Pictures of How Arthritis Affects the Feet

How Arthritis Affects the Feet in Pictures

If you live with arthritis, chances are you feel the painful effects in your feet. Many types of arthritis can affect the joints of the feet, as well as the skin and toenails. These include osteoarthritis (OA), rheumatoid arthritis (RA), gout, psoriatic arthritis (PsA), and ankylosing spondylitis (AS).

OA in the feet affects up to 17% of people ages 50 and over. In people with RA, foot involvement is common, and more than 90% of people with RA report foot pain as a symptom. Foot involvement in gout is up to 85%.

PsA can affect the joints of the feet and ankles, as well as the structures supporting the joint. According to the National Psoriasis Foundation, up to 50% of people living with PsA also experience enthesitis in their feet.

Enthesitis refers to inflammation of the entheses, the places where ligaments and tendons connect to bones. Common locations for enthesitis include the bottoms of the feet and in the Achilles tendon. Much like PsA, AS can affect the small joints of the feet and the entheses.

Anyone with any type of arthritis can experience foot involvement. Arthritis of the feet can make it hard to walk and perform activities of daily living. And while arthritis has no cure, there are treatment options available to slow down the disease and relieve symptoms. With appropriate treatment, people with arthritis can manage pain, stay active, and lead fulfilling lives. 

How Different Types of Arthritis Affect Your Feet

It is not unusual to have foot involvement with arthritis. Many types of arthritis are known for attacking the small joints of the feet, ankles, and toes.

Osteoarthritis

OA is considered a wear and tear disease because it causes the cartilage in the joints to wear down from repeated stress over time. As the cartilage thins out and deteriorates, the bones lose their protective coverings and start to rub together, leading to pain and inflammation of the affected joints. 

According to the National Institute on Aging, OA is the most common type of arthritis affecting older adults. It is also a leading cause of physical disability in older adults. OA affects both men and women. Before age 45, it is more common in men than in women; after age 45, it becomes more common in women.

In the foot, OA mainly affects the first metatarsophalangeal joint (MTP) connecting the big toe and the foot. It also affects the midfoot and ankle. 

Sometimes an injury can lead to OA, although it might take years after an injury for OA to develop. For example, an injury to the big toe (e.g., dropping something on the toe) can eventually lead to OA later in life. OA in the midfoot can be the result of a sprain or a fracture. OA in the ankle usually occurs years after a severe sprain or fracture of the ankle.

Foot OA symptoms include pain and swelling of affected joints, stiffness especially after sitting for too long, and pain in joints that improves with rest. Some people with OA might hear crunching noises with movement of their feet or ankles, or they may feel unsteady on their feet.

OA in the ankles might cause ligament instability, which can add strain on joint cartilage. Eventually, this causes weakness of the muscles in the ankles and pain that radiates into the foot and makes it harder to walk and put weight on the ankle.

Abnormal foot mechanics, such as flat feet, can also lead to OA of the feet. Flat feet might reduce stability in the ligaments, which puts excessive strain on the foot joints.

High arches, also called cavus foot, can increase the risk of OA in the feet. With a high arch, weight is placed on the ball of the foot and heel when walking or standing. With time, this means pain and instability of the foot. Anyone can be affected by high arches regardless of age, and the condition can affect one foot or both feet. 

Rheumatoid Arthritis

RA is an autoimmune disease that affects multiple joints throughout the body. Autoimmune diseases are conditions in which the immune system attacks the body’s healthy tissues.

According to the Cleveland Clinic, RA affects more than 1.3 million Americans. It is two and a half times more common in women than in men. And while it can affect anyone regardless of age, including children, RA tends to strike between the ages of 20 and 50.

RA often starts in the feet and ankles. It is symmetrical, meaning it affects the same joints on both sides of the body.

With RA, the immune system causes inflammation that attacks the synovium (lining of the joints) covering the joints, causing them to become swollen and painful. Over time, these attacks can lead to bone, joint, ligament, and tendon damage, which eventually results in joint deformity and/or disability.

