Midfoot arthritis is a common cause of foot pain in middle-aged and elderly patients. The midfoot connects the heel to the front of the foot. Arthritis affecting the midfoot can be particularly disabling for active individuals. How is midfoot arthritis diagnosed, and what can be done 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 them. It generally supports the foot and provides shock absorption for the foot arch.
Symptoms of Arthritis on Top of Foot
The cartilage lining the midfoot joints typically wears away, resulting in bone-on-bone contact. Typically, symptoms of arthritis in the top of foot include:
- Pain in the midfoot is usually made worse by walking or sports
- Stiffness in the midfoot
- Localised swelling
- Limping if arthritis gets worse
Typically, a doctor’s assessment 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.
Typically, individuals with mid-foot arthritis have tenderness to palpation at the site of the arthritis.
We use X-rays to confirm a diagnosis. Sometimes, an MRI or a standing CT scan helps detect early changes that are not visible on an X-ray.
Treatment of Midfoot Arthritis
Generally, we try simple treatments first. Exercise therapy is an effective method for reducing pain and improving function. Effective therapies include calf strengthening exercises, midfoot mobility exercises, joint manipulation, and the use of orthotics.
Other effective treatments include weight loss and the use of 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 for midfoot arthritis
Overall, we recommend injections after simple treatments have been unsuccessful. 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 in joints, bones, 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 mixed effects.
In general, we recommend you start with cortisone first. You can move on to other injectables if you find cortisone less effective.
Generally, we do injections under ultrasound guidance to improve injection 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.
Your information is very good with solid reasoning and great ideas on what to ask one’s own doctor. If I lived in England I would most certainly ask to be one of this doctor’s patient. Education is power and as a Registered Nurse , with a diverse experience background, I found this doctor to be non-condescending and very knowledgeable. And may I add, easy on the eyes too. Also as a RN who has been on her feet for 13 hrs a day, for 20+ yrs I’ve no doubt in my mind that my career choice has had a major impact on my feet, back and other body parts but I wouldn’t change it for the world. Thank you for doing all the work to make these informative online articles. Sincerely Jeannine Crerand BSN RN.