Dr. Pelucacci discusses midfoot arthritis: proper diagnosis and treatment options.

Midfoot arthritis occurs when the cartilage between the middle of the foot wears away over time. As a result, bone on bone contact takes place, which often results in discomfort, stiffness and pain.

The main symptoms of midfoot arthritis are swelling, redness and pain at the top and middle portion of the foot. Stiffness can also occur. Often, these symptoms begin seemingly at random; the patient does not usually recall a specific trauma or injury to the site.

There are various causes of midfoot arthritis, including some of the following: foot shape (high arched or low arched feet), genetics, previous trauma or injury, and different types of inflammatory arthropathies such as rheumatoid arthritis or gout.

Midfoot arthritis is generally diagnosed by performing a medical history and physical examination of the patient, followed by obtaining imaging of the foot. Imaging is usually in form of X-ray, CT scan or MRI, with X-ray being the most common.

Unfortunately, there is no definitive cure for midfoot arthritis, or any arthritis for that matter, but there are treatments that can relieve symptoms. Some treatments include:

• Anti-inflammatory medications: this can be in the form of oral medication (non-steroidal anti-inflammatory drugs (NSAIDs), Tylenol, steroids), topical anti-inflammatory gels, or injectable steroid that is administered directly into the top of the foot.
• Shoe modification: The ideal shoe for midfoot arthritis is one that provides structural support, while also being spacious enough so as not to squeeze the top or sides of the foot. This is usually in the form of a sneaker or tennis shoe.

Additionally, adding an insert or orthotic to the sole of the shoe can provide greater support and prevent increased stress on the midfoot during ambulation. Orthotics can either be prefabricated or custom molded, depending on the patient’s needs.

• Activity modification: this includes maintaining a healthy weight and avoiding excessive ambulation and/or high impact activities such as running and jumping. It is often beneficial for patients to consider lower impact activities instead such as swimming, cycling, elliptical, etc.
• Cold therapy: Applying ice packs or cold compresses directly to the midfoot in 10-minute increments helps control inflammation and pain.
• Physical therapy: Patients learn various stretching and strengthening exercises that increase flexibility, strength and range of motion. This can decrease stress on the midfoot.
• Surgical intervention: This is reserved for cases that do not respond well to conservative treatment. Surgery can include shaving down bony prominences or fusing joints of the midfoot together to eliminate pain.

To summarize, midfoot arthritis can cause significant pain to the top of the foot, often without any notable or recent injury. The pain is usually exacerbated with ambulation and improved with rest. Symptoms may include pain, redness, swelling and stiffness at the site. If a patient is experiencing these symptoms, it is important to contact a foot and ankle specialist in a timely manner. Earlier diagnosis and treatment will lead to less pain and better outcomes long term for the patient.

If you’re experiencing foot pain, contact Dr. Pelucacci’s office at (239) 430-3668 (FOOT) or visit www.NaplesPodiatrist.com to schedule an appointment with one of your award-winning surgical podiatrists.

Dr. Lauren Pelucacci
Brennan Building
730 Goodlette Road, suite 102
Naples, FL 34102

Phone: (239) 430-3668 (FOOT)

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