RA can affect the ankles, the heels, the midfoot (top of the foot), and the forefoot (toes and ball of the foot). Foot involvement becomes worse as RA progresses. Persistent foot inflammation, swelling, and pain from RA will make it harder and painful to walk and stand over time.

Gout

Gout is an inflammatory type of arthritis that causes a great deal of foot pain for people with the condition. Gout is caused by uric acid buildup in the joints, and often that buildup makes its way into the feet.

Uric acid is generally present in blood and eliminated through urine, but with people who have gout, uric acid adds up and crystallizes in the joints.

Gout can affect anyone, although it affects men earlier than it does women. It usually occurs in women only after menopause. Men are up to three more likely than women to have gout because they have higher levels of uric acid in their bodies than women do.

Gout causes swelling and pain in the joints of the foot, especially the big toe. These sudden and intense attacks can make it feel as if the foot is on fire. Other symptoms of a gout attack include redness and warmth over the affected joint.

Gout attacks can recur if gout isn’t treated. Untreated gout can also lead to damage to the joints, tendons, and other tissues.

Psoriatic Arthritis

PsA is a form of inflammatory arthritis that often affects people with the autoimmune skin condition psoriasis. It can affect any of the joints of the foot, plus the ankle joints and the ligaments and tendons of the foot. It causes parts of the feet to become inflamed, sore, and tender. 

PsA affects men and women equally. According to the National Psoriasis Foundation, an estimated 30% of people with psoriasis also have PsA. Psoriasis affects 2% to 3% of the world’s population.

Foot involvement in PsA can cause significant pain and difficulty with walking, especially in the morning and after sitting for a long period. PsA is also associated with many different foot conditions, including dactylitis, Achilles tendonitis, plantar fasciitis, and arthritis mutilans:

  • Dactylitis is severe inflammation around the finger or toe joints. Severe inflammation can make the digits look like sausages. Severe dactylitis can cause the toes to be so rigid that it can be difficult and painful to flex them.
  • Achilles tendonitis occurs when the tendon connecting the calf muscles (the Achilles tendon) to the heel becomes painful or inflamed where it attaches to the heel bone.
  • Plantar fasciitis causes inflammation at the place where the plantar fascia (the soft tissue under the foot) attaches to the heel bone.
  • Arthritis mutilans is a complication of RA and PsA. It is characterized by severe inflammation that damages the joints of the hands and feet, resulting in deformity and disability.

Ankylosing Spondylitis

AS is a type of inflammatory arthritis that attacks the spine and large joints. Much like PsA, AS causes inflammation of the entheses. A common location in the foot affected by enthesitis is the Achilles tendon at the back of the heel. This type of inflammation is painful and can affect the ability to walk and step on the heel.

Additional foot problems associated with AS are plantar fasciitis, foot cramping, toe cramping, and toe clawing. Cramps and clawing of the toes result from spine involvement that affects loading through the legs and feet. Toe clawing is common in people with spine curvature.

Photo Gallery of Arthritic Feet

Arthritic problems related to the feet include arthritis in the heels and ankles, arthritis in the big toe, gout in the big toe, claw toes, and arthritis at the middle or top of the foot.

Arthritis in the Heel and Ankle

Arthritis - heel and ankle

sompong_tom / Getty Images

Several types of arthritis, including OA, RA, AS, and PsA, can affect the heels and the ankles.

Symptoms of arthritis in the heel might include:

  • Stiffness upon awakening in the morning
  • Recurring pain in the heel
  • Swelling of the heel
  • Limited movement
  • Skin changes, including rashes and growths

Inflammation at the heel from RA, AS, or PsA can lead to conditions that cause heel pain. This might include Achilles tendonitis, plantar fasciitis, or retrocalcaneal bursitis, a condition in which the bursa (the fluid-filled sac at the heel bone) becomes inflamed, causing pain and swelling.

