Arthritis Treatment

Arthritis is a condition that affects the joints, leading to pain, stiffness, and swelling. While it can impact any joint in the body, arthritis in the lower limbs can be particularly debilitating, affecting one's ability to walk and carry out daily activities. At Health First Foot and Gait Clinic, our podiatrists specialise in diagnosing and treating arthritis in the feet, helping patients manage their symptoms and maintain their quality of life.

What is Lower Limb Arthritis?

Arthritis is a term for inflammation of the joints. The two most common types that affect the lower limbs are osteoarthritis and rheumatoid arthritis.

Osteoarthritis (OA): Often referred to as “wear and tear” (but more recently being referred to as “wear and repair”), osteoarthritis occurs when the cartilage that cushions the ends of your bones gradually wears away. This leads to the bones rubbing against each other and/or the development of extra bone around the joint (known as osteophytes), causing pain, swelling, and reduced joint movement. Osteoarthritis frequently affects the hips, knees, ankles, mid-foot, and toe joints..
Rheumatoid Arthritis (RA): Rheumatoid arthritis is an autoimmune disorder in which the immune system mistakenly attacks the joints, leading to inflammation. This condition can cause significant pain and swelling, particularly in the small joints of the feet and toes, eventually leading to joint deformity if left untreated.

The information below relates more to osteoarthritis, but some of the information is applicable to rheumatoid arthritis.

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Symptoms of Lower Limb Arthritis

The symptoms of arthritis in the lower limbs can vary depending on the severity and the specific joints affected. Common symptoms include:

Pain: Persistent joint pain is often the most noticeable symptom of arthritis. This pain may worsen with activity and improve with rest.
Stiffness: Joints affected by arthritis can feel stiff, especially in the morning or after periods of inactivity.
Swelling: Inflammation can cause the affected joints to swell, making them appear larger and feel tender to the touch.
Reduced Range of Motion: Arthritis can limit the movement of the affected joints, making everyday tasks such as walking or climbing stairs difficult.

Joint Deformity: In more severe cases, the affected joints may become misshapen due to chronic inflammation and damage to the cartilage and bone.

Treatment Options for Lower Limb Arthritis

Although there is no cure for arthritis, various treatment options are available to help manage your symptoms and improve your quality of life. At Health First Foot and Gait Clinic, we tailor treatment plans to your individual needs, which may include a combination of conservative therapies, lifestyle modifications, and, in some cases, surgical interventions.

Conservative Therapies

Physical Therapy: A personalised exercise programme can help strengthen the muscles around the affected joints, improve flexibility, and reduce pain. Our podiatrists may recommend specific exercises to target the lower limbs, including stretching, strengthening, and low-impact aerobic exercises.
Orthotic Devices: Custom orthotic insoles or braces can help redistribute pressure across the joints, reducing pain and improving mobility. These devices are particularly useful for managing arthritis in the feet, ankles, and knees.
Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) can help reduce pain and inflammation. In some cases, our podiatrists may recommend corticosteroid or hyaluronic acid injections directly into the affected joint for more immediate relief.
Footwear Modifications: Wearing supportive shoes with cushioned soles can help reduce the impact on your joints when walking. We can recommend footwear that provides the right level of support and comfort for your specific condition.
Laser Therapy: This promotes healing so your joints can recover from damage caused by arthritis. It is much closer to being a cure than other conservative medical approaches, but it is not a panacea. However one significant advantage is that it is non-invasive.

Lifestyle Modifications

Weight Management: Maintaining a healthy weight is crucial for reducing the strain on the joints in your lower limbs. Following guidance on nutrition and exercise can help you achieve and maintain a healthy weight.
Activity Modification: Avoiding high-impact activities that exacerbate joint pain, such as running or jumping, can help protect your joints. Instead, consider low-impact activities like swimming or cycling to stay active without putting undue stress on your joints.

