Arthritis of the Midfoot- A Disabling and Common Condition in the Older Patient

Midfoot osteoarthritis (OA) is an often underdiagnosed cause of disabling foot pain, particularly in older patients. Although some people do present to the office with findings of arthritis but no associated symptoms, the prevalence of symptomatic midfoot arthritis is estimated at 12% among individuals older than 50 yrs. Assuming this estimation, slightly over 1 in 10 patients over the age of 50 will have symptoms associated with osteoarthritis of the midfoot!

A little anatomical background into this…

The midfoot is responsible for transferring the load from the hindfoot to the forefoot during the push-off phase of the gait cycle. Inherently, midfoot stability is a crucial aspect of normal gait. Untreated midfoot arthritis can lead to significant midfoot arch collapse, instability and progressive degeneration of other surrounding joints, resulting in a cycle of pain and inability to walk.

The primary strategy of treating midfoot OA is alleviating pain by enhancing midfoot stability and reducing the loads imposed at the inflamed joints. Anti-inflammatory medication both oral and topical have been proven to help. Targeted injection therapy into the affected joints is also effective to reduce pain. However, providing an enhanced structural support for the arthritic foot is the most effective conservative treatment for these patients.

Stiff sole shoes with a “rocker-bottom” modification are a longstanding choicein reducing pain. From a patient perspective, the main disadvantage of this treatment is the lack of freedom to change footwear beyond one specific pair of shoes.

Full length or ¾ length carbon fiber orthotics, which we can help fabricate at LI Advanced Podiatry offer an alternative option to stiff-soled footwear with rocker bottoms for patients with midfoot OA. They can be transferred between footwear of proper size and shape. Most importantly, studies are showing the effectiveness that these devices in your shoes have, to reduce pain, improve pressures on surrounding joints and improve the gait cycle.

Sometimes, arthritis may be so advanced, more invasive options such as surgery are required. Although a vast majority do improve with the conservative options, procedures such as primary joint fusions are required for the later stages of midfoot arthritis. Make your appointment today for a careful evaluation and see if our devices, medications and surgical options can help you get back into motion quickly and pain free!