Rheumatoid arthritis commonly affects the foot in up to 90% of sufferers. It can affect all areas of the foot by causing foot deformity such as bunions, claw toes and flat feet. It is common to get joint swelling (synovitis), achillles pain and arch pain. Sometimes you can get soft lumps known as rheumatoid nodules. There can also be issues with blood flow and nerve damage.
What causes it?
The inflammatory process in RA affects the joints and soft tissue by progressively weakening them. For joints, the inflammation can damage the strong supporting ligaments, which causes the joint to become unstable. This can contribute to changes in foot shape. The inflammation also affects the tendons; they become weak and begin to stretch. This can make walking or standing very painful and uncomfortable.
Treatment is tailored towards symptom relief and assisting with function. In early stages of the disease wearing supportive footwear and orthotics can improve function and limit disability. Physical therapies such as low level laser therapy are excellent for swollen irritable joints. Other techniques such as myofascial release although there is limited research on its effectiveness, the podiatrists at Bounce Podiatry have found improvement in people with RA, particularly in pain levels and joint range of motion. As the disease progresses and foot shape changes, adjustments to footwear choices and orthotics are necessary. For any tendon issues, it is imperative to be given correct exercises to rehabilitate the tendon. It is important to get the RA foot regularly screened for changes in foot shape, biomechanics, skin condition and checking blood flow and nerve function.