Arthritis is something I encounter frequently at Well Heeled Podiatry. It’s an umbrella term for a range of conditions that cause inflammation in the joints. Whether it’s affecting your knees, hips, or even the small joints in your feet, arthritis can be a real hindrance to daily life. Millions of Australians suffer from it, and the pain, swelling, and stiffness it brings can impact everything from walking to simple movements like picking something up off the ground.
When I see patients, their first complaint is often the pain—persistent, sometimes sharp, and often debilitating. The trick is finding a treatment plan that helps manage these symptoms and slows the progression of the disease. In this section, I’ll walk you through some of the best treatments for arthritis, from medications to hands-on therapies that can make a huge difference.
Medication for Arthritis Pain
Medication is typically the first line of defense against arthritis pain. But it’s not just about popping pills and hoping for the best. With advancements in medical research, we now have a range of medications that target different aspects of arthritis. Here’s a breakdown of some of the most common types of medications you might be prescribed:
Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)
NSAIDs are often your go-to for immediate pain relief. They’re effective at reducing both pain and swelling, which is especially helpful during flare-ups.
- What They Do: They work by reducing the chemicals in your body that promote inflammation, pain, and fever. Essentially, they block the production of prostaglandins, which are the troublemakers in your body causing the pain and swelling.
- Examples: Over-the-counter options like ibuprofen (Advil, Nurofen) and naproxen (Aleve) are common. You can also get prescription-strength versions for more severe pain.
- Benefits: They provide fast relief and are great for managing flare-ups.
- Risks: Overuse or long-term use can lead to stomach ulcers, kidney issues, and a higher risk of heart attack or stroke. It’s important to always follow your doctor’s guidance and use them as directed.
Disease-Modifying Antirheumatic Drugs (DMARDs)
For those with rheumatoid arthritis or other inflammatory types of arthritis, DMARDs play a key role in slowing down the disease process. While NSAIDs address the pain, DMARDs tackle the underlying cause by suppressing the immune system.
- What They Do: DMARDs don’t just relieve symptoms—they aim to slow or even stop the immune system from attacking your joints.
- Examples: Methotrexate, hydroxychloroquine (Plaquenil), and sulfasalazine are commonly used.
- Benefits: These drugs can prevent long-term joint damage and even save your joints from permanent harm.
- Risks: DMARDs suppress the immune system, which increases the risk of infections. Regular doctor visits are a must to monitor side effects and ensure the medication is working effectively.
Biologics
Biologics are a newer class of drugs that are often used when traditional DMARDs don’t work. They target very specific parts of the immune system that trigger inflammation, offering a more focused treatment approach.
- What They Do: Unlike general DMARDs that suppress the immune system, biologics hone in on specific molecules involved in the inflammatory process, providing a more targeted treatment.
- Examples: Drugs like adalimumab (Humira), etanercept (Enbrel), and infliximab (Remicade) are common biologics.
- Benefits: These can be highly effective, especially for patients whose arthritis hasn’t responded to other medications.
- Risks: Just like DMARDs, biologics come with an increased risk of infection. They can also raise the risk of certain cancers and liver damage, so regular monitoring is necessary.
Foot Mobilisation and Manipulation Techniques for Arthritis
At Well Heeled Podiatry, we’ve seen the benefits of hands-on therapies for managing arthritis, particularly in the feet and lower limbs. Arthritis can be particularly tough on these areas, leading to stiffness and pain. This is where foot mobilisation and manipulation techniques come in—offering a non-invasive and effective approach to improve joint function and reduce pain.
1. Foot Mobilisation Techniques
Foot mobilisation is one of my go-to therapies for patients dealing with arthritis in their feet. It’s a hands-on technique that focuses on improving joint movement.
- What It Is: Foot mobilisation involves using controlled, gentle movements to stretch, move, and rotate the joints of the foot. By restoring movement in the foot and ankle joints, we can reduce stiffness and improve function.
- How It Helps: The goal is to improve joint mobility and correct any misalignments caused by arthritis. It helps to stretch tight ligaments and tendons and can significantly ease the discomfort that comes with restricted foot movement.
- Real-Life Example: I’ve treated patients who’ve experienced debilitating pain in the big toe joint due to arthritis (commonly known as hallux rigidus). After a few sessions of foot mobilisation, they noticed a significant reduction in pain and improved flexibility, allowing them to walk without as much discomfort.
2. Foot Manipulation Techniques
While foot mobilisation is about controlled, gentle movements, foot manipulation is a bit more forceful and precise. This technique is typically used for realigning joints that have become misaligned due to arthritis or injury.
- What It Is: Foot manipulation (or adjustment) involves quick, precise movements to realign the bones and joints of the foot. The therapy targets the joints that may be restricted or locked due to arthritis, providing a way to restore normal function.
- How It Helps: The primary aim is to reduce pain and restore normal joint function. Patients often feel immediate relief, especially if the joint was restricted or locked in a painful position.
- What You Might Feel: Sometimes, you might hear a popping or cracking sound during manipulation. This is totally normal and occurs when gas bubbles are released from between the joints.
