If you live with arthritis, you are likely to feel the painful effects on your feet. “The feet are tremendously affected by arthritis,” says Vinicius Domingues, MD, a rheumatologist in Daytona Beach, Florida, and medical advisor to CreakyJoints.
In fact, osteoarthritis (OA), the most common type of arthritis, affects the feet of one in six people over 50. With rheumatoid arthritis (RA), the most common type of inflammatory autoimmune arthritis, more than 90 percent of patients develop symptoms in the foot and ankle throughout the disease. In about 20 percent of cases of RA, the symptoms of the foot and ankle are even among the first signs of the disease.
It is not surprising that you can feel arthritis in the feet: the disease mainly affects the joints and your foot contains more than 30 joints.
How different types of arthritis hurt your feet
Several types of arthritis present differently in the feet.
- Osteoarthritis most commonly affects the first metatarsophalangeal (MTP) joint that connects the big toe with the foot, although it is also often found in the middle of the foot and ankle.
- Rheumatoid arthritis usually appears on both feet and affects the same joints on each foot. This contrasts with OA, which usually affects a specific joint.
- Gout often affects only the feet, often the big toe. Read more about the treatment of a gout flare.
- Psoriatic arthritis (PsA) can also affect the toes, causing a sausage-like swelling called dactylitis. PsA is often also accompanied by inflammation of the entheses, the places where the tendons and ligaments attach to the bones. In the feet, this usually presents as a plantar fasciitis, an inflammation of the band of tissue that connects the heel bone with the toes, as well as the bony projections known as bony spurs, which can cause pain if they press or rub other bones or soft tissues.
- Ankylosing spondylitis also causes enthesitis, such as plantar fasciitis and pain in the Achilles tendon.
How to cure arthritis foot pain
Now that we’ve established why your feet hurt, consider these strategies to relieve the pain, stiffness and swelling that arthritis patients often know all too well.
1. Use pain medication
Nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen, and naproxen, available in both the over-the-counter and prescription versions, are a first-line treatment to reduce the pain, swelling, and redness associated with arthritis, even when arthritis strikes the feet. NSAIDs help block the production of prostaglandins, a group of chemicals that play a role in pain and inflammation. Because these medications can increase the risk of cardiovascular and gastrointestinal problems, be sure to talk with your doctor before taking them for short or long term use. Your doctor may choose instead to prescribe a topical anti-inflammatory such as Voltaran Gel, which is minimally absorbed systemically and is less likely to cause side effects.
2. Invest in suitable footwear.
“When you have arthritis, your shoes will help you or hurt you,” says Jackie Sutera, DPM, a podiatrist surgeon in New York City. The proper fit is a key factor in how foot-friendly shoes are. In addition to having to accommodate an arthritic joint that may have stiffness, swelling and contracture, the shoes must fit the hammertoes and bunions that often occur along with the arthritis. Comfort brands such as Vionic, Ecco, Clarks and Mephisto are designed to be stylish and comfortable. They include arch support, heel cups, thick soles, cushioning and shock absorption.
People with bad osteoarthritis of the feet can benefit particularly from shoes with rocker sole, which have a thicker than usual sole with a curved heel. A shoe with this type of sole (common in sports shoes) reduces the pressure under the toenail joint by 12 percent in people with OA, according to a study. In a recent study, the pain score in those wearing rocker-sole shoes improved by 22 points.
3. Establish a goal of weight loss
When it comes to arthritis, what your scale says really matters. People with a higher body weight are diagnosed with arthritis at a younger age and have more severe arthritis. It makes sense: “The feet are a joint that supports weight, so obesity worsens arthritis,” says Dr. Domingues. Even an extra pound in your frame can equal approximately five extra pounds of strength on your feet. Losing 20 pounds can mean avoiding an additional 100-pound strength from your feet with each step.
Excess body weight also increases inflammation, which feeds the painful symptoms of inflammatory types of arthritis such as rheumatoid arthritis and psoriatic arthritis. It is not easy to lose weight when you have stiff or aching joints, but it has been shown that even a reduction in body weight of five to 10 percent drastically reduces joint pain and improves exercise tolerance. Take a look at these weight loss tips that are especially useful when you have arthritis.
4. Move more
It can be difficult for even healthier people to maintain an exercise program, so for people with joint pain it can be especially difficult. But the benefits of exercise when you have arthritis are clear: research shows that moderate regular exercise helps maintain joint function while reducing pain and fatigue and relieving stiffness. And, of course, it can be very useful to burn calories, so you can lose weight. Be sure not to believe this obsolete myth about exercise and arthritis.
Try to stay as active as possible (any movement counts, even walking the dog, walking in the garden and stopping while talking on the phone) and find comfortable ways to stay active. Instead of running outside, try walking on the treadmill, which provides more shock absorption. Or try other lower-impact exercises, such as swimming, rowing, bicycling or using the elliptical machine. “You’ll still get cardiovascular benefits from them without hitting your feet,” says Dr. Sutera. Your goal is to perform up to 150 minutes of aerobic exercise a week, divided into shorter periods (even in blocks of five or 10 minutes) if that is easier for your joints.
