Rheumatoid Arthritis In the Foot and Ankle

Rheumatoid arthritis (RA) is a systemic disease that attacks multiple joints throughout the body with the first symptoms typically appearing in the toes and feet.  These initial symptoms include pain, swelling, and stiffness in the joints, sole, or ball of the foot.  The joints may also feel warm and the pain may be so severe that a person’s walking pattern changes.  The new demands placed on the foot can lead to corns, bunion, claw toes, or hammertoes.  Since RA affects the entire body, people frequently have feelings of fever, fatigue, and loss of appetite.  Women are affected three times more often than men are especially under 40 years of age.


The frequent appearance of symptoms to initiate in the foot may mean a podiatrist is the doctor diagnosing RA.  To determine a patient has RA, our doctors will ask about the patient’s medical history, occupation, recreational activities, and family history.  They commonly conduct x-ray studies to determine the amount of damage to the bones and joints.  Blood tests are used to determine if the patient is anemic or has an antibody called rheumatoid factor.  While antibodies are normally produced by and protect the body, in RA a few antibodies turn against the body by attacking the lining of joints.  The attacks lead to joint inflammation causing pain and swelling.  Eventually the lining in the joint breaks down and damage to the bones can occur.  The damage may be so severe that joint deformities form.


Many people with RA can control the pain and disease with medication and exercise.   Medications such as aspirin or ibuprofen are used to control the pain and there are many prescription drugs able to help slow the spread of the disease.  There are also steroid injections available to relieve the joint swelling and inflammation.  In addition to drugs, a podiatrist may prescribe special shoes to help the foot function properly.  Unfortunately, RA is a progressive disease that currently lacks a cure.  Through medication, exercises, and surgery the effects of RA can be reduced and its progress slowed.