Pharmacists need to consider that instability can arise secondary to pain, stiffness, and impaired ambulation when OA affects the MPJ furthermore, falls occurring in the elderly need to be assessed using a multidimensional approach that considers such factors as medications, functional disability, and neurologic impairment. 8 Furthermore, reduced flexibility and mobility in seniors can result in limitations affecting not only the movements and locomotion required for everyday functioning and responsibilities, but also leisure activities, vacations, and caregiving. OA of the first metatarsophalangeal joint (MPJ) of the big toe/great toe is a common condition (hallux limitus/rigidus) marked by pain, stiffness, and impaired ambulation. high heels, sandals, slippers) on a regular basis in their past were more likely to experience foot pain in their later years compared with those who wore “average” shoes. 5 Interestingly, Dufour et al examined factors associated with foot pain, including current and past shoe wear their findings revealed that women who wore “poor” shoes (e.g. Shoes and other footwear may be an important modifiable factor in foot pain, particularly as it relates to rheumatic disorders according to Riskowski et al, it is surprising that this topic has received little attention in the rheumatology community. 6 According to the Framingham Heart Study, prevalence data indicate that 29% of women and 19% of men reported foot pain on most days of the month. 5 The prevalence of foot pain among community-dwelling older adults ranges from approximately 36% to 70%, depending on definitions and populations studied. Today, arthritis and foot pain are both major public health problems. 2,3 Further, according to a North American survey, adults over age 65 years accounted for 37% of arthritis cases in 2005 and will account for 50% by 2030. 1 Musculoskeletal disease is the most common cause of chronic disability in individuals older than 65 years, and arthritis, currently a growing medical problem, is the most common cause of disability in people over 75 years of age. Osteoarthritis (OA), considered a musculoskeletal disorder ( Table 1), is the most prevalent articular disease in the elderly. Only recently becoming available in Australia, this is certainly a product that I am very excited to now be able to offer my patients.The prevalence of disabling joint diseases increases with age.
This technique has been extensively studied in the UK and Canada, with excellent 5 year results. Pain relief, and an improvement in range of motion. One of the huge potentials of this procedure, is that people are able to have the best of both worlds. This ‘cap’ is embedded within the arthritic 1st MTP joint to help separate the arthritic bones from each other. ‘Cartiva’ is a synthetic hydrogel cap made from a similar material to the contact lens’ that people wear to replace glasses. While this is a very successful procedure, and still the treatment of choice for certain patients, a new technique has been developed for this condition. This involves joining up the bones of the 1st MTP joint to eliminate the painful arthritis.
Traditionally, end stage arthritis of this joint has been managed by a fusion procedure to help alleviate pain. Thankfully, a new technique has recently become available in Australia. Many women find it unmanageable to wear high heels due to limited motion of that joint. This frequently leads to pain and swelling in this area, and difficulty ‘pushing off’ when mobilising. Big toe arthritis is a common condition that typically affects the 1st metatarsophalangeal (MTP) joint.
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