As we age, there are a number of different disorders that can interfere with our ability to remain active and healthy. One of those is arthritis, which is characterized by a painful swelling of the cartilage and lining of the joints. Because the foot and ankle contain a significant number of the body’s bones and joints – not to mention the tremendous daily load they support – it isn’t surprising that many people first start to notice the symptoms there. In this article, we provide an overview of Rheumatoid arthritis (RA) of the foot an ankle.
Rheumatoid arthritis is a chronic autoimmune disease that can affect joints throughout the body. It often starts in the small joints of the ankle and foot. Rheumatoid arthritis is the most common type of inflammatory arthritis. Up to 90% of people with Rheumatoid arthritis complain about foot pain and discomfort associated with living with RA. When an ankle or foot is affected by Rheumatoid arthritis, the inflamed synovial membrane leads to pain when walking, standing, or even wearing shoes.
How Rheumatoid arthritis shows up in the foot and ankle
There are over 30 joints in the foot and ankle. These joints are called synovial joints. The name is derived as a result of the presence of a thin membrane called synovium. The membrane produces a clean and viscous fluid that nourishes and lubricates the joints. In patients suffering from RA, there is a malfunction of the body’s autoimmune system, thereby attacking healthy tissue. Because of the daily loads placed on the foot and ankle area in normal daily and physical activities, inflammation and degeneration can progress more rapidly than elsewhere in the body.
Symptoms of Rheumatoid arthritis
Rheumatoid Arthritis symptoms usually occur in multiple joints on both feet. In particular, you may feel pain or experience joint pain, tenderness, and swelling of the joints. Most patients experience these symptoms in the forefoot, which include the toes and metatarsophalangeal joints at the ball of the foot. Unlike “everyday” aches, this pain may stretch into days or weeks, prompting them to see a podiatrist for assistance.
If left untreated, the most frequent symptoms are abnormal appearance (deformities) of the foot, pain, stiffness and joint instability. The symptoms of RA can vary within an individual, improving for a period of time, and then dramatically increasing in what is called a “flare”, which can suddenly increase levels of inflammation and pain for months.
Aside from the joint damage, RA symptoms can include rheumatoid nodules (small growths appearing under the skin), inflammation and scarring int he lungs that can interfere with normal breathing, inflammation of the blood vessels that can lead to neuropathy, and more. These complications require that patients exercise self-management after being diagnosed with Rheumatoid arthritis. The goals of self management are to relieve symptoms, stop inflammation, prevent joint damage, and reduce the risk of dangerous complications long term.
Treating of Rheumatoid Arthritis of the Foot and Ankle
Anti-Rheumatic drugs can be of help. However, there are special types of treatment that target the foot and ankle. Your foot and ankle specialist should work with your rheumatologist to provide a great management plan.
Non – Surgical treatments
Physical Therapy can be used to stretch and straighten joints of the ankle and foot. This will improve joint mobility and function. Physical therapy can also prevent future joint damage and reduce the risk of foot deformity.
Foot massage often helps the tendons and soft tissues of the foot to remain tender and also promote blood circulation, which may have been reduced due to the inflammation caused by RA).
Supportive shoes and orthotics can make walking more comfortable. Avoid wearing high heels.
Inflammation and pain can be reduced by steroid injection. However, excessive steroid injection can further damage the soft tissues of the foot.
A pediatric surgeon will consider surgery if you cannot walk without pain or if foot and toe deformities cannot be managed effectively with accommodative braces and shoes.
Surgery can also be recommended if the doctor thinks that surgery will improve foot biomechanics and functionality, thereby preventing future joint degeneration. The goal of surgery is reducing pain, correcting physical deformity, improving foot function, making standing and walking comfortable and increasing shoe options.
At Houston Foot and Ankle Care, we help patients impacted by debilitating diseases such as Rheumatoid arthritis, osteoarthritis, diabetes, and others. These patients often need treatment for acute foot and ankle problems, where Dr. Maislos can provide non-surgical and treatment. Living with these disorders, they also need a knowledgeable foot specialist whose passion is helping people preserve mobility and maintain healthy feet. Call (713) 541-3199 to schedule an appointment with Dr. Maislos. We accept most forms of major medical insurance.
Call (713) 541-3199 if you experience:
- pain in the forefoot lasting more than a week
- swelling and tenderness in the ankle
- appearance of bumps in the ball of the foot