MTP Joint Arthritis

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Image Credits: mortonsneuroma.com

“Health is a large word. It embraces not the body only, but the mind and spirit as well; …and not today’s pain or pleasure alone, but the whole being and outlook of a man.” - James H. West

From the anatomy of the feet image that is shown above, the metatarsophalageal joints (MTP joints), are identified as the connection points between the phalanges (toe bones) and the metatarsal bones in the feet. If you imagine your feet as a mechanical system, the addition of enough stress and strain induced by either sporting activity or daily life, can result in the joint alignment being shift. The result of the MTP joint misalignment is that the joint cartilage and lining can both be damaged, resulting in a painful sensation and also in the severe cases - joint arthritis. 

With five MTP joints on each foot, technically, the “MTP Joint” is the term referring to the big toe joint. There are three main pain points in the MTP therapy, and this site is the most prevalent. The main MTP joint is critical to balance, and care must be taken in the instance of pain experienced in the area. 

Statistics have shown that arthritis in the feet, is a condition that plagues adults over the age of 50. One of the areas of the feet affected by joint arthritis include symptomatic radiographic foot osteoarthritis, which affects approximately 17% of the adult sufferers in the defined category. The regions of the feet affected by this condition include: 

  1. The First Metatarsophalangeal Joint

  2.  The Second Cuneometatarsal and Talonavicular joints

Treatments of the aforementioned conditions are variable, with a range of therapies from physical therapy, foot inserts and surgery in the adverse case.

Background

As an illness, osteoarthritis (OA) is a leading cause of disability in the aging population, with 10% of people aged over 60 years being diagnosed with this condition. With time, this debilitating condition can degenerate and lead to the following life changes in an individual: 

  1. Reduction in Locomotor Function. Mobility is affected. 

  2. Social Impact, due to reduction in ability to participate in physical activity

  3. Economic productivity due to limited mobility 

  4. Poor Balance 

  5. Risk of Falling 

  6. Increase in Medical Visits 

With statistics indicating that one in ten people over the age of 70 will be developing foot conditions, there is a need to improve the awareness of foot care. As scientific studies increase, it will be possible to classify foot conditions faster, and improve their treatment rates. Technologies such as a radiographic atlas, and grading system, are helping to facilitate appropriate root cause analysis. Since various factors such as gout, osteoarthritis, rheumatoid arthritis, psoriatic arthritis and septic arthritis can influence the same final symptoms, it will be critical to determine the course of treatment according to the source. 

How is MTP Joint Arthritis Treated? 

The treatment of arthritis is a case by case analysis, that is dependent on severity. In the early stages the following treatments can be utilized: 

  1. Conservative interventions, including analgesic or anti-inflammatory medications

  2.  Intra-articular injections

  3. Physical therapy 

  4. Footwear modifications

  5.  Foot orthoses

If the need escalates, then surgery is considered. With respect to the surgical procedure, you will consult with your orthopaedic surgeon in order to determine the best surgical treatment path for yourself. Conservative treatments appear to work for the majority of patients. Drug therapies such as the use of Oral non-steroidal anti-inflammatory drugs (NSAIDs) have been found to be effective. Treatments such as piroxicam and naproxen were found to provide successful therapeutic impacts in patients who were placed on these treatments. 

Surgical Interventions

MTP joint surgery is a last resort treatment, for patients with adverse arthritis in the joint. Patient treatments are via three treatment streams: cheilectomy for joint preservation, implant arthroplasty and arthrodesis for joint restoration. 

As with all treatments, consult with your orthopaedic surgeon for the best path forward. Your health is your wealth. 

Reference Articles: 

  1. Types of MTP Joint Problems: https://www.healthline.com/health/mtp-joint

  2. Foot osteoarthritis: latest evidence and developments: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5871064/

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