Midfoot Arthritis

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What is midfoot arthritis?

The midfoot is an anatomical area in the middle of the foot. Midfoot arthritis develops when the midfoot joints have damaged or worn out cartilage. It predominantly affects the tarsometatarsal joints.

Midfoot arthritis is characterised by pain, swelling and stiffness. Usually symptoms develop gradually overtime. There is often an associated bony prominence on top of the foot. The foot can change shape, with progressive flattening or collapse of the medial arch.

Why does midfoot arthritis develop?

Midfoot arthritis develops for several reasons. The midfoot is predisposed to developing post-traumatic arthritis following a midfoot fracture or dislocation, for example a Lisfranc injury, even if initially well managed. Osteoarthritis of the midfoot can develop even in the absence of an injury. The midfoot can be affected in patients with inflammatory arthritis, for example rheumatoid or psoriatic arthritis. Tibialis posterior tendon dysfunction is when the medical arch of the foot can flatten and overtime arthritis can develop.

What are the available treatments for midfoot arthritis?

In the first instance simple treatment measures are recommended to try and reduce your symptoms. These can have significant benefit and help avoid having surgery. Some treatments for midfoot arthritis are listed below, but it is not exhaustive.

Weight loss if you are overweight can be extremely effective to lessen further joint damage and reduce midfoot pain.

Appropriate footwear should be tried consisting of a supportive stiff soled shoe. Alternatively a “rocker bottom” shoe can reduce the forces going through the midfoot joints whilst walking.

An Orthosis (a medical insole) can be useful in improving foot function and reducing pain by supporting the foot. You can be referred to the Orthotist for a specialist opinion.

Simple painkillers such as paracetemol, ibuprofen or anti-inflammatory gels can reduce pain. Ask advice from your doctor or pharmacist before taking anti-inflammatory medicines as they can have side-effects in some people.

Physiotherapy may be beneficial in the early stages of the condition to keep the calf muscles stretched and avoid overloading the midfoot whilst walking.

Steroid injection into the midfoot, although more invasive, can help reduce pain and inflammation.

Surgery for midfoot arthritis is only recommended as a last resort, once all simple treatment measures have been exhausted and if your symptoms remain significant. Surgery can involve removing any bony prominences on top of the foot but most often entails a midfoot fusion of the painful joints.

Wellbeing Advice

Patients that have a healthy diet, take regular exercise and refrain from smoking are more likely to experience a quicker recovery with a more successful outcome from their surgery.

If you have any concerns about your general health and well-being (diet, exercise, smoking cessation) you are encouraged to discuss this with your GP, who will be able to provide advice on the options available to you.

We hope this leaflet has answered any questions you might have. If you have any further queries, please feel free to discuss them with any of the medical or nursing staff.