Oh My Aching Feet

With the NBA finals now over, the sports world turns to focus on the Pacific Northwest as the U.S. Open golf tournament begins. Phil Mickelson is one of the top three favorites. It is amazing he has had such a successful golf career while suffering from psoriatic arthritis.

Psoriatic arthritis is a result of having psoriasis (a skin condition). This differs from osteoarthritis (OA), which is your traditional “wear and tear” form of arthritis that occurs as we age. I will focus this blog on OA since it is so common.

OA can be broken down into idiopathic vs. secondary and localized vs. generalized. The term “idiopathic” just means we don’t exactly know what causes it. Localized OA pertains to less than three arthritic joints while generalized refers to greater than three. The term “secondary” means that the condition is a result of another underlying condition. Examples include trauma, genetic disorders, inflammatory conditions such as Charcot foot (collapsing of the foot arch) or Paget disease. Unfortunately, it is very difficult to prove definitively that the arthritis is truly a result of these underlying conditions, especially being that most of these conditions are somewhat rare while OA is very common.

Here at Cast a Foot Podiatry in Hempstead, we will take X-rays which assist greatly in confirming a diagnosis of OA; however, a podiatrist can usually be about 80% sure based on a patient’s history and physical exam alone. For example, OA is almost always idiopathic and localized. Generalized arthritis is almost always seen secondary to an inflammatory condition like rheumatoid arthritis. Also, the exact joints affected tend to clue a physician into OA vs. an inflammatory arthritis. Specifically, a podiatrist would expect an arthritic toe joint to be OA whereas an arthritic ankle is usually secondary to trauma or an inflammatory arthritis.

If you experience painful joints in your feet, then you should be evaluated by a podiatrist because other conditions, like bursitis or nerve pain, can present similarly. X-rays, physical exam, and the story you share with your doctor will either lead to a diagnosis or referral to rheumatology if less common inflammatory types of arthritis are suspected.


Nicole M. Castillo, DPM 

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