- Real-Life Example: I once had a patient with severe ankle arthritis that made walking painful, particularly during their morning routine. After a session of foot manipulation, they experienced almost instant relief, noticing that their ankle joint felt looser and less stiff. With regular sessions, their mobility improved greatly.
3. Why Foot Mobilisation and Manipulation Matter
If you’ve got arthritis in your feet or lower legs, these techniques can offer several benefits that make a real difference in your daily life:
- Pain Relief: Both foot mobilisation and manipulation can help reduce the pain caused by arthritis, especially in the early stages of the disease. In my experience, patients often feel immediate relief after just one session.
- Improved Mobility: If arthritis is causing stiffness in the joints, these techniques can help you regain movement. For instance, if you’re struggling to walk comfortably, a series of foot manipulation sessions can help you move more freely and reduce the restrictions caused by joint stiffness.
- Natural and Non-Invasive: For those who prefer to avoid medications or surgery, foot mobilisation and manipulation are a natural, non-invasive treatment option. These therapies can help to improve joint function and alleviate pain without the need for any pharmaceuticals or invasive procedures.
- Example: A lot of dancers come to see me with arthritis in their feet or ankles. Foot manipulation can be a game-changer for them, helping to restore fluid movement and reduce the pain that comes from their rigorous routines.
Foot Orthotics: Supporting Arthritis Relief
Foot orthotics are another highly effective tool in managing arthritis, particularly when it comes to protecting your joints from further strain and offering extra support. As a podiatrist, I frequently recommend custom-made orthotics for patients with arthritis in the feet, as they help realign the joints, reduce pain, and improve overall mobility.
1. Types of Foot Orthotics
There are two main types of foot orthotics: custom-made and over-the-counter. The right choice depends on the severity of your arthritis and the level of support needed.
- Custom-made Orthotics: These are tailored specifically to your foot shape and needs. I take a detailed assessment of your foot structure, create a mould, and craft orthotics that perfectly fit your feet. They provide the best support and pain relief, as they’re specifically designed for your foot type.
- Over-the-counter Orthotics: These are pre-made and available in various sizes. They offer general support and cushioning but aren’t tailored to the individual. While not as effective as custom orthotics, they can still provide relief for mild arthritis pain.
2. How Orthotics Help
Orthotics provide several benefits for those living with arthritis, particularly in the feet:
- Alignment: Proper alignment of your feet and ankles is crucial for reducing arthritis pain. Orthotics help realign your joints, allowing for better foot mechanics and reducing strain on your joints.
- Pressure Redistribution: For patients with arthritis, certain areas of the foot may bear more pressure than others, leading to increased pain and damage. Orthotics help to evenly distribute your body weight across your feet, relieving pressure from the inflamed joints.
- Shock Absorption: Orthotics often have cushioning properties that absorb the impact while walking, reducing the strain on your joints.
- Example: One of my patients, who suffered from osteoarthritis in the knees and feet, found that wearing custom orthotics relieved pressure from their knees and reduced the pain when walking. They found it much easier to walk longer distances without feeling exhausted or in pain.
3. The Benefits of Foot Orthotics for Arthritis
- Pain Relief: Orthotics help alleviate the discomfort caused by arthritis by providing support and correcting alignment issues.
- Improved Mobility: With better support and reduced pain, patients can walk more comfortably, making daily activities much easier to handle.
- Protecting Joints: By redistributing pressure and providing proper support, orthotics protect the arthritic joints from further wear and tear, helping to prevent further deterioration.
- Example: A patient with arthritis in their heels was initially struggling to walk without severe pain. After trying orthotics, they experienced a significant decrease in heel pain, which made walking long distances, even during a family outing, much more comfortable.
4. Considerations When Choosing Orthotics
When selecting the right orthotics for arthritis, there are a few things to keep in mind:
- Material: Orthotics can be made from various materials, such as soft foam or rigid plastic. Your podiatrist will help you choose the right material based on the severity of your arthritis and the level of support you need.
- Footwear Compatibility: Make sure the orthotics fit well into your shoes. Some shoes have more room and can accommodate thicker orthotics, while others require slimmer designs.
- Frequency of Use: Depending on the severity of your arthritis, you may need to wear orthotics all day, or just during specific activities that exacerbate your symptoms.
5. Maintenance and Care
Just like any piece of equipment, orthotics need proper care to maintain their function:
- Regular Check-ups: It’s a good idea to have your orthotics checked periodically to ensure they’re still providing the necessary support.
- Cleaning: Keep them clean and fresh by wiping them down regularly, especially if they’ve been exposed to moisture or dirt.
- Replacement: Over time, orthotics can wear out. Be sure to replace them when they begin to lose their shape or cushioning.
Lifestyle Adjustments: Adding Support Beyond Treatments
While medications, foot mobilisation, and orthotics play crucial roles in managing arthritis, there are also lifestyle adjustments that can greatly enhance the overall treatment plan. These changes can improve your comfort, reduce pain, and prevent further joint damage. As a podiatrist, I always work with my patients to incorporate these strategies into their daily lives.
