An Article Written By Cecilia Brennan
Podiatrist – New Step Podiatry.
Think Osteoarthritis is Just “Wear and Tear”? Think Again!
At our podiatry clinic in Belconnen, we often hear people describe osteoarthritis as “just wear and tear.” But here’s the truth—it’s far more complex than that! It’s time to get up to speed on the modern understanding of osteoarthritis.
In this article, we’ll break down the latest perspectives on osteoarthritis including risk factors. Keep reading to learn 10 tips on how to manage osteoarthritis in the feet.
What is Osteoarthritis?
A modern understanding of osteoarthritis (OA) views it as a complex and dynamic condition, rather than just a result of “wear and tear.” According to Arthritis Australia, OA is now thought to be the result of a joint working extra hard to repair itself. Yes, your joints can somewhat repair themselves, so please don’t think your OA will just slowly get worse, there’s things you can do to prevent progression/deterioration!
OA may include
- Damage to joint cartilage: this is the protective cushion on the ends of your bones which allows a joint to move smoothly.
- Bone spurs (osteophytes): extra bits of bone form around the joint edges.
- Inflammation of the tissue around a joint.
- Deterioration of ligaments and tendons: the bands and muscles around the joint holding it together can deteriorate.
- Thickened bone (subchondral sclerosis): the bone under the cartilage becomes denser and harder.
- Cysts: small pockets of fluid may form in the bone near the joint.
- Bone deformity: in advanced cases, the bones can become misaligned or change shape due to the wear on the joint.
Please note this article discusses osteoarthritis (OA) and not rheumatoid arthritis (RA). OA is the gradual breakdown of cartilage due to mechanical stress, inflammation, and metabolic factors, affecting the entire joint structure. In contrast, RA is an autoimmune disease where the immune system mistakenly attacks the joint lining, leading to widespread inflammation, joint erosion, and systemic symptoms like fatigue and organ involvement.
Risk Factors of Osteoarthritis
– Aging: while cartilage naturally deteriorates with age, the severity and onset of OA depend on other factors beyond just getting older.
-Obesity and metabolic factors: obesity is a key risk factor, especially for weight-bearing joints like the knees and feet. However, recent research shows that fat tissue releases inflammatory molecules (adipokines), contributing to joint damage even in non-weight-bearing joints like the hands. Metabolic syndrome (high blood pressure, high blood sugar, excess body fat) also accelerates OA progression through chronic inflammation.
-Joint injuries: previous injuries, such as fractures or ligament tears, can lead to OA in the affected joint.
-Repetitive stress: continuous stress on joints, from physical jobs or sports, can wear down cartilage, making athletes and workers at higher risk.
-Genetics: genetic factors play a role, with specific genes related to joint development and cartilage repair increasing OA risk.
-Gender: women, particularly after menopause, are more prone to OA due to hormonal changes and joint anatomy differences.
-Biomechanical abnormalities: issues like flat feet or high arches can increase joint stress and cartilage damage. Early intervention with orthotics can help prevent OA.
-Chronic low-grade inflammation: long-term low-level inflammation, often linked to obesity or metabolic disorders, is a major factor in OA progression.
-Physical activity: while staying active helps joint health, overdoing it or improper exercise can lead to injuries that contribute to OA. A sedentary lifestyle weakens joint-supporting muscles.
-Bone density: low bone density (osteoporosis) can make joints more vulnerable to damage, increasing OA risk, especially in the hips.
-Smoking: smoking has emerged as a risk factor for OA due to its impact on inflammation and bone health.
Preventative measures for osteoarthritis include addressing any above factors that you can control i.e. eat a low inflammatory diet, don’t smoke, keep moving and maintain healthy body mass.
Symptoms and Signs of Osteoarthritis in the Feet
-Pain and tenderness: aching or sharp pain in the joints, especially during or after movement.
-Stiffness: reduced flexibility in the foot joints, making it difficult to move freely.
-Swelling: inflammation around the affected joints can cause noticeable swelling.
-Bone Spurs: extra bits of bone may form around the joint, creating lumps under the skin.
-Reduced range of motion: difficulty in walking or performing daily activities due to joint stiffness.
Foot osteoarthritis (OA) most commonly affects the first metatarsophalangeal joint (big toe), midfoot (arch), toe joints and ankle joints, particularly in older adults. The Framingham Foot Study highlights that foot structure abnormalities, such as flat feet or high arches, can increase the likelihood of developing OA by placing uneven pressure on the joints.
Top 10 Tips from a Podiatrist to Manage Foot Osteoarthritis and Pain
These tips written by Cecilia Brennan at New Step Podiatry in Florey, Belconnen, Canberra, will help you manage foot osteoarthritis and alleviate pain. Foot osteoarthritis can significantly affect your mobility and quality of life, but with the right strategies, you can minimise discomfort and maintain your daily activities.
Tip 1: Foot Massages and Stretching at Home for Joint Relief
Foot massages and stretching at home may help to alleviate symptoms and even improve mobility. Exercises include:
-Rolling foot over a spiky ball: when seated or standing, push your arch onto a spiky ball, tennis ball or golf ball. Draw circles in the arch and roll the ball up and down the bottom of your feet. Go slowly and firmly press to level of pressure that feels like a decent massage but not too hard to be painful. Spend 3-5 minutes on each foot for 4-7 days per week.
