An overview of ankylosing spondylitis that affects the feet, symptoms and treatment options for this medical condition.

An overview of ankylosing spondylitis that affects the feet, symptoms and treatment options for this medical condition.

Ankylosing spondylitis (EA) is a chronic inflammatory disease that mainly affects the spine and causes pain, stiffness and loss of mobility. However, this disease can also affect other parts of the body, including feet. People with EA may experience various feet problems, which can contribute even more to the discomfort and deterioration of the function.

One of the common problems of the feet associated with the EA is entities, which refers to inflammation in the place where tendons or ligaments bind to bones. At the feet, inflammation usually occurs in the Achilles tendon, causing pain and swelling. This can hinder people with EA to carry out activities that involve walking, running or even standing for prolonged periods.

In addition, the EA can also affect the feet joints, the most affected the small joints and the joint that unites the heel bone (calcaneus) with the astragal bone. This can cause pain, rigidity and limitation of the amplitude of movement in the affected joints. In severe cases, joint fusion can occur, known as anquilosis, which causes permanent deformities and further hinders the function of the foot.

Important information:

  1. People with ankylosing spondylitis may experience feet problems such as entities and joint involvement.
  2. Enthesitis mainly affects Achilles, causing pain and swelling.
  3. The joint involvement of the feet can cause pain, rigidity, limitation of the amplitude of movement and a possible joint fusion.

Symptoms of Ankylosing Spondylitis in the Feet

When it comes to the feet, several symptoms may appear. These symptoms can vary in gravity and gradually develop over time. One of the most common symptoms is chronic pain in the foot, which can be present in one or both feet. This pain can be located in specific areas, such as the heel or the arc of the foot. In addition, people with the feet may experience stiffness and limited mobility, which makes it difficult to walk or perform daily activities.

Important information:

  • Ankylosing spondylitis is a chronic autoimmune disease that mainly affects the spine, but can also affect the feet.
  • The symptoms of the EA in the feet include chronic pain, stiffness and limited mobility.
  • Swelling and sensitivity in the affected joints, such as ankles or toes, can also indicate the presence of EA on the feet.
  • The early diagnosis and proper treatment of the EA of the feet are crucial to minimize lon g-term complications and improve the quality of life.

Understanding the Early Signs and Symptoms of Ankylosing Spondylitis Feet

1. Pain and rigidity: One of the characteristic symptoms of EA is persistent pain and stiffness, usually in the lumbar zone and buttocks. However, it is important to point out that EA can also cause pain and feet stiffness. These discomforts can be more evident in the morning or after periods of inactivity. People may experience difficulty moving or folding their feet, and pain can radiate to other areas of the lower extremities.

  1. Foot deformities: As the EA progresses, structural changes can occur on the feet. These changes may include the development of bone growth, known as Enthesouts, in the feet joints. Enthesings can cause joint stiffness, limited mobility and even deformities such as claw fingers or flat feet. If they are not treated, the feet deformities associated with EA can considerably reduce everyday activities and quality of life.
  2. Plantar fasciitis: Another early sign of EA in the feet is the appearance of plantar fasciitis. This condition is characterized by the inflammation of the plantar fascia, a thick band of tissue that runs through the sole of the foot. People with EA may experience acute and sharp pain in the heel, especially when taking the first steps in the morning or after rest periods. Plantar fasciitis can contribute even more to foot mobility problems and aggravate general discomfort.

In people with EA, feet can be one of the first affected areas, and early recognition of feet symptoms can allow timely intervention and improve lon g-term results. It is essential that people consult their doctor if they experience pain, stiffness or persistent feet deformities, especially if they have a family history of EA or other autoimmune diseases.

First signs and symptoms of ankylosing spondylitis feet:
Pain and rigidity in the lumbar area and the buttocks.
Pain and stiffness in the feet, especially in the morning or after periods of inactivity
Deformities development on the feet, such as claw fingers or flat feet
Inflammation and plantar fasciitis, with acute and sharp pain in the heel

How Ankylosing Spondylitis Affects the Feet

One of the main characteristics of AS is the development of enthesitis, which refers to inflammation in the places where tendons or ligaments attach to bones. In the feet, this usually occurs in the Achilles tendons and plantar fascia, causing pain and swelling. Inflammation can also cause bone spurs or excessive bone growth in affected areas, further contributing to foot problems in people with AD.

