Rheumatoid arthritis (RA) in the feet occurs due to an autoimmune condition. This means a person’s immune system mistakenly attacks their own body.
Medication, ice packs, and rest may aid in managing symptoms. Some lifestyle changes, such as exercising regularly and quitting smoking, can also help. Once deformities develop, surgery may be necessary to help reduce pain.
Keep reading to learn about the symptoms of RA in the feet and how the condition affects the joints. The article also discusses treatment options and some lifestyle tips to consider.
RA is a chronic, progressive condition. According to the American Academy of Orthopedic Surgeons (AAOS), it develops in roughly 1% of the world’s population. Additionally, females are three times more likely to develop it than males.
With a condition such as RA, instead of fighting infections, the immune system attacks body tissues. This causes inflammation in the lining of joints, damages the cartilage in them, and eventually destroys the affected joints and the tissues supporting them.
The most commonly occurring symptoms are swelling, pain, and stiffness in joints, according to the AAOS. Osteoarthritis usually affects a few joints, and on occasion — only one joint. By contrast, RA affects multiple joints and the same joints on both sides of the body.
As the condition progresses, inflammation in the joints may result in weakened ligaments and instability and deformity of the joints. This in turn may lead to stress fractures.
According to the AAOS, in more than 90% of people with RA, symptoms occur in the ankle and foot.
An early sign of ankle involvement is difficulty walking on stairs or ramps. Later, walking and standing become painful.
An early sign of heel involvement is difficulty walking on uneven ground. Over time, the alignment of the bones may shift and cause a flatfoot deformity. Pain and discomfort may be present.
Toes and ball of foot
Signs include bunions, pain under the ball of the foot, and a deformity of the toes that resembles a claw. The big toe often crosses over the second toe. Bumps may develop on the ball that turn into calluses.
The ligaments weaken, which may cause a collapse of the arch. When this happens, the front of the foot points outward. The inflammation damages the cartilages, which cause pain with or without shoes.
Other body areas
Aside from the foot, the condition can affect multiple joints and result in inflammation throughout the body.
The Arthritis Foundation explains that when this happens, it can cause:
Treatment for RA can be nonsurgical or surgical.
Nonsurgical treatments include:
- Disease-modifying antirheumatic drugs: These medications help stop the immune system from attacking the joints.
- Ice: This involves placing ice over a painful area of the foot for 20 minutes. A person can apply ice three to four times per day.
- Rest: Stopping or limiting activities that worsen the pain helps. However, a person with the condition should still attempt to exercise regularly.
- Nonsteroidal anti-inflammatory drugs: Medications such as naproxen and ibuprofen reduce pain and inflammation. A person should consult a doctor before taking any of these drugs.
- Steroid injections: Administering a cortisone shot in an affected joint may help in the early stages. However, while it may reduce inflammation temporarily, it does not stop the progression of the condition.
- Orthotics: Soft orthotics, such as shoe insoles, may reduce pressure and pain. Hard orthotics generally create more pain.
- Braces: A lace-up ankle brace may help alleviate mild to moderate foot and ankle pain. People with a severe flatfoot deformity may benefit from a leather or custom-made brace.
The following are some of the surgical options:
- Fusion of the affected joints: This surgery fuses together the two bones that make up a joint. It is the most common type of surgery for RA.
- Front of the foot surgeries: These include operations to correct hammertoes. These deformities involve an abnormal bend in the middle joint.
- Ankle replacement: In some people, this can decrease pain and discomfort.
- Joint replacement implants for midfoot: These may preserve some midfoot function.
An array of lifestyle strategies can improve a person’s quality of life. The
- Getting regular exercise: Experts recommend 150 minutes of moderate exercise per week, even for a person with RA. Examples of appropriate activities for a workout include walking and swimming.
- Enrolling in an RA physical exercise program: These are community-based classes that enable people with the condition to safely get enough exercise.
- Quitting smoking: Smoking worsens the condition and makes it harder to exercise. That is why a person may wish to seek help with stopping smoking.
- Joining a self-management education class: This program teaches individuals how to manage symptoms and live with arthritis.
- Maintaining a moderate weight: In people with the condition, obesity may lead to many problems.
Getting medical attention quickly may help preserve joint function. It may also reduce the risk of the development of other serious problems.
People should watch for symptoms such as joint pain, swelling, and stiffness. It is also advisable to make an appointment with a doctor if joint symptoms linger 3 days or more or if several episodes of joint symptoms occur within a month.
When seeking medical attention, an individual may wish to start with a primary care doctor. However, they may need to see a rheumatologist, who is a specialist in diseases that affect the joints. A primary care doctor can refer a person to a rheumatologist.
RA in the feet involves inflammation that can weaken ligaments and damage joints. This in turn may lead to the development of an array of painful deformities.
In addition to affecting the feet, the condition may develop in the hands and other parts of the body, such as the skin, eyes, blood vessels, and major organs, such as the heart and lungs.
RA can result in permanent joint damage. That is why a person should contact a doctor as soon as symptoms appear. Treatment may slow the progression of the condition.