How to Banish Rheumatoid Arthritis-Related Foot Pain

When you have rheumatoid arthritis—or any other type of rheumatic disease—you’re more prone to developing foot issues. But you don’t have to live in pain; read on to find relief!

Jean Weiss
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Feeling hampered by pain when you walk? A slew of annoying culprits—from bunions to hammertoes to gout—could be the cause. And if you have rheumatoid arthritis (RA) or other rheumatic conditions, you’re even more likely to develop these problems. But there are ways to find relief from these common offenders. Just read on . . .

Pain offender: corns and calluses
These thickened layers of skin are caused by repeated pressureor friction and are a common problem for people with arthritis. Luckily, they’re easy to treat.

Pain reliever: remove excess skin
Extra skin can be simply and safely removed with a blade. But go to a podiatrist, not a pedicurist, to remove them—especially if you have foot pain. “Most pedicurists have no training with surgical instruments,” says Dr. Reid. “And they don’t know how to recognize what a corn or callus really is.”

Pain offender: hammertoes, mallet toes, claw toes
Which problem you have depends on which of the two joints in your toe is bent downward. You have a hammertoe when the joint near the base of your toe is bent down. A mallet toe results when the joint near the tip of your toe is bent. And it’s a claw toe when both joints are bent.

Pain reliever: stretched leather shoes with a spacious toe box
Wearing leather shoes—which are more flexible than man-made materials—that can be stretched to fit around your toes may reduce the pain associated with these conditions, says Dr. Reid. “You also need a deeper toe box because the toes bend upward,” she adds. If your shoes are not roomy enough, you can always have them stretched. Dr. Reid says, “Just as with bunions, you can ask your doctor about standard pain relievers and cortisone injections to reduce pain and inflammation, or surgery can straighten bent joints.”

Pain offender: gout
This happens when uric acid—normally flushed out of the body—pools around joints. Gout can strike any joint, though it often occurs in the big toe.

Pain reliever: ice the painful joint
Sudden attacks of gout are extremely painful, and icing your toe throughout the day can ease the inflammation. If the pain won’t go away, Dr. Reid suggests asking your doctor to recommend an over-the-counter anti-inflammatory.     

Pain offender: bunions
This unsightly bump is caused by a bone that sticks out from the side of your big toe joint—and it’s a common cause of foot pain. A recent study in Arthritis Care & Research found that a little over a third of people with osteoarthritis (OA) have a bunion, and the bigger the bunion, the worse the pain and disability—which can be significant, considering the big toe joint carries a lot of the body’s weight while walking.

Pain reliever: a bunion splint, and shoes with a wider toe box
If you still have mobility in your toe joint:
A bunion splint can realign your toe and ease the pain by removing pressure from the joint, says Marlene Reid, MD, DPM, president of the Illinois Podiatric Medical Association. “A splint can’t permanently fix the problem,” she notes, “but there are additional things you can do to help, such as wearing shoes with a wider toe box.” You can also ask your healthcare provider about custom orthotics—shoe inserts made especially for your feet.

But if your toe joint isn’t flexible: Ask your healthcare provider about using over-the-counter anti-inflammatory drugs—or if your pain flare-ups are really bad, you can ask about getting cortisone shots in the toe joint. Surgery may be another option, Dr. Reid says, noting that it can work for someone who is healthy overall, relatively young and has good circulation.

Alert! Your joints might not be your foot-pain culprit
Don’t automatically blame arthritis, bunions or bent toes for your foot pain. Here are other common causes that require a visit to your healthcare provider.

  • Soft-tissue injury: This happens when your ligaments or tendons have been strained or torn.
  • Bone spur fracture: Small pieces of an enlarged bone can break off and create pain in your foot—such as a spur that has grown on a bunion because of abnormal wear and tear.
  • Compressed or entrapped nerves: Nerves in your foot can get squeezed or stuck between parts of bone or scar tissue, creating pressure and pain.
  • Bursitis: Sometimes the fluid-filled sac—known as a bursa—that lies near a joint and acts as cushioning becomes inflamed. This could happen as a result of arthritis, injury, infection or overuse of the joint or tendons in that area.
April 2013