Those from the baby boomer generation have been the active, industrious backbone of our nation for many decades. As a natural consequence of the aging process in active individuals, arthritis can develop in many areas of the body including the toes, feet and ankles.
Although there are many forms of arthritis, osteoarthritis is by far the most common form. Osteoarthritis can be related to previous injury. However, in most people it is a result of the gradual wear and tear on the joints over a life time.
Osteoarthritis may begin with a subtle ache or stiffness in a joint. As it progresses, one may notice stiffness, catching and enlargement of the joint. In later stages, significant lack of mobility, large spurs and sharp pains becomes commonplace.
In the foot and ankle, osteoarthritis can cause a frustratingly painful limp or "hitch" in the stride. Diminished physical activity can lead to an overall decline in one's health. Common areas in the feet affected by osteoarthritis include the great toe joint, the midfoot joints and the ankle joint.
True-to-form baby boomers say no to the sidelines. This usually starts with the drive to learn about conditions and treatment options. There is a general unwillingness to submit to inactivity and pain in this "can do," "can fix" generation. Fortunately, due to advanced medical and surgical techniques, many people with osteoarthritis are able to return to active, pain-free lifestyles.
Although, there is no one perfect cure for arthritis, more treatment options are available now than ever before. It is best to seek treatment early on so that the rate of joint degeneration can be slowed and conservative treatments are more effective. Conservative options include medica- tions, injections, therapy, shoe changes, advanced custom foot orthotics and bracing. Sometimes a small change can have a great impact. You just need to know what to change.
When conservative care options have been exhausted, better surgical procedures are helping patients to stay active. The great toe joint can be treated with the surgical removal of spurs and loose bone chips. The joint can be altered with realignment surgeries. New techniques for cartilage transfer are available. In advanced arthritis, surgical fusion or joint replacement may be necessary. Many patients are surprised to find pain-free return to activity even after the fusion of the great toe joint.
Midfoot arthritis surgeries, although more technically challenging, have also improved. Bone scans, MRI and CT scans help us visualize specific arthritic areas that can go undetected on regular X-rays. Deformity and pain can be eliminated by removal of arthritic spurs or fusing specific midfoot joints.
Ankle joint scar tissue and spurs can be removed in many cases with arthroscopy, a surgical technique that allows access to the joint through small incisions. A camera and instruments are then placed through these small portals to fix the joint. Ankle ligament repair and advanced arthritic conditions require a larger incision. Ankle joint replacement implants are available and are continually improving. They are also more challenging than hip or knee replacements due to the nature of motion and smaller size of the ankle joint.
Over the past 15 years, it has been exciting to witness the advanced techniques and innovative surgical instruments and implants. These have made it easier to provide relief for those who suffer from debilitating arthritis of the foot and ankle. It has been equally as impressive to rub shoulders with those of the baby boomer generation. Their industrious, independent spirit and will to overcome adversity is very American to me. It only seems fitting that the boomers are helped in fixing their "hitches" so they can remain active throughout retirement.
Dr. Tyson Williams is a podiatrist at Trinity Health Foot and Ankle Clinic in Minot.