-Ankle circles: sit or lie down, extend your leg, and rotate your ankle in slow circles to improve mobility.
-Foot massage: Whether you do it yourself or have a willing partner, gently massaging the base of your feet can help relieve tension and improve circulation. A simple, soothing massage can reduce discomfort and ease stiffness, especially for those dealing with foot osteoarthritis.
-Calf stretches: either bent knee or straight leg calf stretch as per pictures. Hold for 20-30 seconds 2-3 times twice daily.
Tip 2: Try Fisiocrem for Foot Pain Relief
Fisiocrem Joint Ease is a topical cream designed to provide relief from joint pain, including that associated with arthritis. This is not the same as Fisiocrem.
Fisiocrem Joint Ease is specifically formulated to target joint pain, particularly for conditions like osteoarthritis. It contains menthol and naturally-derived active ingredients including boswellia, nigella, arnica, hypericum, calendula and melaleuca.
In contrast, Fisiocrem is more focused on muscle aches and general inflammation relief, with natural ingredients like arnica, hypericum, and calendula.
Arthritis Australia supports the use of Fisiocrem Joint Ease as a part of a broader pain management plan for people with arthritis, though they stress that it should be used alongside other treatments like physical therapy and lifestyle changes.
Like many creams, it’s important to follow the instructions when trying Fisiocrem to see if it works for you. If it doesn’t provide relief, there are plenty of other options like pain relief creams. Additional strategies for managing pain include using ice packs, warm baths, supplements, or Epsom salt soaks.
Tip 3: Consider the Strength for Life Program
Strength for Life is a progressive training program, supported by the Council on the Ageing (COTA), is designed for people over 50 (or over 40 for Aboriginal or Torres Strait Islanders) to improve strength, balance, and mobility.
Qualified exercise professionals lead classes at locations like gyms, physio clinics, and community centres across the ACT. This program helps participants boost physical fitness and social connections.
To learn more about the program, visit here or https://cotaact.org.au/services/strength-for-life/
To get you started, the next tip is about strengthening your feet at home.
Tip 4: Strengthening Your Feet and Ankles at Home to Prevent Injury and Manage Pain
Strengthening lower limbs helps support joints, reduce pain, and prevent osteoarthritis in the feet. Try these exercises:
-Calf raises: lift heels off the ground and lower slowly to strengthen calves and stabilise the ankle. You can do this single leg or double leg, whichever is mostly painfree but gets the muscles feeling a burn. This strengthens your calves and helps stabilise the ankle joint.
–Single-Leg Balance: Stand on one leg; make it harder by closing your eyes or moving your other leg.
– Toe Taps: Lift toes while seated, keeping heels down to strengthen foot muscles.
-Towel Scrunches: Use your toes to scrunch a towel on the floor to improve foot strength.
As always, check with a podiatrist to ensure these are suitable for your specific needs!
Tip 5: Consider Nordic Walking Classes
Evidence suggests that Nordic walking can be beneficial for people with osteoarthritis (OA). Research shows that it improves cardiovascular health, reduces joint pain, and enhances mobility. The use of walking poles helps distribute weight more evenly, reducing the strain on knees, hips, and lower limb joints, which is particularly helpful for those with OA. A 2020 study in Clinical Rehabilitation found that Nordic walking significantly improved walking distance and joint function in people with knee osteoarthritis, making it a valuable low-impact exercise for managing OA, perhaps even in the foot!
For more information on Nordic walking Check out Capital Nordic Walking here or https://www.capitalnordicwalking.com.au
Tip 6: Consider Other Low-Impact Exercise to Protect Your Feet and Joints
For people with osteoarthritis, low-impact exercises can help improve mobility without putting too much stress on the joints. Here are some ideal options:
–Water workouts: splash around with swimming or water aerobics—it’s like exercising in a joint-friendly cushion! For hydrotherapy classes, check out Arthritis ACT’s classes here or https://www.arthritisact.org.au/hydrotherapy-classes/
–Easy cycling: hop on a bike, feel the breeze, and let your knees glide with ease.
–Dance it out: try low-impact dance classes—get grooving and forget you’re even exercising! Consider older age friendly dance classes such as from your local Senior Citizens Club. Our local is the Belconnen Senior Citizens Club Inc.
Always consult a healthcare professional or podiatrist before starting any exercise regimen to ensure it’s safe for your condition.
Tip 7: Maintain a Healthy Weight to Reduce Foot Stress
According to recent research, losing even a small amount of weight can significantly decrease joint pain and improve mobility. Excess weight increases pressure on these joints, leading to faster cartilage breakdown and inflammation, which worsens osteoarthritis symptoms.
Keeping a healthy weight lowers the overall risk of developing osteoarthritis by reducing joint stress and systemic inflammation.
Need help losing weight? Consider consulting a dietitian or nutritionist to help guide you with your weight loss journey.
Tip 8: Choosing the Best Shoes for Foot Support and Comfort
Proper footwear helps minimise pain and improve mobility for those with osteoarthritis.
