The Center for Podiatric Care and Sports Medicine

Arthrogryposis: Exploring Treatment Strategies To Reduce Pain & Improve Mobility

Posted by on Thursday, November 7th, 2013

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Arthrogryposis is a congenital disorder where the calf muscle tissue is too fibrous and fatty, which makes walking difficult and puts tremendous pressure on the joints. Often, club feet deformity accompanies this condition, which can be improved through casting. While this condition can be very debilitating, there are treatments available that can improve pain and mobility.

What Is Arthrogryposis?

About 1 in every 3,000 babies is born with arthrogryposis. In some children, only a few joints are mildly affected. In others, movement is severely restricted. In extreme cases, nearly every joint can be affected. While it’s not a degenerative condition that worsens over time, many sufferers require lifelong help with daily activities.

Fetal akinesia — lack of baby movement in the womb — is the main cause of this disorder. This may occur because a central nervous system malfunction does not send nerve impulses to the baby’s muscles or because amniotic fluid leaks out of the womb, causing it to be an atypical shape that leaves little room for movement. In other instances, the baby’s muscles do not form normally for whatever reason. A third of babies with arthrogryposis have a genetic cause, but most families have no greater risk for having another child with the disorder.

arthrogryposis
Image Source: DINF.ne.jp

How Is Arthrogryposis Treated?

“For most types of arthrogryposis, a rigorous treatment of physical and occupational therapy can be successful in the improvement of the range of motion of the affected joints,” according to Shriner’s Hospital for Children. Early treatment includes using splints and casting to improve foot position and increase range of motion. Surgery is often required to address more serious deformities. Yet, new technology-based treatments are emerging, such as the Wilmington Robotic Exoskeleton that helps little Emma Lavelle [pictured below] get around.

Avenues, a national support group for people with the disorder, conducted a survey for their newsletter assessing the effectiveness of various pain management techniques. They found that:

– 44% of people found some relief using prescription or OTC anti-inflammatory medication.

– 20% used massage or deep muscle therapy.

– 18% used hot packs, hot showers, baths, or saunas to find relief.

– 12% used exercise, physical therapy, wheelchairs, or canes to get by.

Our NYC Center for Podiatric Care Treats Tough Medical Issues

Occasionally, in extreme cases when other treatments fail to provide pain relief, a patient may choose amputation. “This is a very personal decision, but severe pain can lead you to these kinds of decisions and it is difficult for an outside person to judge,” acknowledges Dr. Nadia Levy, who has treated difficult congenital conditions at our NYC Center for Podiatric Care and Sports Medicine. She warns against viewing amputation as an “easy solution” to pain. She adds, “When making the decision to amputate, one should keep in mind the risk of phantom pain and any other compensatory pains that can results from altering biomechanics.” Instead, she recommends getting a second opinion on more conservative measures that can improve a person’s quality of life.

 

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If you have any foot problems or pain, contact The Center for Podiatric Care and Sports MedicineDr. Josef J. GeldwertDr. Katherine Lai, Dr. Ryan Minara and Dr. Mariola Rivera have helped thousands of people get back on their feet. Unfortunately, we cannot give diagnoses or treatment advice online. Please make an appointment to see us if you live in the NY metropolitan area or seek out a podiatrist in your area.