Arthritis and Podiatric Medicine

							Arthritis and
Podiatric Medicine:
Walking Hand-in-Hand

       David J. Sands, DPM
   560 Northern Blvd., Suite 206
       Great Neck, NY 11021
   Diplomate, American Board of
         Podiatric Surgery
          Arthritis Facts
• Arthritis in one form or another afflicts 66
  million Americans or nearly 1 in 3 adults
   – 42.7 million Americans have doctor-
     diagnosed arthritis and 23.2 million others live
     with chronic joint symptoms but have not
     been diagnosed by a doctor
• Doctors of podiatric medicine are often
  the first to diagnose arthritis because the
  feet have 33 joints that can be affected,
  and there is often pain associated with
  weight-bearing
          Arthritis Facts
• Arthritis is one of the most prevalent
  chronic health problems and the nation’s
  leading cause of disability among
  Americans over age 15.
• Arthritis is second only to heart disease
  as a cause of work disability.
• Arthritis limits everyday activities such as
  walking, dressing and bathing for more
  than 7 million Americans.
         Arthritis Facts
• Arthritis results in 39 million physician
  visits and more than a half million
  hospitalizations.
• Costs to the U.S. economy total more
  than $86.2 billion annually.
• Arthritis affects people in all age groups
  including nearly 300,000 children.
• Baby boomers are now at prime risk.
  More than half those affected are under
  age 65.
   Definition of Arthritis
• Arthritis is inflammation and swelling
  of the cartilage and lining of the
  joints, generally accompanied by an
  increase of fluid in the joints.
• Often arthritis is a component of
  complex diseases that may involve
  more than 100 identifiable disorders.
     Causes of Arthritis
• Hereditary tendencies
• Age (arthritis often targets those over 50)
• Trauma or injury (athletes and industrial
  workers at higher risk)
• Bacterial or viral infections that strike
  joints
• In conjunction with inflammatory bowel
  diseases
• Use of prescription or illegal street drugs
• Possible congenital autoimmune
  association
      Types of Arthritis -
        Osteoarthritis
• Osteoarthritis is the most common form of
  arthritis
• Often called degenerative joint disease or “wear
  and tear” arthritis
• Onset is generally gradual (i.e., the aging
  process causes a breakdown in cartilage)
• Pain usually progresses, but rest can relieve
  pain
• Characterized by dull, throbbing nighttime pain
  with accompanied muscle weakness or
  deterioration
• Particularly seen in the feet when patients are
  overweight due to the deterioration of cartilage
  and development of bone spurs
      Types of Arthritis –
       Rheumatoid (RA)
• Rheumatoid arthritis is the most serious
  and crippling
• Complex, chronic inflammatory system of
  diseases, often affecting more than a
  dozen smaller joints, usually in a
  symmetrical fashion
• Characterized by lengthy morning
  stiffness, fatigue and weight loss
       Types of Arthritis –
        Rheumatoid (RA)
• Can affect eyes, lungs, heart and nervous
  system
• Women are 3-4 times more likely than
  men to suffer
• More acute onset than osteoarthritis
• Intermittent periods of remission and
  exacerbation
• Resultant joint deformity and loss of
  motion
 Types of Arthritis - Gout
• Gout is caused by a buildup of the salts of uric
  acid (a normal byproduct of the diet) in the joints.
  It can also be caused by metabolic disorders in
  the kidney
• Most commonly affects the great toe joint in the
  foot but can affect any joint in the foot including
  the ankle
• Extreme acute onset of intense pain without
  injury
• Men are much more likely to be afflicted than
  women
• Perhaps hereditary, but usually due to a diet rich
  in red meat, sauces, shellfish, liquor and fatty
  foods
  Symptoms of Arthritis
• You should visit your podiatrist if you
  have one or more of the following:
  – Swelling in one or more joints
  – Recurring pain or tenderness in any
    joint
  – Redness or heat in a joint
  – Limitation of motion in joint
  – Early morning stiffness
  – Skin changes, including rashes and
    growths
   Diagnosis of Arthritis
• Early diagnosis is important since
  destruction of cartilage is not
  reversible
• Your podiatrist or primary care
  physician can diagnose arthritis by:
  – History and clinical exam
  – When suspected, the doctor can
    administer blood tests
   Treatment of Arthritis
• While there is no cure, the management
  of inflammation is the key
• Patient education
• Physical therapy and exercise
• Medication
• Control of foot function with orthotics or
  braces
• Prescription shoes for those with fit issues
• Surgical intervention with possible joint
  replacement as a last resort
  Treatment of Arthritis
• Because the foot is where arthritis
  often manifests, the DPM is often
  the first physician to encounter some
  of the typical complaints
• Since arthritic feet can result in loss
  of mobility and independence,
  frequent visits to the podiatrist can
  help avoid this with early diagnosis
  and proper medical care
 Arthritis is manageable

• By working with your podiatric physician
  and your primary care doctor, you can
  treat and manage arthritis. The key is to
  seek care and follow up periodically to
  manage your care with all your doctors.

           David J. Sands, DPM
             (516) 482-8826