Rheumatoid Arthritis in Feet: What to Know

Rheumatoid arthritis (RA) is a chronic inflammatory condition that affects many joints throughout the body, including the feet. RA is an autoimmune disease; it develops when your immune system mistakenly attacks its own tissues. RA in the feet causes pain, swelling, limited movement, and difficulty with everyday tasks.

This article discusses RA in the feet, including the symptoms, complications, and treatment.

Symptoms of RA in the Feet

There are 26 bones, 30 joints, and more than 100 supporting soft tissues in each of your feet. Rheumatoid arthritis can affect any or all of these joints. In fact, more than 90% of people with RA will have symptoms that affect their feet.

Rheumatoid arthritis causes inflammation that affects the soft tissues and bones in the joints of your feet, causing pain, swelling, reddened and/or warm skin, and limited movement.

Tissues such as cartilage (padding between your bones), ligaments (connecting bone to bone), tendons (connecting muscles to bones), and the joint capsule (tissue that encloses the entire joint) are broken down by the body's immune system.

You'll likely have difficulty walking and standing for long periods of time as the disease progresses. RA affects both feet at the same time, making standing tasks even more difficult.

Complications of RA in the Feet

As rheumatoid arthritis in the feet progresses, deformities often develop. These include:

• Flattened arch: As the ligaments that hold your foot bones in place are damaged, bones begin to move out of place. This can cause your arch to "collapse," causing a flatfoot deformity.
• Bunion: RA can cause your first toe to angle in toward your second toe, causing a painful bump at the base of your big toe. This deformity is called a bunion.
• Claw toe: This deformity affects your second through fifth toes when the small joints of your toes are bent at sharp angles, giving them the shape of a claw.

RA can also affect circulation to your feet from damage to your blood vessels. Nerve damage can also occur, leading to tingling or "foot falling asleep" sensations.

How Is RA in the Feet Treated?

Rheumatoid arthritis is a "whole-body" condition. Some treatments are aimed at your overactive immune system, while others target the symptoms in your feet. Treatment includes medications, home remedies, and sometimes surgery.

Medications

Medications called disease-modifying antirheumatic drugs, or DMARDs, are commonly used to suppress the overactive immune system in people with RA. These drugs can eventually help decrease symptoms in your feet, but it can take several months for them to be effective.

Anti-inflammatory medications can help with foot symptoms during a flare-up, or periods of time when your symptoms are worse. These can include over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) such as Aleve (naproxen) and Advil (ibuprofen), or prescription-strength steroid medications for more severe symptoms.

Home Remedies

Home remedies can significantly decrease pain caused by RA in your feet.

• Rest: Avoid activities that increase your pain. This can be difficult with foot pain. If you have to walk or stand frequently, schedule rest breaks into your day.
• Unload your feet: Consider using a cane or walker to unload your feet if you're having significant pain with walking. When using a cane, either hold it in the hand opposite the foot that hurts the most or use a cane in each hand. A walker with wheels can be helpful for long distances. Some walkers have a seat attached to provide a place for you to sit and rest.
• Wear compression socks: Wear compression socks during the day to help improve circulation and reduce swelling from RA.
• Warm them up: Apply hot packs to your feet or soak them in warm water for 15 to 20 minutes at a time to increase blood flow and decrease pain. Heat can also help decrease stiffness.
• Keep them moving: RA causes joint stiffness. Gentle exercise can help decrease stiffness in your ankles and feet. Sit with your legs elevated. Slowly circle your ankles in each direction 10 times. Draw the alphabet in the air, using your big toe to "write." Avoid any movements that increase your pain.
• Choose your shoes: Footwear can contribute significantly to RA symptoms in your feet. Choose shoes with a wide toe-box (front of the shoe) to avoid additional pressure on your joints. Avoid high heels. Choose shoes with built-in arch support if you have pain in the soles of your feet.
• Try orthotics: Shoe inserts can provide additional support for your feet. Although you can buy inserts over-the-counter, you might have better results with custom-fitted orthotics. Consult a physical therapist or podiatrist for specific recommendations.

Surgery

In some cases, surgery might be required to treat symptoms of RA in the feet—particularly if you have deformities.

Summary

Rheumatoid arthritis is an autoimmune condition that causes inflammation throughout the body. RA commonly affects the joints, including your feet. Symptoms include pain, swelling, warmth, red skin, difficulty walking, and foot deformities. Treatment includes medications, home remedies, and sometimes surgery.

A Word From Verywell

Rheumatoid arthritis in your feet can make every step you take painful and frustrating. However, help is available. See a physical therapist for individualized exercise instructions and tips for making walking easier. If your medications aren't effective, talk to your healthcare provider about other options. Consider joining a support group for encouragement and additional tips for improving your quality of life.