Management of foot problems in arthritis
PAIN in the foot is often a disabling problem for the arthritic patient, and the pain may often be relieved by conservative, nonoperative treatment.
One of the most painful foot deformities is a hammertoe (Fig. 1A), caused by synovial thickening at the metatarsophalangeal joint, resulting in upward displacement of the toe. When there is direct pressure from the shoe or stocking on the proximal interphalangeal joint of the toe, a painful excrescence occurs over this joint; this may be a callus, a hard corn, or an adventitious bursa.
Conservative treatment for this painful condition consists of applying a buttress or sling pad. A sling pad (Fig. 2) is constructed of ¾-inch tubular gauze, felt dental roll, and moleskin in the following manner. (1) A piece of felt dental roll cut to the exact width of the affected toe is covered with tubular gauze; (2) this encased roll is then placed under the affected toe, with the loose ends brought up between the toes; (3) the loose ends are then joined together over the toe and secured with moleskin. The felt dental roll under the hammertoe extends the distal phalanx, and the moleskin removes pressure from the painful proximal interphalangeal joint (Fig. IB and C). Continued use of this sling has proved most effective in giving prolonged relief to arthritic patients with painful contracted toes.
A metal ring and ball stretcher (Fig. 3) is used to “spot” stretch a patient’s shoe, thereby providing more room for a contracted toe and relieving . . .