In the UK, around 10 million people have arthritis. It affects people of all ages. There are over 200 kinds of rheumatic diseases – the word rheumatic means aches and pains in joints, bones and muscles.
Rheumatoid Arthritis (RA) is an autoimmune disease in which your body’s immune system which normally protects your health by attacking foreign substances like bacteria and viruses mistakenly attacks your joints. The abnormal immune response causes inflammation that can cause joint destruction and organ damage.
The severity of the disease can vary from person to person. Symptoms can change from day to day. Sudden increases in symptoms and illness are called flare ups. A flare up can last for days or months. Key symptoms are pain, fatigue and warm, swollen, reddish joints. Long periods of joint stiffness in the morning are common. Inflammation in the small joints of the wrist and hand is typical. If a joint on one side of the body is affected, the same one on the other side is usually affected, too.
How does rheumatoid arthritis affect the feet?
RA affects the smaller joints such as the fingers and toes first, so feet are often one of the first places to be affected. Symptoms usually strike the toes first and may then affect the back of the feet and the ankles. The joints may enlarge and even freeze in one position, so they can't extend fully.
The metatarsal-phalangeal joints are often affected (where the long bones of the feet meets the toes), and can result in Hallux valgus (the big toe is angled excessively towards the second toe) and hammer toe deformities (the toes curl up in a claw-like shape). Each of these deformities can cause further problems, for example, if you have hammer toes, you'll be more likely to develop corns on the tops of your toes.
If the joints in the middle of the foot are affected, the arch can collapse leading to a flatfoot deformity and spreading of the forefoot (where the front section of the foot becomes wider). The fatty pads on the balls of the feet may slip forward, causing pain on the balls of the feet and backs of the toes. If this happens, it can feel as if you are walking on stones.
If the joint where the heel bone meets the ankle (the joint that lets you rotate your ankle) is affected, it can lead to a condition known as valgus hindfoot (where the heel bends outwards), making it difficult to walk.
Finding a safe and comfortable environment for your feet is not always as easy as you might imagine. Soft leathers and linings without minimal seams are key to allowing an active life, trainer, casual shoe.
Osteoarthritis known as degenerative joint disease, is “wear and tear” arthritis, it is the most common form of arthritis. It is associated with the breakdown of cartilage in the joints, primarily in the hands, neck, spine, hips and knees. Osteoarthritis can get worse over time; as the cartilage wears down, bones can be exposed and start rubbing against each other. Osteoarthritis can occur at any age, and is most common after age 65. In fact, just about everybody has some degree of osteoarthritis in one or more joints by age 60. There is no cure but a number of treatments can slow the progression of the disease, improve joint function and ease pain.
Osteoarthritis symptoms can range from mild to very severe and include joint aching and soreness, tenderness when pressure is applied, stiffness, loss of flexibility, grating sensation and bone spurs from bone rubbing on bone. The disorder most often affects the hands and weight-bearing joints such as the knees, hips, feet and the back, but can affect almost any joint in the body. Women are more commonly affected than men. Most people first begin to notice pain and stiffness in the affected joints after prolonged sitting or when first getting out of bed in the morning. The pain tends to worsen as the day goes on with increased activity, and lessens with rest. Physical therapy and doing low impact, moderate exercise on your own can strengthen the muscles that support the joints, though it’s important to note that excessive exercise, just like too little exercise, may worsen pain.
How does osteoarthritis affect the feet? OA can affect any of the 33 joints in the feet but mostly affects the joints at the base of the big toes. This joint is more prone to wear and tear from the pressures of walking, especially if you over-pronate (ie roll your foot in excessively as you walk). Wear and tear at the ends of the bone cause the cartilage to erode and the bone ends may begin to join together. Eventually your big toe may become rigid (a condition known as hallux rigidus) which makes walking difficult. Or your big toe may drift towards your other toes (hallux valgus) which can lead to bunions.
You may initially feel a toothache-type ache in the affected joint that gets worse when you're active, wearing high-heels or when it's cold and damp. It may progress to the stage where your feet ache at night. In severe cases, the range of movement in the joint may fall to the extent that you can't move it at all.
Footwear Minimise the stress on the joints by choosing well-cushioned shoes. Go for shoes with lace-up fastenings or an adjustable strap: they keep the heel in place and stop the toes being pushed to the front of the shoe. Your feet should keep their natural shape when in shoes. There should be a centimetre between the end of your longest toe and end of shoe. They should also be roomy enough to accommodate any swelling, so go for a wide, deep pair.