The ankle is not affected by arthritis as often as other joints, but it can be a source of severe pain and instability when it is affected. Additional symptoms of ankle arthritis include swelling and stiffness of the ankle and problems with mobility. Ankle arthritis will eventually affect gait—the way a person walks.

Arthritis in the Toes

Arthritis in the Toes

Ocskaymark / Getty Images

Arthritis in the toes is often the result of wear and tear of the cartilage in the toe joints or inflammation of the toe joints. The big toe is most often affected by arthritis, but other toes can also be involved.

Common symptoms of arthritis of the toes may include pain that can take hours or days to resolve and swelling and inflammation in and around the toe joints. Both RA and PsA can cause significant pain and swelling. However, with PsA, the toes become so swollen that they can resemble sausages (dactylitis).

Additional symptoms of arthritis in the toes might include:

  • Restricted range of motion due to swelling or cartilage damage
  • Development of bone spurs, which can further restrict movement
  • Difficulty and pain with bending the toes
  • A toe that might bend permanently downward
  • Pain that worsens with weight-bearing activity—running, walking, climbing stairs, etc.
  • A bump formation or sore
  • Pitted, separated, thickened toenails
  • Curling of toes—hammertoe or claw toe

Gout in the Big Toe

Gout in the big toe and foot

Robert Kirk / Getty Images

A gout attack in the big toe might cause intense throbbing and burning joint pain. Gout attacks are known for coming on suddenly and causing swelling, tenderness, redness, warmth, or discoloration of the affected joint. 

Because gout attacks can cause severe pain and swelling, a person experiencing the attack can struggle with walking or standing for long periods.

Claw Toes

Claw toe
PAUL CAMPBELL / Getty Images.

Claw toes are a condition in which the toes bend into a claw-like position. Claw toes are not a serious problem on their own, but they are generally a sign of an underlying condition like arthritis.

You should call your doctor if your toes show signs of becoming clawed. Your toes may seem flexible early on, but they can become stuck in this position permanently over time. Treatment is important to keep this from happening.

Arthritis in the Middle/Top of the Foot

Mid/Top of the Foot Arthritis
SDI Productions / Getty Images.

Arthritis might affect the middle or top of the foot. In the midfoot, symptoms include pain and swelling that becomes worse with standing and walking. Arthritis can also cause a bony bump or bulge at the top of the foot.

Other Changes in Appearance

OA, RA, PsA, gout, and AS can cause changes in the appearance of feet. These include skin and nail changes, bunions, bursae inflammation, and nodules.

Skin and Nail Changes

Skin and nail changes

daizuoxin / Getty Images

Inflammatory arthritis, especially PsA, can cause skin and nail changes. For example, rashes associated with PsA and psoriasis can occur anywhere on the body, including on the feet. PsA is also associated with a condition called palmoplantar pustulosis, which can cause tiny, pus-filled blisters on the soles of the feet.

Up to 80% of people with PsA will have nail involvement. Toenail symptoms are also common in people with RA.

Nail changes associated with arthritis include pitting (small indents in the nails), discoloration, brittle nails, and onycholysis (nails separating from the nail bed).

Bunions

Bunions

bgwalker / Getty Images

Bunions are bony bumps that form at the joint at the base of the big toe. They occur when the bones at the front part of the foot move out of place. This will cause the tip of the big to be pulled toward the smaller toes, forcing the joint at the base of the big toe to stand out. The skin covering the bunion can become red and sore.

Bunions are often associated with arthritis conditions, especially inflammatory types, like RA.

Bursae

Bursae
Pornpak Khunatorn / Getty Images.

Inflammatory arthritis can inflame the natural bursae of the foot. Bursae are thin, fluid-filled sacs that act as a cushion and reduce friction between bones and soft tissues like muscles, tendons, and skin. The foot and ankle have several bursae that can become inflamed and painful.

Conditions like RA can cause the bursae to become inflamed, leading to a symptom called bursitis. This symptom is often seen in the early stages of RA. Bursitis can lead to pain, swelling, and redness. Bursa pain can be disabling and affects the ability to walk.

