What is Midfoot Arthritis?

Midfoot arthritis occurs in one or more joints between the bones in the middle of the foot which are at the top of the arch. The joints consist of the naviculocuneiform and tarsometatarsal joints. Arthritis of the midfoot is much less common than hip or knee arthritis. Primary idiopathic osteoarthritis (no obvious cause) is the commonest form of mid foot arthritis but it may occur following an injury, chronic malalignment such as a flat foot or after a previous ankle fusion. These conditions change the contact forces and load bearing mechanics of the joints. Loss of cartilage then ensues. People with midfoot arthritis often have tight calf muscles. Whether this has primarily caused overload of the region during the gait cycle (walking) over a lifetime or whether it is simply exacerbating the problem is not known.

What are the Symptoms?

Arthritis, in general, is associated with pain and stiffness. The midfoot joints normally allow little movement so stiffness is not an issue. Rather than stiffness the arch may collapse causing a flat foot (if not already present) or a foot which has changed shape. In the midfoot, pain usually occurs across the top of the foot. Pain is worse with activity but as the disease progresses can be present constantly. These symptoms may affect your ability to walk, negotiate stairs and do your normal daily activities. 

What is the Treatment?

In the early stages non-surgical treatment may be effective. Changing your activities and footwear, wearing an arch support, and pain medication such as paracetamol or anti-inflammatories may be sufficient. Exercises to stretch your calf muscle and Achilles tendon may help.

Failing the above, surgery is often beneficial. People with early disease, before the arch has collapsed, or in high risk patients will often benefit from a simple endoscopic gastrocnemius recession. In more advanced cases midfoot fusion provides reliable pain relief.