How to Relieve Rheumatoid Arthritis Foot Pain

Most RA patients experience foot problems, such as painful ankles, swollen joints, and discomfort in the big toe. Find out how to reduce and ease stiffness and discomfort in your feet.

The 55-year-old blogger Cathy Kramer was diagnosed with rheumatoid arthritis (RA) in 2004. For her, the hallmark of RA has always been painful feet.

My feet's joints were among the first to suffer damage; X-rays have revealed minor joint erosion. My feet have always been a bothersome spot, even on my best days," Kramer adds. The wearing away of bone and cartilage in a joint is referred to as erosion. It is brought on by inflammation of the lining of the joint.

Kramer isn't by himself. The American Orthopaedic Foot and Ankle Society estimates that almost 90% of RA patients experience some form of foot discomfort, which makes walking challenging and limits everyday activities.

Foot and Ankle Issues Associated with RA: Pain, Burning or Tingling, and More

The American Academy of Orthopaedic Surgeons (AAOS) states that foot and ankle problems are the initial sign of rheumatoid arthritis in around 20% of cases. Rheumatoid arthritis can affect any joint in the foot, however, it usually affects the joints or ball of the foot. The ankles may seem swollen and provide the most pain for certain persons.

Patients typically complain of pain in their ankles, ligaments, or toe joints when they get out of bed. It is linked to warmth, redness, and swelling in the joints. Additionally, rheumatoid nodules may form. A larger shoe size may be required as a result of joint abnormalities and forefoot broadening, according to Maya Mattar, MD, a rheumatologist at the Louis Stokes Cleveland Veterans' Administration Medical Centre in Ohio. Dr. Mattar continues, "You might have to wake up an hour or more early to get ready for the day because the pain and stiffness might be worse in the morning."

In October 2022, a study published in Rheumatology International found that among individuals with rheumatoid arthritis, the most common self-reported foot symptoms were pain (73%), dry soles (68%), thickened toenails (58%), and cold feet (57%).

Patients with RA may also develop rheumatoid neuropathy, or nerve pain, in their feet. A summary of a study published in the journal Cureus in January 2023 states that burning or tingling in the foot can be caused by peripheral nerve discomfort. This sensation can start slowly and progress up the legs. Tarsal tunnel syndrome or nerve entrapment (compression) can be brought on by persistent pressure on the foot.

How Inflammation Leads to RA-Related Foot Pain

Rheumatoid arthritis produces inflammation of the synovium, the lining that lines the joints of the foot, just like it does in other parts of the body. According to the AAOS, inflammation can result in joint bone erosions and other damage that damages the foot.

The joint capsule, which typically functions as a sleeve to protect the joint by providing stability, is one of the targets of this inflammation.

Rheumatoid arthritis-related abnormalities include some of the following:

Hallux Valgus Bunions This is an expansion of the big or little toe's base joint.
Toe Hammer When the toes are bent all the time, it might result in claws or hammertoes.
Bursitis: Under the ball of the foot, fluid-filled sacs called bursae form. These sacs can swell and become inflamed. They frequently coexist with bunions.
Known by the name Charcot Foot and Ankle Arthropathy A deformity known as Charcot arthropathy may develop in the foot if one or more ankle or foot joints sustain significant injury.
Foot Fasciitis Pain beneath the heel is a result of inflammation of the plantar fascia in the foot's sole.
Arthritis Nodules These pea-sized, solid lumps develop when pressure is applied to the foot, such as the big toe joints and soles.
Converse Heel A valgus heel is the result of the heel pushing outward due to joint injury.

Treating Rheumatoid Arthritis Foot Pain

A range of shoes, braces, orthotics, exercise therapy, and surgery are among the treatment options for different foot ailments, as reported in a study that was published in the Journal of Foot and Ankle Research.

According to AAOS, surgery is frequently required to relieve the pain brought on by bunions, hammertoes, and nodules. To rectify the position of bones and joints, foot surgery may entail resetting bones or fusing joints.

Injections of local steroids are very helpful for plantar fasciitis and inflammatory joints. However, the AAOS advises trying noninvasive methods like braces or selecting shoes or inserts made to support your feet before booking surgery or an appointment for injections.

You must treat and manage your RA to lessen the inflammation-related foot pain you experience. According to Mattar, disease-modifying anti-rheumatic medications (DMARDs) can reduce inflammation and shield joints from harm.

If neuropathy is the cause of foot discomfort, DMARDs, along with other drugs such as analgesics and some antidepressants, physiotherapy, and a transcutaneous electrical nerve stimulation unit, are advised.

The Best Shoes to Wear When You Have RA

The Arthritis Foundation states that heels and narrow- or pointy-toed shoes are unhealthy for the foot because they force the wearer to place pressure on the ball of the foot, which can result in abnormalities.

According to a review of studies published in the Journal of Foot and Ankle Research, orthotics—special inserts placed between the bottom of your foot and the insole of your shoe—can relieve rheumatoid arthritis-related foot pain and may even help prevent deformities in the foot. Additionally, good arch support will help distribute weight evenly over your entire foot.

According to a study of medical specialists that was published in PLoS One, if you have RA, you should purchase shoes with midfoot support, a large, roomy toe box, easily adjustable fastenings, and detachable insoles.

More Tips to Relieve or Avoid Foot Pain

Apart from appropriate footwear, medicine, and possibly surgery, there exist methods to mitigate foot pain caused by rheumatoid arthritis:

Modify the exercise you choose to do. Exercise is necessary to maintain joint mobility, but selecting activities that don't strain your feet excessively, like swimming, can help prevent more foot pain. When she can, Kramer says she likes to ride her bike.
Engage in podiatric work. In addition to helping you discover the ideal orthotics for your shoes, a foot specialist may take care of calluses and other irritations on your feet to make them feel more comfortable.
Invest in shoes that you will truly wear. According to Mattar, people don't always wear the special shoes that have been recommended because of issues with fit, comfort, or style. Kramer suggests trying on new shoes in a range of settings and occasions. She gets her shoes online and returns them if they don't fit her expectations.
Take note of your feet. Kramer claims that by becoming more attuned to her feet, she has learned to choose the shoes she will wear every day. She says, "I don't have many shoes, but the ones I do have are good and let me hear what my feet have to say." Her feet, for instance, require a lot of assistance on certain days and space to breathe on others.
Release the weight. Don't stand still all day. Make an effort to switch up your schedule so that you spend some of the day standing and some sitting.
Aim for a healthy weight. High body mass index "was significantly correlated with foot pain and foot-related activity limitations" in RA patients, according to a June 2023 study published in Current Rheumatology Reviews. It was also linked to issues with shoes and foot abnormalities.
Every day, check your feet for issues. As soon as you see blisters or small cuts and scratches, bandage them; if they don't heal after two or three days, consult a physician.
Get a massage or take a warm foot bath. To relieve sore joints, experiment with hot or cold therapy as needed. Kramer uses coconut oil to massage her feet every day, and she swears by it.

The ideal strategy to treat your rheumatoid arthritis is to maintain control over your foot pain. You can maintain your feet's happiness if you do.

FAQs

Is walking good for arthritis in feet?

Walking is recommended for people with arthritis

How can I stop arthritis pain at night?

Avoid doing activities in the evening that cause flare-ups of arthritis pain.

What is the best pain reliever for feet?

Acetaminophen (paracetamol) or aspirin

Does arthritis foot pain go away?

There is no cure for arthritis

Is arthritis in the foot serious?

Untreated osteoarthritis in the feet can result in total cartilage loss.