The midfoot represents the area of the foot between the ankle joint and the metatarsals (toes) and is made up of a series of small bones that are linked to provide the foot with it position and strength when walking or running.
Like all other joints that are lined with cartilage they can degenerate causing wear and tear arthritis (osteoarthritis). Sometimes this wear and tear process can be exacerbated by breaking or injury that area of the foot in the past meaning the joint surface is damaged. Inflammatory arthritic processes such as Rheumatoid arthritis can destroy these joints in the foot. If the medial arch is lost due to tendon dysfunction the position of the foot changes causing midfoot discomfort and excessive wear.
What are the symptoms?
Like all other arthritic processes the most common presentation is one of pain and ache worsened with any form of activity or standing for a long time.
Patients tend to lose flexibility of the foot when walking on uneven ground.
Patients notice the shape of their foot has altered tending to be more flat footed or have a prominent lump around the middle portion of the foot. As a result of this wearing footwear can become uncomfortable.
How is it diagnosed?
A clear and detailed history is important in conjunction with a thorough examination of the whole foot and ankle. To confirm the diagnosis an x-ray will identify the extent of the arthritic process but sometimes further imaging may be required.
How is it treated?
Non-operative treatment –
Painkillers are a simple start and in some patients can be enough alone to mean little modification to their life.
Modification of footwear to a wider stiffer fitting shoe can help mobilizing as the stiffer shoe supports the midfoot in the walking cycle.
Targeted injections sometimes with ultrasound guidance can be useful either as a treatment or as a diagnostic tool potentially progressing towards surgery.
Operative treatment –
If all non-operative methods have failed to improve the quality of life then surgery can be considered. The mainstay of surgery to the midfoot requires stiffening or fusing the small bones together.
Important: this information given above is only a guideline as is not complete. For more information or to book an appointment please contact us.