Important information:

  • AS can cause pain and swelling in the feet due to enthesitis in the Achilles tendons and plantar fascia.
  • Inflammation of the feet can lead to bone spurs and excessive bone growth.
Effects of ankylosing spondylitis on the feet
Bone spur formation
Inflammation of the Achilles tendons and plantar fascia
Pain and swelling in the feet
Mobility problems and discomfort

It is essential that people with AD pay attention to any symptoms they experience in their feet and seek medical evaluation. Prompt diagnosis and treatment of foot involvement can help relieve pain, improve mobility, and prevent further complications. Treatment options may include medications to reduce inflammation, physical therapy exercises to improve flexibility and strength, orthotics to provide support, and, in severe cases, surgery to correct deformities or fuse joints.

Diagnosis: Identifying Ankylosing Spondylitis in the Feet

Symptoms: When diagnosing AD in the feet, it is essential to know the characteristic symptoms. The most common foot symptoms associated with AS include persistent pain and stiffness in the heels, loss of range of motion, difficulty walking, and fatigue. These symptoms usually worsen in the morning or after periods of inactivity. In severe cases, AS can cause the joints in the feet to fuse, resulting in a fixed, rigid posture of the foot.

Note: It is worth mentioning that the involvement of the feet in AD can vary from one person to another. While some individuals may experience noticeable foot symptoms, others may have minimal or no foot-related problems. Therefore, a thorough evaluation of the patient’s history, physical examination, and imaging studies is essential to make an accurate diagnosis.

  • Medical history: The doctor will ask about the patient’s medical history, including any family history of AD or other related conditions. She will also ask about the duration and progression of foot symptoms, as well as any other joint pain experienced.
  • Physical examination: an exhaustive examination of the feet is performed to evaluate sensitivity, swelling, limitations of movement amplitude and any visible deformity. The doctor can also evaluate the patient’s posture and the mobility of the spine, since the EA mainly affects the spine.
  • Image studies: Radiographies or magnetic resonances (RM) may be recommended to visualize the joints, bones and soft tissues affected. These image techniques can help identify characteristic changes in the feet associated with the EA, such as erosions, narrowing of articular space and new bone formation.

Table: Key steps in the diagnosis of EA on the feet

Passed Action
1 Get a detailed medical history
2 Perform an exhaustive physical examination of the feet
3 Request image studies, such as radiographs or magnetic resonances
4 Review and analyze the results
5 Confirm the diagnosis based on the established diagnostic criteria

Treatment Options for Ankylosing Spondylitis Feet

1. No n-steroidal ant i-inflammatories (NSAIDs)

NSAIDs are usually the first line of treatment for EA and can be effective in reducing pain and inflammation of the feet. The most common NSAIDs are ibuprofen and naproxen, which can be acquired without recipe or prescribed by a healthcare professional. It is important to follow the recommended dosage and consult with the doctor possible side effects or interactions with other medications.

    • They relieve pain and inflammation of the feet.
    • They can be acquired easily without a medical recipe
    • They can be used as part of a lon g-term treatment plan.
  2. Disadvantages of NSAIDs:
    • Possible side effects, such as stomach irritation or kidney problems
    • Possible interactions with other medications

2. Physiotherapy and exercise

Physiotherapy and exercise play a crucial role in the treatment of EA symptoms, including feet related. Working with a physiotherapist can help people develop a personalized exercise program that focuses on stretching and strengthening foot muscles. Regular exercise can improve flexibility, reduce rigidity and relieve feet pain.

It is recommended to consult with a physiotherapist or health professional before starting any exercise program to ensure that it is safe and adequate for the person’s condition.

  1. Benefits of physiotherapy and exercise
    • Improves flexibility and mobility of the feet
    • Strengthens the muscles that support the feet
    • Reduces pain and rigidity

Medications and Pain Relief

Nonsteroidal anti-inflammatory drugs (NSAIDs) are usually the first-line treatment for AS and can significantly relieve pain and inflammation. These medications reduce inflammation and suppress the body’s immune response. NSAIDs can be purchased without a prescription or can be prescribed by a healthcare professional. Some common NSAIDs are ibuprofen, naproxen, and diclofenac. It is important to note that prolonged and excessive use of NSAIDs can have side effects such as gastrointestinal problems, so it is crucial to follow the recommended dosage and consult with a healthcare professional.

