What is foot and ankle rheumatoid arthritis?
Rheumatoid arthritis (RA) is an autoimmune disease in which the immune system is overactive and attacks multiple joints throughout the body. In many cases of RA, symptoms start in the small joints like the hands and feet and typically affects the same joints on both sides of the body. A staggering 90% of those diagnosed with RA will develop symptoms in the foot and ankle at some point in their lives following diagnosis.
What causes foot and ankle rheumatoid arthritis?
There is no direct cause of foot and ankle rheumatoid arthritis. While there are murmurings that the cause may be genetic, most doctors and researchers suspect that it takes a chemical or environmental “trigger” to activate the disease in those who inherit RA.
What are symptoms of foot and ankle rheumatoid arthritis?
Symptoms of foot and ankle rheumatoid arthritis include:
- Pain
- Swelling
- Stiffness
- Affecting the same joints on each side of the body
Signs of RA in the ankle include:
- Trouble with ramps and stairs
- Pain on the inside or outside of the ankle
- Pain with walking or standing alone
Signs of RA in the heel include:
- Trouble walking on uneven ground
- Pain below the shin radiating toward the outer edge of the foot
- Flatfoot deformity due to shifting bones
- Pain and discomfort in the arch of the foot
Signs of RA on the top of the foot include:
- The arch of the foot collapsing and feet that point outward
- Pain resulting from damaged cartilage with or without shoes on
- Shape of the foot may even change over time due to the degenerative nature of the disease
- Prominent, bony enlargement may also appear on the arch of the foot making it increasingly difficult to wear shoes.
Signs of RA in the toes and ball of the foot include:
- Bunions, claw toes, and pain in the ball of the foot
- Additional bumps on the ball of the foot can cause calluses to develop
- In the most severe cases, ulcers may form from the pressure being placed on the toes and ball of the foot
How is foot and ankle rheumatoid arthritis diagnosed?
If your healthcare provider suspects foot and ankle rheumatoid arthritis, following an in-office exam, they may order an x-ray, CT scan or MRI to get a better look at your specific affliction. A referral to a rheumatologist may be made for further testing and assessment by those who know the disease best to provide a course of action.
What are treatment options for foot and ankle rheumatoid arthritis?
Unfortunately, there is no known cure for RA, but there are several treatment options available to manage the pain and encourage patients to live healthy and active lives. Often, your rheumatologist may suggest physical and occupational therapy, or intervention from a rehabilitation specialist or an orthopaedic surgeon.
It’s important to note that while intervention may provide relief, it does not stop the progression of the disease. In most cases, treatment is nonsurgical and involves pharmaceutical drugs that have been designed to prevent the immune system from destroying the joints. Your doctor may also recommend resting, icing, taking NSAIDs, using orthotics or a steroid injection as a conservative, non-invasive route to relief from symptoms.
In more severe cases and/or if conservative options have been exhausted, your doctor may recommend surgery that fuses or replaces the affected joint.