Surgical Interventions

In cases where conservative treatments are not effective, surgical intervention may be necessary to relieve pain and restore function. Surgical options include:

Joint Replacement Surgery: In severe cases of arthritis, particularly in the hips or knees, joint replacement surgery may be recommended. This procedure involves removing the damaged joint surfaces and replacing them with artificial implants.
Arthroscopy: This minimally invasive procedure involves inserting a small camera with cutting tools into the joint to clean out any debris, smooth rough surfaces, and repair damaged tissue.
Fusion Surgery: Fusion surgery may be recommended for arthritis in the smaller joints of the feet or ankles. This procedure involves permanently joining the bones in the affected joint to reduce pain and improve stability.

Managing Arthritis at Home

In addition to professional treatment, there are several steps you can take at home to manage arthritis symptoms and maintain joint health:

Hot and Cold Therapy: Applying heat or cold to the affected joints can help reduce pain and inflammation. Heat therapy is particularly effective for relieving stiffness, while cold therapy can help reduce swelling.
Regular Exercise: Staying active is essential for maintaining joint flexibility and muscle strength. To keep your joints moving, engage in low-impact exercises such as walking, swimming, or yoga.
Healthy Diet: A balanced diet rich in anti-inflammatory foods, such as fruits, vegetables, and omega-3 fatty acids, can help reduce inflammation and support overall joint health.

Causes and Risk Factors

The exact cause of arthritis is not always known, but several factors can increase your risk of developing the condition, particularly in the lower limbs:

Age: As we age, the risk of developing arthritis increases, with joints experiencing wear and tear over time.
Genetics: If there’s a family history of arthritis, your chances of developing the condition may be higher, particularly with rheumatoid arthritis.
Previous Injury: Injuries such as fractures or dislocations can lead to arthritis later in life.
Obesity: Carrying excess weight places additional stress on the weight-bearing joints in your lower limbs, increasing the risk of osteoarthritis.

Repetitive Strain: Jobs or activities that require repetitive motions or heavy lifting can contribute to the development of arthritis in the lower limbs.

Close-up of young woman feeling pain in feet at home. Health care and medical concept. Young woman's pain is putting her hands on her feet, solving the problem of cramps caused by muscle spasm.

Diagnosing Lower Limb Arthritis

A thorough assessment by our podiatrists is essential to accurately diagnose arthritis in the feet & ankles. During your consultation, we will review your medical history, conduct a physical examination, and may recommend imaging tests such as X-rays or MRIs to assess the extent of joint damage.

Physical Examination: Our podiatrists will assess the affected joints for signs of swelling, tenderness, and reduced range of motion. We will also evaluate your gait and posture to identify any compensatory movements that may be contributing to your symptoms.

Imaging Tests: X-rays help us visualise the extent of cartilage loss and bone damage, while MRIs provide a more detailed view of the soft tissues, including cartilage and ligaments.

When to Seek Professional Help

If you experience persistent joint pain, stiffness, or swelling in your lower limbs, it’s important to seek professional help. Early intervention can help prevent further joint damage and improve your quality of life.

At Health First Foot and Gait Clinic, our experienced podiatrists are here to provide comprehensive care for all aspects of foot & ankle arthritis. We offer a range of treatment options tailored to your individual needs, helping you manage your symptoms and maintain an active, pain-free lifestyle. Contact us today to schedule an appointment and take the first step towards better joint health.

I was recommended to go and see Jonathan from an excellent local pilates instructor who I trust implicitly, so I knew that the recommendation didn't come lightly. I was not disappointed. Jonathan has been attentive, professional, knowledgeable and provided a very considered solution to my plantar fasciitis. His team are always friendly and helpful - even when I got stuck in traffic and missed my appointment! Highly recommend!

Clare Price

Excellent service. The clinic was efficient enough that Jonathan was able to undertake toe surgery on the same day of my first appointment (just minutes after the problem was diagnosed!). The staff were very friendly and informative, and kept me very much at ease during the entire process. I was very appreciative and will be returning if I have any similar problems in the future. Highly recommended!