  • Corticosteroids: These medications are powerful anti-inflammatories that may be useful in treating acute flares of AD, including foot pain. They work by suppressing the immune system and reducing inflammation. Corticosteroids can be taken orally, injected directly into the affected joint, or applied topically. However, long-term use of corticosteroids can have significant side effects, so they are often used for short-term symptom relief.
  • Disease-modifying antirheumatic drugs (DMARDs): As their name suggests, DMARDs modify the course of the disease and help control inflammation. They are commonly used in the treatment of other types of inflammatory arthritis, such as rheumatoid arthritis, but their role in the treatment of AD is still being studied. Some DMARDs that may be prescribed for AD are sulfasalazine and methotrexate.

It is essential to consult with a healthcare professional before starting any new medication, as they can help evaluate the risks and benefits and adapt the treatment plan to individual needs.

In addition to medications, there are other non-drug approaches that can help relieve pain in AS, such as physical therapy, exercise, heat or cold therapy, and assistive devices. These complementary strategies may work in conjunction with medications to maximize pain control and improve overall quality of life for people with AD and foot involvement.

Physical Therapy and Exercise for Ankylosing Spondylitis Feet

Physical therapy for feet with AS focuses on maintaining or improving joint mobility, reducing pain and inflammation, and improving strength and balance. An individualized treatment plan developed by a physical therapist typically includes a combination of manual therapies, exercises, and functional training. The goal of these interventions is to treat stiffness, correct posture, and promote flexibility and stability in the feet.

The objectives of physiotherapy and feet exercise with EA include:

  1. Improve joint mobility on feet and ankles.
  2. Reduce pain and inflammation.
  3. Strengthen the muscles surrounding the feet and ankles.
  4. Improve balance and stability.
  5. Improve general functional capacity and quality of life.

Example of feet exercise routine with EA:
Exercise Description
Fingers of feet fingers with resistance With a resistance band, flex the fingers of your feet towards you. Keep the position for a few seconds and repeat.
Elevation of calves Stand up with your feet separated at shoulder height and slowly raise on the tips of your feet. Go down again and repeat.
Circles with the ankles Sit in a chair with one foot lifted from the ground. Turn the ankle in the direction of the clock needles and then in the opposite direction. Change foot.
Heel Walk by placing one foot in front of the other, with the front foot heel touching the tip tip.

Although physiotherapy and exercise can help control foot symptoms related to EA, it is essential to consult a healthcare professional, such as a physiotherapist or a rheumatologist, before starting any exercise program. They can guide the suitability of specific exercises depending on the severity of the condition and individual limitations.

Lifestyle Changes: Managing Ankylosing Spondylitis in the Feet

1. Maintain a healthy weight: excess weight can be an additional load for the feet and worsen the symptoms of ankylosing spondylitis. Adopting a healthy diet and practicing regular physical activity, people can reach and maintain ideal body weight. This can help reduce the pressure on the feet and relieve discomfort.

  • Follow a balanced diet rich in fruits, vegetables, whole grains and lean proteins.
  • Avoid excessive consumption of processed foods, sugary snack and rich foods.
  • Incorporate low impact exercises to your routine, such as swimming or cycling, to minimize feet tension.

2. Choosing adequate footwear: Wearing adequate footwear is crucial to control ankylosing spondylitis on the feet. Proper footwear can provide support, reduce the impact and relieve pressure on the affected joints. It is recommended:

  1. Opt for shoes with padded sole to absorb impacts and reduce feet tension.
  2. Make sure the footwear has a wide toe to accommodate any swelling or deformity.
  3. Consider the use of custom orthopedic templates or templates to provide additional support and stability.

Tips for choosing footwear:

1. Míd your feet regularly and buy shoes that are well.

2. Avoid high heels and opt for shoes with a low or medium heel height for greater stability.

3. 3. Look for shoes made of breathable materials to avoid excessive sweating and discomfort.

Author of the article
Dr.Greenblatt M.
Dr.Greenblatt M.
Medical oncologist at the Robert Larner College of Medicine, MD, at the University of Vermont

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