Hindfoot Arthiritis

What makes up the hindfoot?

The hindfoot is made up of the joint beneath the ankle joint which is called the ‘subtalar joint’. It also consists of two more joints collectively called the ‘Chopart joints’ which lie in front of the subtalar joint and connect in front to the midfoot.

What are the causes of hindfoot arthritis?

Arthritis means ‘ pain in a joint’. Causes of hindfoot arthritis are:

Osteoarthritis
Osteoarthritis, also known as degenerative or “wear and tear” arthritis, is a common problem for many people after they reach middle age. The smooth, gliding surface covering the ends of bones (cartilage) becomes worn and frayed. This results in inflammation, swelling, and pain in the joint. Osteoarthritis progresses slowly, the pain and stiffness it causes worsens over time.

Rheumatoid Arthritis
Unlike osteoarthritis which follows a predictable pattern in certain joints, rheumatoid arthritis is a system-wide disease. It is an inflammatory disease where the patient’s own immune system attacks and destroys cartilage.

Post-Traumatic Arthritis
Can develop after an injury to the foot or ankle. This type of arthritis is similar to osteoarthritis and may develop years after a fracture, severe sprain, or ligament injury.

What are the symptoms caused by this condition?

Symptoms vary depending on the severity of the arthritis. You may experience:

Pain and stiffness
Swelling over the affected joint
Reduced range of motion
Difficulty in walking due to any of the above

How is this condition diagnosed?

Your consultant will examine your foot clinically and this usually makes the diagnosis clear. X-rays will also be taken to determine the degree of arthritis.

Can the condition worsen?

Arthritis pain may initially be a nuisance factor. It may however progress gradually over many years to cause significant pain and restricted mobility.

What treatment options are there?

Options are based on the degree of severity of symptoms. Most patients are seeking advice and reassurance.

Non surgical options are:

Footwear modification:
Wearing a robust soled shoe which is not very flexible may help to reduce the movement of these joints. A ‘rocker-bottom’ shoe may also help as it allows the foot to rock forward rather than bend during gait.

Steroid injections:
These can be given for relief of pain in the short to medium term. These can be offered for an acute flare up of symptoms and help by reducing the inflammation in the joints.

Is surgery necessary?

The decision to proceed with surgery should be taken after non surgical options described above have been exhausted. The majority of patients will benefit from shoe wear modifications. If symptoms continue to affect lifestyle and function inspite of this then surgery may be discussed with your consultant and he will advise you regarding the pros and cons of surgery. Please refer to ‘hindfoot fusion’ under ‘information on surgical procedures’ in this website for more guidance.