EFFECTS OF RHEUMATOID ARTHRITIS ON THE FEET

Rheumatoid arthritis is a chronic disease that attacks multiple joints throughout the body.  It most often starts in the small joints of the hands and feet and usually affects the same joints on both sides of the body.  More than 90% of people with rheumatoid arthritis develop symptoms in the foot and ankle over the course of the disease.

Rheumatoid arthritis is an auto immune disease which means that the immune system attacks its own tissues an the defences that ordinarily protect the body from infection damage normal tissue instead (such as cartilage and ligaments) and soften bone.  The lining of the joint swells and becomes inflamed which slowly destroys the joint.

Symptoms you may be experiencing:

  • pain, swelling and stiffness in joints of both feet (unlike osteoarthritis, which usually effects one specific joint, symptoms of rheumatoid arthritis usually appear in both feet, affecting the same joints on both feet);
  • difficulty walking up stairs and ramps (inclines) which indicates that the ankle is affected;
  • difficulty walking on uneven ground, grass or gravel which indicates that the heel region is affected;
  • shape of foot changing to become flatter, resulting in pain in the arch of the foot or the inside of the ankle;
  • collapsed arch making the front of the foot point outwards;
  • large bony prominence (bump) in the arch;
  • bunions;
  • claw toes;
  • pain under the ball of the foot (metatarsalgia);
  • bumps on the ball of the foot, creating calluses.

Initial care - things to try at home:

  • apply a heat pack to sore feet to help relieve symptoms of stiff, painful joints;
  • ensure that you wear comfortable, well-fitted shoes;
  • limit activities that make the pain worse - consider non-weight bearing activities such as swimming;
  • ice painful areas after activity, ensuring that you use a wet cloth between the ice pack and the skin.

Our approach to solving your problem:

  1. Our Podiatrists will complete a thorough assessment of the foot and ankle including skin condition, foot shape, flexibility and tenderness to pressure.
  2. As part of this assessment, you may be referred off to get an X-ray, MRI or CT scan.  If you are not already seeing a rheumatologist, this may also be arranged for you via communication with your GP.
  3. We will assist you to make good footwear choices to compliment your changing foot shape and function.
  4. Providing skin and nail care may be necessary if your movement and flexibility is effected by your arthritis, rendering you unable to reach your feet to cut your own nails.
  5. By doing a biomechanical assessment, we will consider whether orthotic therapy may be beneficial for you to give you more arch support and structure for your feet.  
  6. In severe cases, an ankle brace may also be prescribed and fitted for extra support of the joints in the back of the foot and ankle.
  7. We will ensure that we communicate thoroughly and consistently with your GP, rheumatologist and any other health care professionals on your management team.

We will then create a management plan specific to you to:

  1. help settle the pain;
  2. address the causative factors;
  3. identify the biomechanical dysfunction;
  4. strengthen the related muscles around the joints;
  5. provide long-term solutions, where possible;
  6. liaise with other members of your health care team;
  7. keep you as active as possible, enjoying the activities that you love!

As a sufferer of rheumatoid arthritis, you may be eligible for a Chronic Disease Management plan which would entitle you to up to five bulk-billed podiatry appointments in a calendar year at our clinic.  If this is the case, your GP will arrange the paperwork to be sent to our clinic, usually via fax at 9894 0242.

If you would like help from one of our Podiatrists to manage your arthritis symptoms, please give us a call on 9894 2463 or book online to make an appointment.