Rheumatoid Arthritis

Rheumatoid arthritis is a condition where the immune system attacks the joint lining tissue, causing painful inflammation and stiffness. Nearly 1.3 million people in the United States have some form of RA.



Foot problems caused by RA commonly occur in the forefoot, although they can also affect other areas of the foot and ankle. The most common signs and symptoms of RA-related foot problems, in addition to the abnormal appearance of deformities, are pain, swelling, joint stiffness and difficulty walking.

Deformities and conditions associated with RA may include:

  • Rheumatoid nodules (lumps), which cause pain when they rub against shoes, or pain when walking if they appear on the bottom of the foot.
  • Dislocated toe joints
  • Hammertoes
  • Bunions
  • Heel pain
  • Achilles tendon pain
  • Flatfoot ankle pain

Over time, these symptoms can cause your foot to become increasingly painful and difficult to use. One of the long-term symptoms is known as joint destruction. This happens when the bone, cartilage, and other joint tissue breaks down. This can make your foot joints weaker and extremely painful to use, and you may notice a change in your foot shape as a result.

As you age, flare-ups may become more severe and periods of remissions shorter, but your experience may differ based on what treatments you receive, how often you’re on your feet, and your overall health.

Potential Treatments

Your doctor will develop a treatment plan aimed at relieving the pain of RA-related foot problems.

The plan may include one or more of the following options:

  • Orthotic devices. Your doctor will fit you with custom orthotic devices to provide cushioning for rheumatoid nodules, minimize pain when walking and give you the needed support to improve the foot’s mechanics.
  • Accommodative shoes. These are used to relieve pressure and pain and to assist you with walking.
  • Aspiration of fluid. When inflammation flares up in a joint, the surgeon may aspirate (draw out) fluid to reduce the swelling and pain.
  • Steroid injections. Injections of anti-inflammatory medication may be applied directly to an inflamed joint or to a rheumatoid nodule
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