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Osteoarthritis is a long term affliction that is characterised by stiffness and degradation of cartilage in the joints, commonly affecting hands, feet, spine, shoulders, knees and hip joints. According to the 2010 Global Burden of Disease Study, between 10% and 15% of all adults have osteoarthritis to some degree. As populations continue to increase in age, the number of those affected is likely to increase.

When it comes to osteoarthritis the most commonly affected part of the foot is the big toe. The big toes endure more pressure because of walking and any number of sports, leading to stiffer joints, resulting in difficulties walking. The symptoms at the beginning are a stiff feet. This is a result of the cartilage between the joints starting to lose its elasticity.

Over time, that cartilage begins to break down, leading to the joints in the foot becoming inflamed. Inflammation can cause distinct pain, along with bunions, hammertoes and other feet deformities, which are other indicators of the onset of osteoarthritis. Do not ignore these signs and it is highly recommended that a person seek medical advice if they begin to notice these issues. There are a number of fields in which experts can help: podiatry, rheumatology, physiotherapy and, of course, your GP.

Anatomy of the feet

Every foot contains 26 bones, all connected through elastic smooth cartilage. The 33 joints and 19 tendons and muscles enable them to interact with one another effortlessly. The feet help maintain the body’s balance and work with other parts in the upkeep of our body’s mobility. Yet our constant habit of wearing shoes, boots or glamorous heels can damage our feet, leading to further complications with our knees, hips, and other lower joints. The risk is that, over time, big toes will become very stiff (hallux rigidus) and eventually these toes may move towards the other toes (hallux valgus).

You can find more information about how osteoarthritis affects your feet and other parts of your body here.

Footwear - Shoes For OA - OA Knee Pain Bones of the right foot (lateral view)

What are the best shoes for arthritis?

There are a number of ways that individuals can help themselves to combat arthritis: diet, supplements, medicine, exercise. All are beneficial, but wearing the right shoes is an addition benefit and one that can be carried out a lot of the time. Wearing the wrong kind of shoes can only make the problem worse. The right kind of shoes will be of great benefit to the user, helping with reducing pain and swelling.

Osteoarthritis shoes, or OA shoes, require forethought and some consideration. The first thing to do is to make sure that that the shoe is the right shape for your foot. This might sound strange, but many people will look at shoes for what they look like instead of what they might do for the foot. Many people are fashion conscious, whether they realise it or not, and so might seek out shoes that appear fashionable rather than practical.

Remember that while solid soles are good for your feet, you do not want to get shoes with soles that are too heavy otherwise they are likely to increase the pressure on your knees.

Another aspect to consider is cost. Shoes, trainers and boots all have a variety of costs depending on the type and brand you choose to shop for. Shoes for knee arthritis can be expensive but that cost should be weighed against the longer term damage that a person might suffer and the alterations that they might have to make in their lives further down the line. It all might be simpler to invest in a pair of slightly costlier shoes now rather than having to endure larger costs in the future, not only to finances but also to quality of life too.

There are definite advantages to having insoles, wedges or braces so long as they are able to provide unloading. There is evidence to suggest that unloading - reducing the stress on bones and joints - may be an effective way to reduce pain and reduce the rate of structural damage taking place to the feet. Look out for shoes that have removable insoles as this means that you can add your own customised soles and not make the shoe too tight.

Shoes for knee osteoarthritis in particular need to be flexible and easily adjustable. Bending down to tie laces may become more difficult over time, which is why having footwear that are more flexible and easy to put on allows easier manoeuvrability for the wearer.

Shoe specifics

Shock absorption is probably one of the most important elements of osteoarthritis shoes. This is vital to alleviating the pressure on the toes and the cartilage in between them. It is also necessary for shoes to provide a good arch. This will stop the flat from becoming too flat. If the osteoarthritis makes the users feet swell up then the user may wish to consider a shoe made of stretchable material. This will give them a degree of flexibility and comfort to adjust to the inflammation.

Common sense also applies. If a shoe hurts, it is going to cause unseen damage. Avoid anything that is totally impractical. OA shoes will do a specific job for your feet - focus on that goal. Pay attention to your gait. Look at what walking has done to previous pairs of shoes. This is will be a good guide in what to buy next. For example, if you wear out the outer edges of your shoes, you might have flat feet, in which case you should look for shoes that will provide strong arches.

Make sure that the shoes you settle on work well for you. Do not be self conscious and take the time to walk around in the shoes to make sure they are comfortable and will do the job for you. Remember, these are an investment in your physical wellbeing and should be bought to last.

Flats

Flat shoes are acceptable but they must provide suitable absorption and cushioning for the sole of the foot. The sole of the shoe should be solid and strong, not the kind that can be twisted or folded. For extra cushioning, it may be worth considering an insole.

Sandals

Sandals consist of less material so ensure that the material, particularly in the sole, is strong and solid enough to provide good support. Make sure that they have a strap at the back otherwise the toes will over compensate for the lack of support by gripping harder, potentially resulting in foot strain and hammertoes. Good straps can help to accommodate the foot if it is inflamed.

Flip-flops

As with sandals, there is less material to support the foot so what is there needs to be strong. Flip-flops are generally not very stable and can affect those with weaker joints. However, there are benefits, as flip-flops can be good shoes for knee osteoarthritis. Wearing flip-flops or going barefoot reduces the pressure on the knees. Flip-flops should have solid arch support and pronation control.

Heels

Anyone who knows anything about shoes will tell you that high heels are bad for your feet, even if they will not admit it aloud! For those who consistently wear high heels, arthritis and general foot pain is much more likely to be a factor in later years. It can lead to lower back pain, knee degradation and constantly wearing of the joints. The pressure from pushing down on the ball of the feet increases, meaning that the damage continues up the leg to affect other parts. Avoid as much as possible!

Low heels mainly include a pointed toe, which is going to produce discomfort as the shape of the feet are distorted in order to fit the shoe. There is also a risk to a body’s balance as a narrow heel provides less stability. Consider wearing heels that have wedges and wider tips to allow for more comfort and space.

Trainers

Trainers are incredibly common and there are many differences in them. Some trainers that are dedicated to specific sports will have traits that make them worse for the foot and leg while others may offer some benefits and respite. Sports trainers may have thicker cushioned soles in order to help them generate power in their games, but as casual osteoarthritis footwear, this would not be advisable as this kind of stability in a shoe can add to the stress on knees. Some stores offer new high-tech foot scans.

Boots

Boots are very beneficial for those who suffer from knee or ankle issues. The best kind of boots for osteoarthritis footwear are those that have low, wedged heels and rubber soles. Sturdy boots that have a degree of flexibility will offer the best support for ankles along with decent arch support. It is also important to ensure that such boots are laced to the top to make the most of what they offer.

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