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Arthritis

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Among adults over age 65, the prevalence of arthritis is 50 percent. The prevalence of arthritis is higher among women (28.3%) than men (18.2%).

Many forms of arthritis and related conditions that affect the joints, muscles, and bones cause pain, stiffness, and swelling in the joints of the feet. If the feet seem more susceptible to arthritis than other parts of the body, it is because each foot has 33 joints that can be afflicted, and there is no way to avoid the pain of the tremendous weight-bearing load on the feet. Sometimes the cartilage wears away between the bones; and without the protective cartilage, the bones rub together. This inflames the tissue and causes pain and swelling. Arthritis afflicts almost 40 million Americans. Although the prevalence of arthritis increases with age, all people from infancy to middle age are potential victims. People over 50 are the primary targets.

An estimated 12.1 percent of the U.S. population (nearly 21 million Americans) age 25 and older have osteoarthritis. Although osteoarthritis is more common in older people, younger people can develop it – usually as the result of a joint injury, a joint malformation, or a genetic defect in joint cartilage.
Toe arthritis is caused by inflammation of the toe joint. The disease most often attacks the big toe, but the others may be affected as well. Past injuries or traumas, such as a broken or sprained toe, can cause arthritis down the road. Osteoarthritis, rheumatoid arthritis, and gout may also be to blame. Other medical conditions can cause additional problems including numbness and tingling, pitted nails, painful ulcers, or thickened skin.

How Common are Foot Problems?
One in three people over the age of 65 has foot pain, stiffness, or aching feet. Older people who are living in long-term care facilities tend to have even higher rates of foot problems. In the United States, up to 87% of people have painful feet at some time in their lives. Most of these problems derive from poorly fitting shoes, such as pointy-toed or high-heeled shoes. Older or obese people, women, and people with diabetes, cardiovascular disease, osteoporosis, or knee, hip, or back pain have much higher rates of foot problems. For women, pain in the toes and ball of the foot is much more common than in men, and it gets worse with age.

Older people are more likely to have foot pain if they also have a chronic disease. Foot pain in younger people tends to come from aching muscles and stress on bones. In older people, pain most often comes from corns, calluses, and toe deformities, of which 75% are bunions. As much as one third of older people have a bunion. About 30% of older people with foot pain have calluses and about 15% have corns on their toes.

It has been estimated that one-third of all older people have fungal infections in a toenail. The likelihood of having a fungus infection is even higher in older people with diabetes, psoriasis, reduced immunity, poor circulation, or obesity.

Painful feet and toes are debilitating all by themselves. To subject them to the discomfort of a tight top sheet is unconscionable. If you suffer from any of these, you likely know how intolerable the pressure of a flat top sheet can be.

  • Osteoarthritis (OA). The most common form of arthritis, osteoarthritis is a chronic condition characterized by the breakdown of the cartilage that cushions the ends of the bones where they meet to form joints. This breakdown causes the bones to rub against each other, causing stiffness, pain and loss of movement in the joint. In the foot, osteoarthritis most commonly affects the big toe, but it can also affect the midfoot.
  • Rheumatoid arthritis (RA). Rheumatoid arthritis is a chronic inflammatory disease of the joints that occurs when the body’s immune system – which normally protects us from infection – mistakenly attacks the synovium, the thin membrane that lines the joints. The result can be joint damage, pain, swelling, inflammation, loss of function and disability. Rheumatoid arthritis commonly affects the small joints of the feet, often causing symptoms in several joints of both feet. This can lead to the development of corns and bunions, and the curling and stiffening of the toes into positions such as claw toe or hammer toe.
  • Juvenile arthritis (JA). Juvenile arthritis is the term used to describe arthritis when it begins before age 16. There are several different types of juvenile arthritis that can cause pain and swelling in the joints of the feet.
  • Gout. Gout is a form of arthritis that occurs when excess uric acid, a bodily waste product circulating in the bloodstream, is deposited as needle-shaped monosodium urate crystals in tissues of the body, including the joints. For many people, the first symptom of gout is excruciating pain and swelling in the big toe – often following a trauma, such as an illness or injury. Subsequent attacks may occur off and on in other joints. After years with the disease, lumps of uric acid, called tophi, may form beneath the skin in different parts of the body, including the feet.
  • Reactive arthritis. Reactive arthritis is a chronic form of arthritis that often occurs following an infection of the genital, urinary or gastrointestinal system. Features of reactive arthritis include inflammation and swelling of the joints, eyes and structures within the gastrointestinal or genitourinary tracts, such as intestines, kidneys or bladder. A small percentage of people with the disease develop a rash or hard nodules on the soles of their feet or the palms of their hands.
  • Lupus. Lupus is a chronic autoimmune disease, meaning the body's immune system creates antibodies that attack healthy tissues, including the joints. The wrist and small joints of the feet are among those most commonly affected by lupus. Lupus also can cause inflammation in many organs, including the skin, heart, lungs and kidneys.
  • Psoriatic arthritis. Psoriatic arthritis is a form of arthritis accompanied by the skin disease psoriasis. The skin disease often precedes the arthritis; in a small percentage the joint disease develops before the skin disease. Psoriatic arthritis can affect the toes. The associated skin disease can affect the skin of the feet and cause the toenails to thicken, develop pits and separate from the nail bed.
  • Infectious arthritis. Also called septic arthritis, infectious arthritis refers to arthritis that is caused by an infection within the joint. Infectious arthritis is often caused by bacteria, which spread through the bloodstream to the joint. Sometimes it is caused by viruses or fungi and can affect the joints of the feet.
  • Raynaud's phenomenon. Raynaud’s phenomenon is a condition characterized by a narrowing of the blood vessels to the extremities, usually in the hands and feet, in response to cold temperatures or stress. When blood vessels close down, toes become cold and white, then blue, and numb or painful. When the vessels open up again, the toes become red or purple. Raynaud’s is often associated with connective tissue diseases, notably scleroderma.
  • Osteoporosis. Osteoporosis is a condition in which the bones lose enough mass that they become brittle and prone to breaking with slight trauma. In people with osteoporosis in bones of the foot, just stepping off of a curb can cause a stress fracture. The condition can occur with aging, inflammatory disease (such as rheumatoid arthritis) inactivity, a low-calcium diet or use of corticosteroid medications.
  • Scleroderma. “Scleroderma” comes from two Greek words: “sclero” meaning hard, and “derma” meaning skin. Hardening of the skin is one of the most visible manifestations of the disease. Scleroderma is an umbrella term for disorders that involve the abnormal growth of the connective tissue supporting the skin and internal organs. Although there are several different forms of scleroderma, all forms can cause thickening and tightening of the skin on the fingers and backs of the feet called sclerodactyly. Other symptoms include joint pain, exaggerated response to cold (Raynaud's disease), and heartburn. Scleroderma more often affects women. It commonly occurs between the ages of 30 and 50.


 

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