Nodules

This photo contains content that some people may find graphic or disturbing.

Rheumatoid nodules on toe joints

Hopfphotography / iStock / Getty Images

Some people who have RA can develop hard lumps under their skin called rheumatoid nodules. In the feet, these nodules appear over the Achilles tendon, in the heel, or over any bony spots. Nodules can be painful with walking and as they rub against shoes or socks.

More Symptoms of Arthritis in the Foot

Additional common symptoms of arthritis in the foot include swollen or warm joints, joint pain and stiffness, clicking or popping sounds with movement, and locked joints.

Swelling or Heat

Swelling and warmth are common characteristics of inflammation. When inflammatory arthritis affects the feet or the ankles, you may experience swelling of one or more joints of the feet, ankles, or toes. Abnormal warmth in one or more areas of the foot often accompanies swelling in the joints of the feet, even while the rest of the body remains generally cool.

Swelling is noticeable after a person has been sitting for a long time, or after they get out of bed in the morning. Swelling can make it hard to put on your shoes, and shoes may feel tight when you first start walking around.

Pain and Stiffness

Pain is one of the most common symptoms of arthritis in the feet. You may feel general foot pain with stepping, pain in the toes, and/or pain only in the big toe.

Foot pain can be sharp or stabbing depending on the amount of inflammation or the level of damage in the foot. Pain can make it harder to do normal daily activities.

Arthritis is known for wearing away at the cartilage between the joints, inflaming tissues, and damaging synovial fluid (fluid responsible for lubricating joints). All these changes will make the joints in your feet, ankles, and toes stiff and make it harder for you to move.

The lack of cushion and support makes joints harder to bend and stretch, which leads to pain. And because your toes play a big part in maintaining your balance, pushing your feet off the ground, and moving with each step you take, you might experience further pain with walking.

Clicking or Popping Sounds

The sound you hear when you crack your knuckles is the same one your toes will make when flexed if you have arthritis. You hear this sound because the cartilage has deteriorated. With no cushion, the bones will rub against one another and cause these noises.

If you develop bone spurs in the feet, you may hear clicking and popping. According to the Cleveland Clinic, the feet are commonly affected by bone spurs, either from arthritis or from joint damage.

Locked Joint

Locked joints are typical when there is a lot of swelling and stiffness. Locking means that the joint is hard to bend. Rough edges on bones and bone spurs can also cause joints to lock up.

Toe joints can get locked up, which can be painful. Fortunately, a locked toe joint isn’t permanent. You can usually loosen a locked joint by walking around or manipulating the toe joint so it bends again.

Coping With Arthritic Feet

Your doctor might recommend different therapies to treat arthritis in your feet. This might include:

Your doctor might recommend surgery if other treatments don’t work to manage foot and ankle arthritis. Surgical options might include:

  • Arthrodesis: Also called fusion surgery, this involves fusing bones together with rods, pins, screws, or plates. When bones heal, the bones will stay joined.
  • Joint replacement surgery: Also called arthroplasty, this surgery is used only in severe cases. The surgeon will take out damaged bones and cartilage and replace them with metal and plastic.

Home remedies you can try to help you cope with arthritic feet include:

  • Creams containing capsaicin or menthol: These creams may stop the nerves from sending out pain signals.
  • Hot or cold packs in the affected areas
  • Gentle exercises, including yoga and tai chi
  • Foot massage

Making changes to your lifestyle can also help you to feel better and keep arthritis in your feet from getting worse. Lifestyle changes might include choosing low-impact exercises like swimming rather than high-impact ones (e.g., jogging), maintaining a healthy weight to keep stress off joints, and reducing or avoiding activities that trigger symptoms in the feet and ankles.

A Word From Verywell

Arthritic foot and ankle pain can be debilitating, but it is treatable. If you have foot pain that is connected to diabetes, a recent trauma, or a high fever, you should seek out immediate medical attention.