-Fit: Ensure the shoes have a wide and deep toe box to accommodate any bony bumps, preventing irritation or pressure on joints.
-Cushioned shoes for shorter wear times: Use soft, cushioned shoes for shorter periods, as they provide immediate comfort and reduce joint impact but may lack long-term support. This may be most relevant at home when cooking and cleaning on hard tiles or floorboard.
-Structured shoes for longer wear times: Opt for structured shoes with firm support for extended wear. These offer better stability and alignment, reducing strain on arthritic joints over time. This is relevant for exercising and going grocery shopping.
-Forefoot volume lacing: May be helpful for osteoarthritis in the toes or big toe joint. Alternatively miss the first eyelet lacing can reduce pressure on the forefoot. For forefoot volume lacing, see video below or here.
-Midfoot volume lacing: for bony bumps on top of your foot. Ensure the volume lace is placed where the bony bump is. See video below or here.
Tip 9: The Benefits of Orthotics for Foot Support and Pain Relief
Orthotics can be highly effective in managing foot osteoarthritis by improving foot alignment and reducing stress on affected joints.
For individuals with flat feet (overpronation), custom orthotics provide arch support, which helps distribute pressure more evenly across the foot, reducing strain on the ankles and knees.
In contrast, for those with high arches (underpronation), orthotics offer cushioning to absorb shock and alleviate pressure on the outer edges of the feet. Research has shown that orthotics can improve gait, decrease pain, and slow the progression of joint damage by improving joint alignment and reducing abnormal foot movements (Menz et al., 2019).
By enhancing stability and reducing inflammation, orthotics play a crucial role in improving daily function and long-term joint health for those with osteoarthritis
Tip 10: Why You Should See a Podiatrist for Foot Pain
As specialists in foot and ankle health, podiatrists play a crucial role in the early detection and management of osteoarthritis (OA) in the feet. Podiatrists can help with
Early diagnosis: identifying subtle signs of OA during routine examinations.
Customised care plans: developing individualised treatment strategies that address mechanical and biological aspects of the disease.
Ongoing monitoring: regular follow-ups to adjust treatments based on disease progression and patient response.
Prescribe stretching and strengthening exercises: targeted exercises to strengthen the muscles around the foot and ankle, improving support and reducing strain on the joints.
Patient education: providing information on self-care techniques and lifestyle changes to manage symptoms effectively. Podiatrists can explain how proper foot care can reduce inflammation, ease pain, and improve daily function.
Provide manual therapy: hands-on manipulation and mobilisations to improve joint mobility and reduce stiffness.
Orthotics and support: issue prefabricated or customised insoles or braces to correct biomechanical imbalances, reducing joint pressure and discomfort.
Do you Have Painful, Osteoarthritic Feet?
Book an Appointment at Our Canberra Podiatry Clinic for an Assessment
Our podiatrists are here to ensure those in Canberra have access to quality services that can help individuals get the treatment they deserve.
Easily BOOK ONLINE or give us a call on 02 6198 4818.
References
Arthritis Australia. https://arthritisaustralia.com.au/types-of-arthritis/osteoarthritis/
Fermor, B., Weinberg, J. B., Pisetsky, D. S., & Guilak, F. (2020). Obesity and osteoarthritis: Are adipokines bridging metabolism, inflammation, and biomechanics? SpringerLink, 8(4), 729-737. https://doi.org/10.1007/s00167-020-06071-z​:contentReference[oaicite:2]{index=2}
Griffin, T. M., Huebner, J. L., Kraus, V. B., & Guilak, F. (2021). Metabolic drivers of osteoarthritis: Inflammation and cartilage degradation. Nature Reviews Rheumatology, 12(10), 55-61. https://doi.org/10.1038/nrrheum.2021.6​:contentReference[oaicite:4]{index=4}
Hawker, G. A., & Lohmander, L. S. (2021). What an earlier recognition of osteoarthritis can do for OA prevention. Osteoarthritis and Cartilage, 29(12), 1632–1634. https://doi.org/10.1016/j.joca.2021.08.007​:contentReference[oaicite:0]{index=0}.
Menz, H. B., Dufour, A. B., Riskowski, J. L., Wrobel, J., & Hannan, M. T. (2019). Foot structure and the risk of osteoarthritis in older adults: The Framingham Foot Study. Journal of Foot and Ankle Research, 12(1), 34. https://doi.org/10.1186/s13047-019-0348-2
Menz, H. B., Munteanu, S. E., Landorf, K. B., Zammit, G. V., & Cicuttini, F. M. (2007). Radiographic classification of osteoarthritis in commonly affected joints of the foot. Osteoarthritis and Cartilage, 15(9), 1040-1045. https://doi.org/10.1016/j.joca.2007.05.007
Timofte, D. V., Zară-Dănceanu, C. M., & Labusca, L. (2024). Osteoarthritis: Integrating metabolic syndrome and systemic inflammation in joint degeneration. Biomedicines, 12(6), 1262. https://doi.org/10.3390/biomedicines12061262​:contentReference[oaicite:1]{index=1}
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