If you have rheumatoid arthritis—especially if you’ve been recently diagnosed—chances are that you have dealt, or will deal, with RA symptoms in your feet.
According to the American Academy of Orthopaedic Surgeons, at least 90% of people with RA experience foot or ankle inflammation at some point.
The good news is there are specific treatment options available to lessen pain, maintain mobility, and head off possible deformities.
Where and when symptoms occur
If you have RA, pain and inflammation in your feet, ankles, and/or toes may come and go when you’re experiencing a flare-up—or it may be more constant. But even if the symptoms subside after a flare-up, it’s important to seek treatment in order to delay or prevent long-term damage to the joints and soft tissues.
RA symptoms in the feet and ankles are often located in 3 main places:
- In the ball of the foot, where the long metatarsal bones in the foot meet the base of the toes
- Between the bones of the toes, sometimes referred to as the toe knuckles
- In the back of the foot and the ankle
Common symptoms are pain, stiffness, swelling, tenderness, and joints that are warm to the touch. As is usual with RA, symptoms are usually experienced in both feet at the same time. RA can also trigger the growth of nodules (round hard bumps under the skin) on the balls of the feet, on the toes, or on the instep.
How RA in the feet can be treated
Part of the overall treatment plan for any RA symptoms in the feet and ankles will include your general treatment for RA throughout your body, such as disease-modifying anti-rheumatic drugs (DMARDs) or biologics.
Additionally, there are several measures that can be taken to address foot and ankle symptoms:
1. Choose the right shoes.
Choose shoes that are both comfortable and supportive. If you have symptoms in your ankle, shoes with “rocker” soles may help.
2. Try orthotics.
In addition to the right shoes, you may benefit from shoe inserts, especially if your symptoms are at the middle or front of your foot. Check with your insurance about coverage for custom inserts.
3. Go to a physical therapist.
Expert guidance on the best ways to exercise and strengthen your joints can make a big impact both on current pain and mobility and future risk for deformities.
4. Do cold therapy.
Cold footbaths or compresses can ease inflammation and swelling. You can also use warm footbaths to improve circulation.
5. Wear a splint or brace.
This can add stability and prevent posture errors that could contribute to pain or future deformity.
6. Consider steroid injections.
These can be helpful for short-term and limited use, but experts discourage their use long-term because the repetitive use can damage soft tissues.
In the immediate term, these measure can help lessen pain and swelling and improve mobility. They also offer longer term benefits, like delaying or preventing foot deformities such as dislocated toes, bunions, hammertoes, or flatfoot.
In severe cases—such as when deformities have already occurred and/or walking is impossible without pain—there are surgical procedures that can help too. Surgery may also be recommended for young patients who are in danger of developing deformities later.
Surgical options vary depending on the joints involved and the extent of damage. They may include removing cartilage and bone to accommodate the joints, replacing joint structures with implants, or fusing bones together to eliminate the joint completely.
If RA symptoms in your feet or ankles are causing you pain or limiting your everyday activities, talk with your doctor about the best treatment options for you.