Joe Miller
Jonathan Small and his team have been excellent. A person centred, straight forward approach and really genuine team. I had been told by NHS and other podiatrists that the healing after ingrowing toe nail would take up to 12 weeks yet after the surgery at Health First Foot, it has completely healed in just over 3 weeks. Going privately was one of the best investments I've made. Thank you Health First !

Nikki Jackson

A caring and professional service backed up by experience. I had tried every over the counter cure and a few dodgy ones from the internet for my persistent verucca with no luck. Jonathan brought all of his extensive knowledge to bear and now it is gone. I felt confident that my best interests were at the heart of any treatments and that I was in safe, professional hands at all times. Highly recommended.

Evelyn Baxter
Absolutely great, two big toes up!

Gary Shaw

My problem was immediately identified and expertly treated. The follow up advice has been do-able and effective to undertake at home. Thanks Liz Bones

Liz Bones
Thank you to Jonathan for taking the time to share your knowledge and experience with me. Five stars! Thanks a bunch!

Hannah Krepski

After running a long-distance ultra marathon, my feet were in poor shape! They got some much-needed TLC (and more sympathy than from my GP!!). Jonathan sorted out a blister that was hidden under another blister and got my feet on the way to healing 😀

Zoe Beale
Jonathan is very helpful and knowledgeable, he has looked after my feet over the years and I trust him completely. He is always polite, kind and considerate

Tracey Bianciardi

After knee surgery I experienced ankle problems, a couple of visits to Jonathan has sorted the problem out. Thank you.

Judith Mary
rapid appointment when I needed it and first class service. surgery went very well and recovery so far good with no pain. recommended without reservation. Jenny

Jenny Wootton

As a foot heath practitioner who has recently attended one of Jonathan’s talks I would refer my patients on to him without reservation should they need specialist input. His lectures are interesting, informative and motivating. I have crossed his path at numerous events where I have listened to him. He instills confidence.

Liza Clarke
hi everyone I've been battling with planter fasciitis in my heel for 15 months, Jonathan small was highly recommended. I got no such luck from my doctor. I give these a ring and got me in straight away. Met Jonathan had a brief chat the knowledge and information given was very helpful put me on a 6 week course and my foot is the best its been in a long time. From start to finish my experience was great. highly recommend Jonathan and his staff all very friendly.

Cheryl Higgins

Knowing Jonathan as a fellow podiatrist. He has a special gift in delivering information and motivating people, which is amazing. I have attended a number of his courses and talks, where he shares his knowledge and skills. An inspirational podiatrist!

Lynda Cowan
Great service and an extremely friendly atmosphere. Lovely people work here.

Liam Alexander

Have been suffering from plantar fasciitis for some time. After treatment and advice from the Foot and Gait Clinic my condition is manageable. Thank you I am now pain free.

Sue Ball
They have always been helpful, professional, courteous and caring

John Veasey

I visited Jonathan with terrible foot pain, he diagnosed it as plantar fasciitis after a full check and I was given sets of exercises to heal my foot, I have just left after my third visit and the pain has all but gone, I found Jonathan and Kate very friendly, would and have recommend to others, Thank you.👣

Paul Fogg
Had a fantastic day observing in clinic yesterday! Jonathan AMAZED me with his extensive knowledge, he was very supportive & I learnt so much just in 1 day! I admire Jonathans determination & drive to help his patients resolve any issues they may have & I hope to follow in his footsteps once I graduate from university. Thanks again for the opportunity your useful and excellent advice will always remain with me. Faye 🙂

Faye Green

Excellent experience at the Health First Foot Clinic. I went with a long term problem with my foot which I had self diagnosed incorrectly as a sprained ankle. My injury was assessed and diagnosed and I had a course of treatment . The treatment was further complicated by recent knee replacement but Jonathan continued to find ways to make the treatment work allowing for my recovering knee .I am pleased to say my injury is almost fully recovered which wouldn't have happened if I hadn't gone and they hadn't been so patient . Very happy with the diagnosis and treatment .

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