Medically reviewed by Dr. Tom Biernacki, DPM
Board-certified podiatric surgeon | Balance Foot & Ankle, Howell & Bloomfield Hills, MI
Last reviewed: May 2026
Balance Foot & Ankle offers same-day appointments for urgent foot and ankle conditions across Southeast Michigan — but the most important factor in outcomes isn’t getting seen quickly. Our podiatrists explain what to do in the first 24-48 hours before your appointment that most patients skip entirely. Call (810) 206-1402 — expert podiatric care across Michigan.
You are in the right place. Dr. Tom Biernacki, DPM, FACFAS — board-certified foot & ankle surgeon with 3,000+ surgeries — explains exactly what foot arthritis (Michigan) means and what actually works. Call (810) 206-1402 for a same-day appointment at our Howell or Bloomfield Hills office.
Medically Reviewed | Dr. Tom Biernacki, DPM | Board-Certified Podiatric Surgeon | Balance Foot & Ankle, Michigan
The most important clinical decision with Arthritis Foot Michigan Podiatrist isn’t which treatment to start with — it’s identifying the correct subtype. That changes everything. Call (810) 206-1402.
Arthritis in the Foot: A Common, Treatable Problem
Arthritis — from the Greek for joint inflammation — is not a single disease but a family of conditions that damage joint cartilage and supporting structures. The foot and ankle contain over 30 joints, providing ample territory for arthritic disease. Yet arthritis in the foot is often undertreated, either because patients assume it’s “just part of aging” or because primary care physicians lack the specialized knowledge to offer foot-specific interventions. A podiatrist specializing in foot arthritis can dramatically improve function and quality of life even in advanced disease.
Types of Foot Arthritis
Osteoarthritis (OA) — the most common form — results from progressive cartilage loss, typically from prior trauma (post-traumatic OA) or repetitive wear over decades. The ankle joint is most commonly involved after prior fractures or chronic instability. The first metatarsophalangeal joint (big toe joint) develops hallux rigidus — arthritis causing stiffness and loss of dorsiflexion (upward bending) that makes every walking step painful. The subtalar, talonavicular, and midfoot joints develop OA after Lisfranc injuries, calcaneal fractures, and progressive flat foot deformity.
Rheumatoid Arthritis (RA) is a systemic autoimmune disease affecting synovial joints throughout the body. The foot is involved in up to 90% of RA patients. RA causes symmetric joint inflammation — typically the forefoot first, with metatarsophalangeal joint swelling, morning stiffness lasting over an hour, and progressive deformity including severe bunions, hammertoes, and lateral deviation of the toes. RA requires systemic treatment by a rheumatologist alongside local podiatric management.
Psoriatic Arthritis can affect the foot with sausage-digit swelling (dactylitis), enthesitis (inflammation at tendon insertions — Achilles and plantar fascia insertion are classic sites), and joint inflammation similar to RA pattern. Skin psoriasis may not be present, making diagnosis challenging without systemic evaluation.
Gout is caused by monosodium urate crystal deposition in joints, most famously affecting the first metatarsophalangeal joint (classic podagra — the gout toe). Attacks are sudden, severe, and exquisitely painful — often beginning at night. The ankle, subtalar, and midfoot joints are also commonly affected. Gout requires both acute management (anti-inflammatory treatment) and long-term uric acid control to prevent progressive joint damage and tophi (urate deposits in soft tissue).
Hallux Rigidus: Big Toe Arthritis
Hallux rigidus — osteoarthritis of the first metatarsophalangeal joint — is the most common arthritic condition treated by podiatrists. It causes progressive stiffness and dorsiflexion loss at the big toe joint, leading to compensatory altered gait (rolling off the outer foot to avoid the stiff joint), metatarsal overload, and significant activity limitation. Conservative management with stiff-soled rocker footwear, custom orthotics with carbon fiber Morton’s extension, and corticosteroid injection is highly effective in moderate disease. Cheilectomy (bone spur removal) restores motion in Grade I–II disease. Fusion (first MTP arthrodesis) provides reliable, durable pain relief in Grade III–IV disease with minimal impact on walking function.
