Midfoot arthritis is a common cause of pain in the foot in middle-aged and elderly patients. The midfoot connects the heel to the front of the foot. So, arthritis affecting the midfoot can be particularly disabling for active people. So, how do you diagnose midfoot arthritis, and what can you do about it?

What is the mid-foot?

The midfoot connects the heel with the front of the foot. It consists of several small midfoot bones with multiple joints connecting the bones. It generally provides support to the foot and provides shock absorption for the foot arch.

Symptom of midfoot arthritis

In general, the cartilage lining the midfoot joints wears away, leading to bone-on-bone exposure. Typically, symptoms of midfoot arthritis include:

  • pain in the midfoot is usually made worse by walking or sport
  • stiffness in the midfoot
  • localised swelling
  • limping if arthritis gets worse

Usually, an assessment by a doctor reveals tenderness at the joints of the midfoot and stiffness in midfoot movements.

Diagnosis of midfoot arthritis

In general, a diagnosis of midfoot arthritis uses a combination of the doctor’s assessment and imaging. In general,  we use X-rays to confirm a diagnosis. Sometimes, an MRI of the foot is helpful to ensure early changes are not picked up on an X-ray.

Treatment 

foot treatment

Generally, we try simple treatments first. Exercise therapy is effective at reducing pain and improving function. Effective therapies include calf strengthening, midfoot mobility exercises, joint manipulation, and orthotics.

Also other effective treatments include weight loss and tablets such as ibuprofen.

In complex cases, an ultrasound-guided injection may help reduce pain and improve your ability to walk and play sports.

Finally, we recommend surgery in cases that have failed simple treatments. Options include a midfoot fusion or osteotomy.

More on injections

Overall, we suggest injections after simple treatments have failed. Generally, we recommend injection therapy in combination with exercise.

Options for injection include cortisone and hyaluronic acid. Cortisone is a potent anti-inflammatory that reduces swelling and pain in the midfoot joints. Hyaluronic acid is a natural substance found in joints, bones,s, and tendons.  It provides lubrication and reduces inflammation. In general, hyaluronic acid lasts longer than cortisone. Finally, PRP has been used by some doctors with good effects.

Generally, we do injections under ultrasound guidance to improve accuracy and effectiveness.

Final word on midfoot arthritis 

Diagnosis of midfoot arthritis is often delayed due to various reasons. Simple treatments such as exercise and orthotics help significantly. However, in some cases, injections improve pain and function and prevent the need to have major surgery.

Related conditions:

Dr. Masci is a specialist sport doctor in London. 

He specialises in muscle, tendon and joint injuries.

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