Rheumatoid arthritis affects about 1% of the population in the United States. Many of these people, close to 90%, will go on to develop chronic foot problems. The most common complaint is pain under the ball of the foot, or metatarsalgia. This is because the joints most often affected in the foot are the metatarsophalangeal joints; the joints where to toes meet the foot.
Different types of foot deformities seen in patients with rheumatoid arthritis include Hallux Valgus or bunions, hammertoes, and widening of the foot with the toes going or pointing toward the little toes.
Rheumatoid arthritis causes joint destruction. This will lead to joint instability, enabling the toes to move out of position. This in turn can cause increased forces to the bone causing instability and the pressure on the bone can cause some erosion to occur at the level of the articular cartilage of the joints. This can lead to an increase in pressure under the ball of the foot and increased pain. At times, rheumatoid nodules (soft tissue growths) will develop and cause pain and difficulty walking.
Inserts and orthotics have been shown to help alleviate the pain and discomfort in some patients presenting with the above problems. If conservative care does not afford the patient relief, surgery may be the solution to getting the patient pain free.
See your podiatrist today if you are showing any signs or symptoms of rheumatoid arthritis. Early detection may give you many more years of pain free ambulation.