5. Use ice or heat.
“I am a great believer in the ice; it’s a great anti-inflammatory, “says William Spielfogel, DPM, head of podiatry at Lenox Hill Hospital in New York City. “But I have patients who swear by the heat.”
Each therapy works differently to provide pain relief: cold therapy contracts the blood vessels in the surrounding muscles, which decreases the flow of blood to the joints to reduce swelling and inflammation. Heat therapy helps loosen muscles to decrease spasms and reduce joint stiffness. Both also act on the receptors in your skin to interrupt the pain signals sent to the brain.
Depending on the type of pain you experience, you may consider using both ice and heat. For example, if you are stiff in the morning, a warm shower can relieve symptoms, so you can move better. When your RA becomes inflamed or has inflammation of the OA (maybe a whole day of standing), a cold compress or a bag of frozen peas (wrap it in a paper towel before applying it to the skin) can help put pain and swelling in the ice. .
6. Investigate the inserts.
Custom-made orthoses can help soothe arthritic foot pain. “The beauty of the orthosis is that there are many ways we can individualize its use,” says Dr. Sutera. They can be customized to change the mechanics of your foot, for example, to limit the articulation of the big toe so that you can not move while walking (and, therefore, reduce discomfort). Or they can be made to fit better on your feet, for example, by adding support cushioning.
Because the severity of foot pain from arthritis can vary between the left and right foot, the customization of your orthosis may be different on each side of the foot. Research on orthosis and foot pain is limited, but a 2016 study that uses shoe insertions to treat pain by MTP found a clinically valuable improvement in foot pain and foot-related disability for a period of time. Three-month period, and almost 80 percent of participants said they were. effective.
7. Try alternative treatments.
Although research has repeatedly shown that supplements such as glucosamine and chondroitin do not work well for most people, Dr. Domingues sometimes recommends them for patients with osteoarthritis, who have fewer medication options than inflammatory types. arthritis. Glucosamine and chondroitin are natural components of the cartilage in joints that break down in people with OA. “Anecdotally, we find that people feel better about them,” he says. The brand that recommends is Osteo Bi-Flex, which contains glucosamine, chondroitin and Boswellia herbal extract, among other ingredients.
Another promising treatment is turmeric, which, according to some research, may be useful for treating osteoarthritis and inflammatory arthritis such as RA. A spice that is the main ingredient in curry, turmeric contains an antioxidant called curcumin that helps fight inflammation.
To add flavor to your arthritis treatment, many doctors also recommend creams that contain capsaicin, a component of chili peppers. “It works very well topically, especially in the feet,” says Dr. Sutera. In a study of 70 people with osteoarthritis and 31 with rheumatoid arthritis, 80 percent of people who applied capsaicin (compared with a placebo) experienced some reduction in pain. After four weeks, the pain of RA was reduced by 57 percent and the pain of OA was reduced by 33 percent.
8. Consult a physiotherapist.
“Physical therapy comes into play when it comes to controlling foot pain due to arthritis and there are all kinds of PD modalities that can be used to reduce inflammation, including massages, swirls, cold compresses, ultrasounds and lasers,” he says. Dr. Spielfogel. Once the initial swelling has subsided, a physiotherapist will develop a stretching and strengthening program to restore flexibility and improve strength to increase balance and reduce stress on the foot joints.
Dr. Sutera finds that patients in the early stages of arthritis benefit most from physical therapy, since they often still have flexibility and most need help to restore their balance.
9. Ask about steroid injections.
Doctors often use steroids such as cortisone to help with the acute inflammatory process and stabilize patients. Cortisone acts as a powerful anti-inflammatory; When injected into a joint, it can help reduce swelling and inflammation and decrease discomfort. When cortisone is injected, its anti-inflammatory effects begin immediately, but the time it takes to experience pain relief can vary from days to weeks. There are many misconceptions about cortisone injections because there are different types of cortisone. In general, says Dr. Sutera, you can receive three injections of cortisone in the same number of months before taking a long break before receiving another round.
10. Pamper your feet
If you have arthritis in your feet, you probably have it in your hands, too, and that can make maintenance difficult. But trimming nails and smoothing corns on a regular basis is important, says Dr. Sutera. “If you already have stiff joints, you do not want to aggravate the problem with long nails, which can take up space in your shoe and create a painful pressure.”
Consider giving yourself a salon pedicure every four to six weeks. Just be sure to choose a room that values cleanliness, for example, by using disposable liners inside the foot tub and allowing you to bring your own nail files, pumice stones and tampons. “You can only clean metal tools, so it’s safer to bring your own,” says Dr. Sutera. If you have diabetes or circulation problems, check with your doctor to make sure it is okay to have a salon pedicure. The development of an infection can lead to serious complications in these cases.
11. Learn about your surgery options
When foot arthritis is severe and conservative treatment options fail, surgical intervention may be an option. A type is a fusion of the joint of the big toe, which fuses the two bones that make up the joint. This limits the range of movement of the joint, helping to eliminate the source of pain. Another option is joint replacement surgery for the toe joints. Both are considered end-of-game measures, but for people who are healthy enough to handle the surgery, it can allow them to function much better.