what is called post-traumatic arthritis.

There are many different surgical and nonsurgical treatment options for osteoarthritis of the foot and ankle.

Nonsurgical Options

Heat

  • Heat may be applied to “loosen up” the joint and can be soothing. Heat is often applied before physical activity.
  • It is very important to ensure a proper temperature from any heat source. In general, heat should not be used in patients with neuropathy such as those with diabetes, as it may cause severe, limb threatening burns. Many people annually unfortunately lose toes and even limbs due to heating pads or excessively hot water because of limited sensation in their feet.

Ice

  • Ice may be applied to decrease pain and inflammation associated with arthritis. It tends to be more useful after physical activity. 
  • Care must be taken to avoid local frostbite when applying ice. Never apply ice directly on the skin. Use a cloth, or towel against the skin prior to applying a cold therapy pack, and limit therapy to no longer than 20 minutes each hour.

Over the counter topical pain medications

  • Products like icy hot, biofreeze, and absorbine have menthol and other chemicals that may provide some temporary relief from joint pain. Instructions should be followed carefully. It’s a good idea to consult with a physician before employing the use of these. These medications are often a good first step as they have very limited side effects and often do not interact with other medications the patient is taking.

Antiinflammatory Medications

  • Nonsteroidal Anti-inflammatory drugs (NSAIDS)
    • Aleve (Naproxen), Advil (Ibuprofen, Mortin), Mefanamic Acid, Indomethacin
    • These medications help alleviate pain and inflammation and are available over the counter as well as in prescription strength. 
    • These medications may be prescribed by the foot and ankle specialist in conjunction with other medications or topicals to treat osteoarthritis.
    • Consult your doctor before taking NSAIDS as they can have harmful side effects and may interact with other medications.
  • Corticosteroids
    • This is a potent class of anti-inflammatory medications that is often prescribed by the foot and ankle specialist for several days.
    • Common side effects include weight gain, mood changes, elevated blood sugar level, difficulty sleeping. 
  • Tylenol (Acetaminophen)
    • Tylenol is a pain reliever that has been shown to be highly effective in treating osteoarthritis. While Tylenol is not an antiinflammatory medication, when taken properly, it can provide significant pain relief for those suffering from osteoarthritis.
  • Diclofenac
    • Topical Diclofenac, or Voltaren gel, is applied directly over the painful joint several times per day. The benefit of this medication is a very limited side effect profile compared to oral medications as the topical gel does not produce significantly high blood levels of the drug compared to pills. 
  • Lidocaine Gel
    • Lidocaine is a topical pain reliever that has been shown to decrease pain associated with osteoarthritis of the foot and ankle. 
    • The medication is available over the counter and in prescription strength.