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Dr Mark Nelson

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Facts On Arthritis And The Foot

Information From The American Podiatric Medical Association

Prevalence of Arthritis

Total number:

40 million people in the United States have some type of arthritis. This represents 15% of the population or one in every seven persons.

The prevalence of arthritis is projected to increase 57% to about 59.6 million people with arthritis by the year 2020. This represents 18.2 % of the population.

Arthritis is a leading cause of work-related disability among people. An estimated 2.8% of the population or 7 million people had arthritis as a major or contributing cause of activity limitation. The prevalence of arthritis related disability is also expected to rise by the year 2020, when an estimated 11.6 million people will be affected.

There are more than 100 types of arthritic diseases. Arthritis was reported as the cause of disability more than any other chronic diseases, such as back pain, heart or lung conditions, diabetes, or cancer.

Prevalence of Arthritis by age and sex:

Arthritis affects all ages including a significant number of adults in the prime of their life (almost 9 million adults) . An estimated 285,000 children are affected with arthritis. There is a higher prevalence in people greater than 65, and in women. Arthritis affects one of every two people over age 65. Arthritis is the most prevalent chronic condition in women affecting 26.4 million. By the year 2020, an estimated 36 million women will be affected.

Cost of Arthritis:

The estimated cost of arthritis is about $64.8 billion dollars. Twenty- four percent was due to direct medical costs, and 76% was due to indirect costs from lost wages. The cost including arthritis and other musculoskeletal conditions was 149.4 billion, which is about 2.5% of the Gross National Product.


Common Arthritis Diseases


This is also known as degenerative joint disease, and is the most common type of arthritis, affecting an estimated 20.7 million adults in the United States, mostly after age 45. It primarily affects the joint cartilage. It usually affects the weight-bearing joints, such as the feet.


Rheumatoid Arthritis

This is a systemic inflammatory disease affecting the synovium or lining of the joints. It typically affects more than one joint and tends to be symmetrical. It affects 2.1 million people in the United States, or about 1 percent of the population. Onset is usually after age 45, but often occurs in the 20s and 30s . The cause is unknown, but it is an autoimmune disease.


Juvenile Rheumatoid Arthritis (JRA)

JRA is the most common form of arthritis in childhood. It affects 70,000 to 100,000 children in the United States. The cause is unknown, but it involves abnormalities of the immune system. JRA can cause altered growth, joint damage, and joint inflammation.


Ankylosing Spondylitis

This is a seronegative spondyloarthritis that primarily affects the spine and causes stiffness. A characteristic lesion is the formation of calcaneal spurs. Heel pain is a common complaint. It usually affects men between the ages of 16 and 35.



This results from a build-up of uric acid which forms sodium urate crystals that deposit in joints and cause inflammation. Gout commonly affects the first metatarsophalangeal joint of the foot. It usually affects men over age 40. Women with gout usually develop it after menopause.


Systemic Lupus Erythematosus

This is also known as lupus or SLE. It is an autoimmune disease in which the immune system harms the body’s own healthy cells and tissues. Nine out of ten people who have lupus are women. Lupus is three times more common in black women than in caucasian women.


Psoriatic Arthritis

This is a seronegative spondyloarthritis which occurs in some people with psoriasis. About 95% have swelling in joints outside the spine. Swelling in the toes gives them a sausage appearance. Pitting of the toenails and other nail changes affect 80% of people with psoriatic arthritis. Psoriatic arthritis affects men and women of all races and usually occurs between the ages of 20 and 50.


Prevention and Treatment of Arthritis

Foot Problems According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases and the Arthritis Foundation early diagnosis and treatment of arthritis can prevent much unnecessary disability. People with arthritis need to self-manage their condition and engage in physical activity.

Arthritis Foundation: Arthritis Information Sheets, 2000

Department of Health and Human Services: National Institute of Arthritis and Musculoskeletal and Skin Diseases: Questions and Answers about Arthritis and Rheumatic Disease, 1999


Reprinted with permission from the American Podiatric Medical Association

Which Orthotic / Arch Support Should I Use?

Dr Nelson's comments: 
The best fitting and functioning type of arch support is a custom made prescription orthotic, which can be made by your podiatrist.  Generally, for most people, I recommend trying a pre-made arch support before progressing to an expensive pair of custom made orthotics.  Finding a comfortable and effective pre-made arch support can be difficult.  There are hundreds of varieties on the market and that can make it confusing for customers.  Due to the variations in people's foot shapes, foot problems and style variations in different products, there is no "one type fits all" arch support available.  That's why DrNelsonClinic offers different brands and models like OrthoFeet, SuperFeet, WalkFit and PowerStep to choose among.  Fortunately, for most people, I've found that the OrthoFeet BioSole gel self-molding orthotics work for almost everybody.  Among the hundreds of pre-made arch supports I've seen and used, the OrthoFeet BioSole models give the best support and pain relief for people with plantar fasciitis and heel pain.  It's by far my favorite model for people with heel pain, due in part to the higher arch and shock absorbing gel under the heel.  Be aware that the standard OrthoFeet BioSole "sport" model is rather thick through the arch and it fits into athletic, work boots and walking shoes, but may not fit into a shallow shoe, like a dress shoe.  If you want to use the OrthoFeet in a shallow shoe, like a dress shoe, then use the "thin-line" or "high heel dress" models.  The "sport" model may also be too high in the arch area for people with very flat feet.  For elderly or arthritic people and those that want extra cushioning and softness under the foot, while still getting extra support under the arch, try the OrthoFeet BioSole "soft" model.  If you don't need extra arch support or heel pain relief  and only want shock absorption and cushioning under the foot, try the OrthoFeet "ThermoFit" model.  After you start using any brand of arch supports, remember to break them in gradually, because is will take some time for the orthotic and your feet to adjust to each other.  I personally use the OrthoFeet BioSole sport model in my athletic shoes and have found them to be as effective and comfortable as my expensive custom prescription orthotics.  But, it did take longer to "break-in" the OrthoFeet supports than my custom orthotics.  If you don't have plantar fasciitis or heel pain or if you have a flat foot and can't tolerate an arch support with a higher arch, but still want great foot support to relieve foot fatigue and strain, you should also consider SuperFeet Synergizer orthotics, which are our most popular arch supports.  SuperFeet Synergizer orthotics have been highly recommended by sports and outdoor publications such as Backpacker


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Last modified: 10/13/10