Midfoot arthritis is an extremely common condition in middle-aged and elderly people and seems to be much more common in women. As the ligaments and joints in the midfoot deteriorate, flattening of the arch can occur.

Deterioration of the joints in the midfoot can occur through a single catastrophic event during trauma. A single highintensity blow, twist, or fracture can damage fragile cartilage and their supporting ligaments enough to begin the deterioration that eventually leads to cartilage destruction. More commonly, the joint destruction is more insidious. Over long periods of time, fairly subtle factors can injure a joint. In the same way that a car with poor shock absorbers jars the passengers within, the cartilage experiences more intense jolts of pressure with normal activity if the bone is stiffer.

Pain, stiffness, and swelling are common signs of arthritis. Often the pain occurs on the initiation of activity or with prolonged or intense activity. In the foot, it can cause arch pain and the loss of the arch and bony prominences around the joints. In general, arthritis progresses over a period of years but the rate of progression is variable and the amount of pain is difficult to predict by simply looking at an x-ray.

Despite its prevalence, midfoot arthritis rarely requires surgery. Nonsurgical treatment includes stress reduction strategies such as rocker-soled shoes, arch supports, and rehabilitative exercises. Surgical treatment usually involves fusion of the arthritic joints, a procedure that requires prolonged weight restriction and a significant risk of complications.