Ankylosing Spondylitis and the Feet

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Image Credit: Arthritis Support Board

“Cheerfulness is the best promoter of health and is as friendly to the mind as to the body.”- Joseph Addison

What is Ankylosing Spondylitis?

The human body, is a system of interconnected systems. There are many root cause conditions which have the ability to develop downstream complications in the body and affect the feet as they progress. Ankylosing Spondylitis (AS) is one such ailment. As an inflammatory condition that first begins in the spinal cord, calcium deposits in the ligament-bone condition can cause a fusion of the spinal cord. There are treatments that can control this condition and slow its propagation to the rest of the body.

In the peripheral regions of the body, there can be complications due to AS. The feet can be affected by more than one condition as a result of AS. The entire skeleton is one interconnected unit, and the spine is connected to the pelvis, and the bones and joints connect all the way to the feet. Since the flow is linear. If there’s a problem in the spine, the propagation to the feet is more than likely imminent.

The body, as a system adjusts its alignment if certain areas become painful. The gait pattern will shift if the muscle and joint connections are shifting. Foot complications developing as a result of this shift are as follows:

Plantar Fasciitis:


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Image Credit: Upstep.com

This condition develops as a result of the inflammation of the plantar fascia fusion to the heel bone. The plantar fascia is one of the tissues in the feet and provides the cushioning under the heel. With the aggravation of this joint due to shifts in the gait and weight distribution, patients often experience painful sensations under the heels at differing points during the day.

Your orthopaedic surgeon will facilitate your treatment. Usually physiotherapy is prescribed, along with treatments that aid to cradle the area (via orthotics) in a means to protect the inflammed segments of the feet. Where necessary, your foot and ankle specialist will inject the area with cortisone (steroid) injections. Carefully wrapping the feet can also provide the appropriate therapies needed.

Insertional Achilles Tendinitis

In some instances, the point at which the Achilles tendon attaches to the heel bone can also become inflamed. This condition is known as Achilles Tendinitis. Painful sensations are experienced at the back of the heels, along with a swollen heel region and painful walking. If not monitored, a Haglund’s bump or bony protrusion is noticed.

Treatments include raising the heels to relieve pressure during healing. Additionally, orthotic use to cradle the area are key to ensuring that mobility is facilitated.

Toe Ailments

Due to posture changes, the gait will change. As the muscles also shift to accommodate the change, then the propensity for muscle spasms and cramping to occur in the toes is a possibility. With AS, if the spine shifts to create a forward curve, the toes will adjust (clawing motion), in order to provide the support to keep the body stable. The knees also adjust themselves to flex, and facilitate the skeletal stability. With the shifts, the knee joints can be affected as well as the toes. Orthotics will enable appropriate support.

Additionally, if there are additional treatments needed, your foot and ankle surgeon will determine what these are.

References:

  1. What is AS: https://www.versusarthritis.org/about-arthritis/conditions/ankylosing-spondylitis/

  2. NASS Article: https://nass.co.uk/about-as/what-is-as/your-feet/

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