Foot Health

Arthritis and Feet

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What is it?

A lot of people are not aware that arthritis affects the feet as well as other parts of the body. The average person takes 7000 steps or walks 8km every day, so it is not surprising that arthritis should affect this hard-working part of the body.The foot is a very complex structure with 33 joints that allow it to absorb the impact of walking and adapt to changes in walking surfaces. Arthritis in one or more joints of the foot will affect the way the joints work and as a result, walking may become painful and difficult.

Why does it occur?

Arthritis in the feet may be caused by:

  • Inherited factors
  • Structural/joint problems
  • Injuries
  • Infections in the joint
  • Systemic conditions or disease (e.g. Psoriasis and Rheumatoid Arthritis)

Who does it affect?

The most common type of arthritis in the feet is osteoarthritis, which usually develops in people aged 45 and older. It may also develop in younger people where a joint has been injured. Other forms of arthritis such as rheumatoid arthritis or gout commonly affect the feet, causing some of the various problems mentioned above.

Symptoms

People who have arthritis in the feet may have

  • Swelling in one or more joints
  • Recurring pain or tenderness in any joint
  • Redness or heat in a joint
  • Limitation in motion of joint
  • Early morning stiffness
  • Pain when walking

Common problems associated with many types of arthritis in the feet may be: bunions, hammer toes, claw toes or generally enlarged joints. Corns, calluses, thickened nails and ulcers or pressure areas can develop due to the occurrence of joint changes.

Diagnosis

Tests may not be required to diagnose osteoarthritis in the feet; signs and symptoms such as restricted joints, stiffness or pain may be enough. Other forms of arthritis such as rheumatoid arthritis or gout may require X-rays or blood tests to confirm the diagnosis.

Management

There are many different important factors involved in the management of arthritis in the feet. Many relate to maintaining a level of comfort so that exercise (another important part of managing arthritis) is possible.

Skin care

Arthritis in the feet may cause joint deformity. These prominent joints may be subjected to increased pressure and lead to the development of skin lesions such as corns and callus over the area. It is important not to let the hard skin build up as it often causes pressure and discomfort.

Footwear

The shape of the foot may change as a result of arthritis so shoes should be selected to accommodate the altered shape.

Important features of a shoe include:

  • Flat: High heels push body weight forward on to the front of the foot thus increasing the
    pressure on these joints.
  • Roomy toe box: The area of the shoe around the toes should be spacious enough so that no part of the shoe rubs against the toes or joints.
  • Leather: Natural fibres allow for better ventilation, which is healthier for the skin.
  • Non-slip rubber sole: Rubber soles provide extra shock absorption, which is often lacking
    in feet affected by arthritis.
  • Fastening across midfoot: Laces, velcro or buckles will hold the shoe firmly on the foot without squashing the toes. Shoes that slip at the heel may rub against the skin and damage
    it. They also increase the risk of falls.
  • Enclosed heel: To provide support and stability for the feet.

Podiatry

There are many things a podiatrist can do to help people with arthritis including:

  • Assessment of the feet and advise about strategies for managing the condition.
  • Advice about the types of shoes most suitable to the activity and the foot shape.
  • Removal or reduction of the hard skin that may develop on toes or under the foot as a result of joint changes. They can also use different methods to protect the areas and prevent recurrence.
  • Treating nails which have become thickened and difficult to cut.
  • Prescription of orthoses or shoe inserts. As part of a consultation the podiatrist will assess the person's feet and way of walking and prescribe the orthoses most appropriate for the type of problem the person has.

You do not need a doctor's referral to visit a podiatrist.

Orthoses

Foot orthoses are shoe inserts designed to support and improve the function of the foot. With arthritis, the foot does not function as well because joint movement may be restricted. Orthotic devices may be used to increase cushioning or shock absorption and also direct pressure away from the more sensitive areas of the feet. Foot orthoses may be custom-made from a cast of the person's foot or they may be off-the-shelf and made to fit a particular shoe size.

People who have orthoses must remember to take the devices when they shop for new shoes as the shoe will need to be deep enough to accommodate the device comfortably. In the case of feet that are particularly misshapen with arthritis, it is be advisable to have shoes fitted by a specialist footwear retailer.

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