Could Your Ankle or Big Toe Pain Be Osteoarthritis?

It’s a big week here in NYC.  The World Series is happening, two teams are playing, and one will likely beat the other for the championship.  Yes, it is thrilling.  Locally, we are getting stoked for the NYC marathon, and the plethora of blisters, stress fractures, tendonitis and nail trauma that is sure to come limping into the office next week.  Meanwhile, in the exciting world of this blog, we are continuing our own world series on arthritis with a fascinating discussion of something we will all likely get - osteoarthritis.

Chances are, specifically 80%, that most of us will develop this type of arthritis, which is the most common type.  Osteoarthritis is also known as degenerative joint disease or wear and tear arthritis.  This is what grandma complains about, among other things (sorry bubbie).  In this process, the cartilage on the joint surface wears down, either due to trauma, genetics, or disease, leading to bone on bone contact.  Cartilage loss, at this time, is a permanent process, and the good cartilage that is so important in protecting the end of the bones and ensures a friction-free gliding motion does not grow back once it’s damaged.  Eventually, the bones may even fuse together, thus limiting motion but ending the painful process.

The early stages of osteoarthritis can be detected on X-ray and felt in stiff painful joints.  Initial treatment is aimed at maintaining motion by staying active.  This is thought to encourage the joints to adapt to the loss of cartilage.  Anti-inflammatory medicine, such as Ibuprofen or Naprosyn, can be used to reduce the pain.  Cartilage supplements, such as Glucosamine and Chondroitin are popular alternative treatments for the early stages as well.  While these are known components of joint cartilage, it is not clear, based on limited research, if the supplements are incorporated into arthritic joints, or just pass through and get incorporated into the local sewer system.  End stage arthritic joints, such as the knee, ankle and big toe, that are very painful and interfere with quality of life, can be successfully managed surgically - typically with fusion or replacement of the joint.

This is a very common process, one that many of us will endure at some point.  Remember to keep active, and consult your local NYC podiatrist/runner before stopping any exercise regimen.

See you in the office.

Ernest Isaacson

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