Ankle Arthritis
End-stage ankle arthritis — most commonly post-traumatic after prior fracture or chronic instability — causes bone-on-bone joint pain that is debilitating with any walking. Conservative management with custom ankle-foot orthoses (AFOs), ankle bracing, corticosteroid injection, and viscosupplement injection provides symptomatic relief for moderate disease. Surgical options for advanced ankle arthritis include ankle arthrodesis (fusion — the traditional gold standard, durable and predictable) and total ankle replacement (arthroplasty — preserves ankle motion with excellent outcomes in appropriately selected patients). Dr. Biernacki discusses both options thoroughly when surgical planning is appropriate.
Conservative Management for Foot Arthritis
Orthotic management is the cornerstone of conservative foot arthritis treatment — rigid or semi-rigid custom orthotics offload painful joints and reduce the compressive forces that accelerate cartilage destruction. Joint injections with corticosteroid provide anti-inflammatory relief; PRP (platelet-rich plasma) injection is increasingly used for joint cartilage support. Activity modification, weight management guidance, and anti-inflammatory dietary strategies supplement professional treatment. Physical therapy with aquatic exercise reduces joint loading while maintaining cardiovascular fitness.
Schedule Your Foot Arthritis Evaluation
If foot or ankle arthritis is limiting your ability to walk, work, or live actively, do not accept chronic pain as inevitable. Effective management exists at every stage of arthritis severity. Call Balance Foot & Ankle in Howell or Bloomfield Hills for a comprehensive arthritis evaluation and treatment plan tailored to your joints and lifestyle.
Dr. Tom's Product Recommendations
Mephisto Mobils Walking Shoe
⭐ Highly Rated
Premium French walking shoe with SOFT-AIR midsole technology — specifically designed to reduce impact forces on arthritic foot joints. Natural leather upper with wide toe box accommodates arthritic joint swelling and toe deformities. The rocker-bottom outsole geometry reduces first MTP joint stress — ideal for hallux rigidus patients who need to limit big toe dorsiflexion during walking. Recommended by podiatrists for foot arthritis and hallux rigidus.
Dr. Tom says: “I have hallux rigidus and Mephisto walking shoes are the only shoes I can wear without pain. The rocker sole is like walking on air for my stiff big toe — I bought three pairs.”
Hallux rigidus (big toe arthritis), forefoot arthritis, and ankle arthritis requiring a rocker sole that reduces arthritic joint loading during walking
High-speed running or technical outdoor activities — Mephisto shoes are premium walking shoes, not athletic performance footwear
Disclosure: We earn a commission at no extra cost to you.
Voltaren Arthritis Pain Topical Gel
⭐ Highly Rated
Diclofenac sodium 1% topical anti-inflammatory gel — the only OTC topical NSAID in the US. Clinically proven to reduce joint pain and inflammation in osteoarthritis when applied directly to affected joints. Preferred over oral NSAIDs by podiatrists because it delivers anti-inflammatory effect to the joint with minimal systemic absorption — safer for patients with stomach, kidney, or cardiac concerns.
Dr. Tom says: “My podiatrist suggested Voltaren Arthritis Pain gel for my big toe arthritis between appointments. It provides real relief — not like a placebo, actually reduces the joint pain and stiffness after application.”
Osteoarthritis of foot joints including hallux rigidus (big toe arthritis), midfoot arthritis, and ankle arthritis — provides localized anti-inflammatory effect with minimal systemic NSAID side effects
Acute gout attack or rheumatoid flare — these require systemic anti-inflammatory treatment; consult Dr. Biernacki for appropriate acute arthritis management
Disclosure: We earn a commission at no extra cost to you.
