Rheumatoid Arthritis of the Foot and Ankle
Rheumatoid arthritis (RA) is a systemic disease that attacks multiple joints throughout the body. About 90 percent of people with rheumatoid arthritis eventually develop symptoms related to the foot or ankle. Usually symptoms appear in the toes and forefeet first, then in the hindfeet or the back of the feet, and finally in the ankles. Other inflammatory types of arthritis that affect the foot and ankle include gout, ankylosing spondylitis, psoriatic arthritis and Reiter’s syndrome.
The exact cause of RA is unknown but there are several theories. Some people may be more likely to develop RA because of their genes. However, it usually takes a chemical or environmental trigger to activate the disease. In RA, the body’s immune system turns against itself. Instead of protecting the joints, the body produces substances that attack and inflame the joints.
Many people with RA can control their pain and the disease with medication and exercise. Some medications, such as aspirin or ibuprofen, help control pain. Others, including methotrexate, prednisone, sulfasalazine and gold compounds, help slow the spread of the disease itself. In some cases, an injection of a steroid medication into the joint can help relieve swelling and inflammation.
We also prescribe special shoes. If your toes have begun to stiffen or curl, you should wear a shoe with an extra-deep toe box. You may also need to use a soft arch support with a rigid heel. In more severe cases, you may need to use a molded ankle-foot orthotic device, canes, or crutches.
Exercise is very important in the treatment of RA. We recommend stretching as well as functional and range-of-motion exercises.