You should also reach out to your doctor if you experience pain in both feet, have swelling, redness, and warmth in one foot or both feet, or if you see a visible deformity in your foot.

If you have chronic foot pain that comes and goes, talk to your doctor about any pain that lasts longer than a couple of weeks, swelling that lasts longer than a few days, or numbness in either foot for any amount of time. These are symptoms that might indicate an underlying health condition that requires ongoing treatment. 

Was this page helpful?
23 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Roddy E, Thomas MJ, Marshall M, et al. The population prevalence of symptomatic radiographic foot osteoarthritis in community-dwelling older adults: cross-sectional findings from the clinical assessment study of the foot. Ann Rheum Dis. 2015 Jan;74(1):156-63. doi:10.1136/annrheumdis-2013-203804 

  2. Lee SW, Kim SY, Chang SH. Prevalence of feet and ankle arthritis and their impact on clinical indices in patients with rheumatoid arthritis: a cross-sectional study. BMC Musculoskelet Disord. 2019;20(1):420. doi:10.1186/s12891-019-2773-z 

  3. Rome K, Frecklington M, McNair P, et al. Foot pain, impairment, and disability in patients with acute gout flares: A prospective observational study. Arthritis Care Res (Hoboken). 2012;64(3):384-8. doi:10.1002/acr.20670

  4. National Psoriatic Arthritis. Classification of psoriatic arthritis.

  5.  National Institute on Aging. Osteoarthritis. Updated May 1, 2017. 

  6. Blalock D, Miller A, Tilley M, Wang J. Joint instability and osteoarthritis. Clin Med Insights Arthritis Musculoskelet Disord. 2015;8:15-23. doi:10.4137/CMAMD.S22147

  7. Penn Medicine. Flat foot and high arches treatment.

  8. Cleveland Clinic. Rheumatoid arthritis. Updated November 17, 2017.

  9. Weatherford BM. Rheumatoid arthritis of the foot and ankle. American Academy of Orthopaedic Surgeons. Updated September 2017.

  10. Cleveland Clinic. Gout. Updated November 15, 2020.

  11. National Psoriasis Foundation. Psoriasis statistics. Updated October 8, 2020.

  12. Detzell E. National Psoriasis Foundation. When psoriatic disease strikes the hands and feet.

  13. Ozaras N, Havan N, Poyraz E, et al. Functional limitations due to foot involvement in spondyloarthritis. J Phys Ther Sci. 2016;28(7):2005-2008. doi:10.1589/jpts.28.2005

  14. University of Washington. Ankle arthritis

  15. Arthritis Foundation. When foot pain may mean arthritis.

  16. American Academy of Orthopaedic Surgeons. Claw toe. Updated September 2017.

  17. Sobolewski P, Walecka I, Dopytalska K. Nail involvement in psoriatic arthritis. Reumatologia. 2017;55(3):131-135. doi:10.5114/reum.2017.68912

  18. Pascual-Ramos V, Méndez-Flores S, Domínguez-Cherit J, et al. Nail abnormalities in a cohort of rheumatoid arthritis patients: repetitive trauma-related findings in toenails are associated with radiographic damage [abstract]. Arthritis Rheumatol. 2019; 71 (suppl 10).  

  19. Arthritis Foundation. Bursitis

  20. Dakkak YJ, Niemantsverdriet E, van der Helm-van Mil AHM, et al. Increased frequency of intermetatarsal and submetatarsal bursitis in early rheumatoid arthritis: a large case-controlled MRI study. Arthritis Res Ther, 2020; 22(1). doi: 10.1186/s13075-020-02359-w

  21. Tastekin E, Birtane M, Kilinc S, et al. From pathology to diagnosis: a symptom-free patient with a rheumatoid nodule in the foot. Turk J Rheumatol 2012;27(3):195-199. doi: 10.5606/tjr.2012.032

  22. American Bone Health. The mechanics of walking. Updated January 28, 2019.

  23. Cleveland Clinic. Bone spurs (osteophytes). November 16, 2020.