✅ Pros / Benefits
- Comprehensive arthritis type differentiation — osteoarthritis vs. RA vs. gout requires different treatment pathways
- Hallux rigidus expertise including cheilectomy and fusion — full surgical spectrum for big toe arthritis
- Ankle arthritis surgical options: both fusion and total ankle replacement discussed for appropriate patients
- Coordination with rheumatology for RA, psoriatic arthritis, and gout requiring systemic management
❌ Cons / Risks
- Progressive arthritic joint damage cannot be reversed — management controls symptoms and slows progression
- Ankle fusion and total ankle replacement require significant recovery (4–6 months) and careful patient selection
- Rheumatoid and gout arthritis require ongoing systemic medical management beyond podiatry scope
Dr. Tom Biernacki’s Recommendation
Foot arthritis is an area where I really emphasize that pain is not inevitable — it’s manageable. Hallux rigidus patients who come in barely able to walk often leave with a carbon fiber plate orthotic and a good rocker-bottom shoe and report 70% improvement at their follow-up. That’s without surgery. For ankle arthritis patients where conservative care isn’t enough, total ankle replacement has transformed what we can offer — patients who would have been told ‘fuse it and live with it’ now have an option that preserves motion. The field has genuinely improved.
— Dr. Tom Biernacki, DPM | Board-Certified Podiatric Surgeon | Balance Foot & Ankle
Frequently Asked Questions
Can foot arthritis be treated without surgery?
Yes — most foot arthritis is managed effectively without surgery using custom orthotics, appropriate rocker-bottom footwear, topical and oral anti-inflammatory medications, corticosteroid joint injections, PRP injection, and activity modification. Surgery is reserved for severe disease with significant functional limitation that has not responded to comprehensive conservative care.
What is hallux rigidus and what causes it?
Hallux rigidus is osteoarthritis of the first metatarsophalangeal joint (big toe joint), causing cartilage loss, bone spur formation, and progressive stiffness. Causes include prior trauma, osteochondral defects, structural foot deformity (long first metatarsal, elevated first ray), and idiopathic wear. It’s the most common arthritic condition of the foot.
Is there a cure for gout?
Gout is manageable but not curable. Acute attacks are highly responsive to anti-inflammatory treatment (colchicine, NSAIDs, or corticosteroids). Long-term prevention requires lowering serum uric acid with medications (allopurinol, febuxostat) and dietary modification. With consistent urate-lowering therapy, most gout patients have no further attacks and prevent progressive joint damage.
What is total ankle replacement and is it appropriate for me?
Total ankle replacement (TAR) replaces the damaged ankle joint surfaces with metal and polyethylene implants, preserving ankle motion — an advantage over fusion for patients who want to walk normally and participate in recreational activity. TAR is appropriate for lower-demand patients with end-stage ankle arthritis, adequate bone stock, and good alignment. Dr. Biernacki discusses whether TAR or fusion is more appropriate for your specific anatomy and lifestyle.
Does Balance Foot & Ankle treat rheumatoid arthritis of the foot?
Yes — foot management for RA patients, including custom orthotics for joint offloading, surgical correction of RA-driven deformities, and coordination with your rheumatologist, is a core service. RA foot problems including severe bunions, hammertoe deformity, and joint destruction are expertly managed with the understanding that systemic disease control is the primary driver of long-term outcomes.
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When should I see a podiatrist?
If symptoms persist past 2 weeks, affect your normal activity, or are accompanied by red-flag symptoms (warmth, redness, swelling, inability to bear weight).
What does treatment cost?
Most diagnostic visits and conservative treatments are covered by Medicare and major insurers. Out-of-pocket costs vary by your specific plan.
How quickly can I get an appointment?
Most non-urgent cases see us within 5 business days. Urgent cases (sudden pain, possible fracture) typically same or next business day.
Ready to fix this for good?
Reading goes only so far. The fastest path to relief is a 30-minute office visit with Dr. Biernacki — same-day Howell or Bloomfield Hills. Call (810) 206-1402 or use our online booking.
In-Office Treatment at Balance Foot & Ankle
If home treatment isn’t providing relief for your foot issues, our podiatry team at Balance Foot & Ankle can help with same-day evaluations and advanced in-office care.
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Dr. Tom Biernacki, DPM is a board-certified foot & ankle surgeon (ABFAS & ABPM) at Balance Foot & Ankle Specialists in Southeast Michigan. With over a decade of clinical experience, he specializes in heel pain, bunions, diabetic foot care, sports injuries, and minimally invasive surgery. Dr. Biernacki is a member of the APMA and ACFAS, and his patient education content on MichiganFootDoctors.com and YouTube has made him one of the most-followed foot & ankle educators on YouTube.