When we think of arthritic degeneration, we typically picture cartilage breakdown in large joints in the body, like the knees or hips. However, cartilage breakdown can occur in much smaller joints, but that doesn’t mean the pain and discomfort it causes is any less real. For some patients, this arthritic degeneration occurs in the area of the body that touches the ground first with every step – their hindfoot. Needless to say, significant arthritic degeneration in this area can be quite uncomfortable and debilitating.
In an effort to help patients who are dealing with hindfoot arthritis, we’re going to use today’s blog to spotlight some of the causes, symptoms and treatment options for the condition.
Causes And Symptoms Of Hindfoot Arthritis
Many larger joints suffer cartilage breakdown after experiencing repetitive strain over the course of many decades, and while repetitive impact can lead to hindfoot arthritis, the most common cause of the condition is the result of acute trauma to the area. Post-traumatic cartilage breakdown is the leading cause of hindfoot arthritis, with falls from a height with the patient landing on their heels as the primary reason the condition eventually sets in. Foot shape changes like adult acquired flatfoot can also increase stress on the hindfoot and increase your risk of arthritic degeneration.
Symptoms of the condition include:
- Pain
- Stiffness
- Discomfort with side-to-side motion
- Deep, aching discomfort in the heel
- Symptoms that worsen when walking on uneven ground
- Loss of natural foot arch
- Worse discomfort in the morning
Diagnosing And Treating Hindfoot Arthritis
The diagnosis process for hindfoot arthritis is pretty straightforward. Your doctor will ask you about your symptoms and conduct a short physical exam while seeing how your feet respond to different motions and stress patterns. To confirm their suspicions, they may conduct a standing X-ray. MRI and CT scan are rarely required but can help confirm a diagnosis with enhanced clarity.
Conservative treatment is the first line of care for patients dealing with hindfoot arthritis. Most doctors will recommend a combination of the following treatment efforts:
- Rest/Activity modification
- Physical Therapy
- Footwear changes/orthotic inserts
- Anti-inflammatory medications
- Ice
- Temporary bracing
Injections may also be considered as a last line of defense prior to surgery. Injections come in a few different forms, and they may focus on calming inflammation, lubricating the joints or stimulating cartilage repair with the help of a biologic injection. It’s challenging to get the injection in the precise location without image guidance and the result can be unpredictable, so it isn’t considered the most effective management technique.
In the event that conservative care fails to provide relief, a surgical procedure may be recommended. In most cases, a fusion procedure is performed to limit movement in one area or across the subtalar, talonavicular, calcaneocuboid joints (triple fusion). Patients will remain non-weight bearing for roughly eight weeks after the procedure, and total recovery can take anywhere from 6-12 months, but the results tend to be quite effective, significantly reducing pain and improving foot function.
If you’re dealing with pain and stiffness in your heel, especially if you’ve suffered a traumatic injury to the heel in the past, connect with Dr. Silverman and the team at OrthoArizona to determine the best care path forward for your heel discomfort. Give our team a call today at (602) 648-5444.