1. Exercise: Staying Active Without Overdoing It
Regular physical activity is vital for people with arthritis. While the idea of moving your joints might seem daunting when they’re swollen and painful, gentle exercises can actually help improve joint function, reduce stiffness, and relieve pain over time.
- Why It Helps: Exercise strengthens the muscles around your joints, providing better support and reducing the load on the affected areas. It also helps maintain joint flexibility and improves overall mobility.
- Low-Impact Activities: For those with arthritis, it’s important to focus on low-impact exercises that don’t stress the joints. Swimming, cycling, and walking are excellent choices. These exercises allow you to stay active without putting too much pressure on your arthritic joints.
- Real-Life Example: One of my patients, a keen walker, found that regular walking sessions helped to alleviate morning stiffness in their knees. We adjusted their walking routine, including plenty of stretching beforehand, and they were able to enjoy pain-free walks after just a few weeks.
2. Weight Management: Reducing Pressure on Joints
Excess weight puts additional strain on weight-bearing joints, like your hips, knees, and feet. If you’re carrying extra pounds, losing weight can provide relief from joint pain and reduce the rate of progression of arthritis.
- Why It Helps: Every extra kilo you carry adds unnecessary pressure to your joints, especially those in your lower body. By losing weight, you reduce the stress on your joints, which can alleviate pain and slow the progression of arthritis.
- Practical Tips: A balanced diet combined with regular exercise can help you maintain a healthy weight. If you’re unsure where to start, consulting with a dietitian or personal trainer can give you the guidance you need.
- Real-Life Example: A patient who struggled with knee arthritis found that losing 10 kilograms over six months significantly improved their knee pain. Not only did it reduce the pressure on their knees, but it also improved their overall energy and mobility, making it easier to stay active.
3. Footwear: Supportive Shoes for Arthritis Relief
The shoes you wear can have a significant impact on your arthritis symptoms, especially if you have arthritis in your feet or lower limbs. Proper footwear can help realign your foot and reduce pain caused by abnormal pressure.
- Why It Helps: Well-fitted shoes provide support, cushion your feet, and help distribute pressure evenly. Shoes with poor support can exacerbate arthritis pain, especially if they cause the foot to roll inward or outward.
- Choosing the Right Footwear: When selecting shoes, look for those with a cushioned sole, adequate arch support, and a wide toe box. Avoid high heels or shoes that don’t provide enough room for your feet to move comfortably. If you have foot pain, consulting a podiatrist for personalised advice can make a world of difference.
- Real-Life Example: I often recommend orthotic-friendly shoes for patients with arthritis. One of my patients, who had been wearing poorly fitted shoes for years, saw a noticeable reduction in foot pain after switching to shoes with proper arch support and cushioning. The right shoes helped alleviate the pressure on their joints, especially in the mornings.
Combination Therapy: Integrating Treatments for Maximum Effectiveness
There is no one-size-fits-all approach when it comes to managing arthritis. That’s why combining multiple treatment options often yields the best results. By combining medication with therapies like foot mobilisation, orthotics, lifestyle adjustments, and exercise, you can create a comprehensive approach that addresses both the symptoms and underlying causes of arthritis.
1. Working with Your Healthcare Team
It’s essential to collaborate with your healthcare team, which may include your GP, rheumatologist, physiotherapist, and podiatrist. Together, you can develop a personalised treatment plan that includes the best combination of treatments for your arthritis.
- Why It’s Important: Each healthcare professional brings expertise in their field. A podiatrist, for example, can help with foot pain and mobility, while a rheumatologist can manage inflammation and immune system function. By coordinating your treatment, you ensure that all aspects of your arthritis are addressed.
- Example: I’ve had patients who benefit from a team approach—one works with a physiotherapist to improve strength and flexibility, while simultaneously receiving Foot Mobilisation Therapy to reduce joint stiffness. This integrated approach allows them to feel more empowered and in control of their arthritis.
2. Patience and Consistency
Managing arthritis is a process. Finding the right combination of treatments and lifestyle changes can take time, and the key is consistency. It’s easy to get discouraged if you don’t see immediate results, but with persistence, you can achieve long-term relief.
- Why It Helps: Arthritis is a progressive condition, so results often take time. Consistently following your treatment plan—whether it’s sticking to medication regimens, attending therapy sessions, or making lifestyle changes—can bring significant improvements over the months and years.
- Real-Life Example: One of my long-term patients with ankle arthritis initially struggled with flare-ups. However, after consistently following a routine that included foot mobilisation, wearing orthotics, and regular low-impact exercise, they saw steady improvement and were able to significantly reduce their reliance on pain medication.
While there’s no “magic cure” for arthritis, a comprehensive treatment plan that includes medication, physical therapy, lifestyle changes, and support from a multidisciplinary healthcare team can dramatically improve your quality of life.
It’s all about finding the right balance of treatments that work for you and sticking with it. Remember, managing arthritis is a journey, and with the right approach, you can reduce pain, improve mobility, and get back to doing the things you love.
