Rheumatoid Arthritis (RA) is a disease in which certain cells of the immune system malfunction and attack healthy joints. RA causes inflammation in the synovium (lining) of joints, most often in the joints of the hands and feet. The signs of inflammation can include pain, swelling, redness, and a feeling of warmth around affected joints. In some patients, chronic inflammation results in damage to the cartilage and bones in the joint. Serious damage can lead to permanent joint destruction, deformity, and disability.
When joints become inflamed due to RA, the synovium thickens and produces an excess of joint fluid. This overabundance of fluid, along with inflammatory chemicals released by the immune system, cause swelling and damage to the joint’s cartilage and bones. Foot problems caused by RA most commonly occur in the forefoot, although it can also affect other areas of the foot and ankle. Deformities and conditions associated with RA may include: rheumatoid nodules, dislocated toes, hammertoes, bunions, heel pain, Achilles tendonitis, flatfoot, and ankle pain.
RA is usually diagnosed prior to visiting a foot and ankle surgeon; however, a podiatrist may be the first to diagnose RA. It is diagnosed on the basis of a clinical examination as well as blood tests. While the treatment of RA focuses on the medication prescribed by a patient’s rheumatologist, there are various options for treatment plans aimed at relieving the pain of RA-related foot problems. The plan may include one or more of the following options: orthotic devices to give proper support, accommodative shoeing to relieve pressure points, steroid injections to reduce inflammation, and surgery as a last resort to correct any deformities associated with RA.