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Rheumatoid arthritis is an autoimmune disease that causes inflammation and pain in your joints. Unlike osteo–arthritis, which is caused by wear and tear to the joints, rheumatoid arthritis attacks the lining of the joints. The symptoms of rheumatoid arthritis generally develop over a period of time, but in some cases can progress quickly. The pain most often associated with rheumatoid arthritis is usually a throbbing and aching pain, it is often worse in the mornings and after a period of rest. As well as pain, your joints may feel stiff, especially in the morning. Because rheumatoid arthritis causes swelling of the joints, they may also feel hot and tender to touch. In some cases, rheumatoid nodules (firm swellings) may develop under the skin around painful joints. Although rheumatoid arthritis mainly affects your joints, other symptoms include a lack of energy, fever, weight loss and lack of appetite.
Although rheumatoid arthritis can cause problems in any joint of the body, the joints of the hands and feet are often the 1st to be affected. Up to 90% of people with this condition will report associated problems with their feet. The metatarsal phalangeal joints (ball of the foot) are most often affected; other common deformities caused by rheumatoid arthritis are hallux valgus (bunions) and hammer toes. The natural fatty padding on the balls of feet is often affected, slipping forward underneath the toes, which can cause a sensation like walking on stones.
It is not only the front of the foot that is affected, it is common for the arch to collapse and for the back of the foot to bend outwards (valgus hindfoot). Rheumatoid arthritis can also affect the ankle joint, leading to pain, stiffness and difficulty walking.
Due to the change in shape of the foot, the development of corns and calluses (hard skin) is very common especially over high-pressure areas: these may develop into areas of ulceration (pressure sores). Some people with rheumatoid arthritis can experience poor circulation to the feet and legs, caused by hardening of the arteries. This can lead to cramp like pains, especially in the calf muscles, thigh and buttock muscles when walking but also makes healing more difficult. Some people may also experience peripheral neuropathy, which leads to a lack of sensation in the feet. Due to these factors, it is imperative to seek professional advice if you are suffering from symptoms affecting your feet. Regular treatments and checkups with your podiatrist cannot only keep your feet comfortable and keep you mobile but also help prevent infection and ulceration.
To prevent painful corns and calluses and to limit the chances of you developing pressure sores/ulceration, you should look to wear a shoe that comfortably accommodates your foot. You may require a shoe that has a deeper and wider toe-box than regular shoes, and that supports your arch. Special insoles, called orthoses, can also be very helpful in maintaining comfort and mobility. These insoles can be designed and manufactured to reduce pressure on painful areas, support the arch and reduce stress on painful tendons and ligaments.
If you suffer from rheumatoid arthritis and have painful or uncomfortable feet, we highly recommend you see a podiatrist regularly. If you suffer from rheumatoid arthritis but do not have any foot symptoms, it is recommended that you see a podiatrist twice a year for checkups to help prevent any problems occurring.