Click on 'watch the video' to watch a video on rheumatoid arthritis
The sooner it's diagnosed, the more effective your treatment can be. Don't ignore joint pain, as RA often shows up in the feet first. You can be referred to an arthritis clinic by your GP. NHS rheumatologists, physiotherapists, occupational therapists and podiatrists (foot specialists) can also help.
- Drugs such as analgesics (painkillers) and non-steroidal anti-inflammatory drugs (NSAIDs) reduce pain and swelling. Disease-modifying anti-rheumatic drugs (DMARDs) slow down the effects of RA on the joints.
- If your arthritis is advanced, you may be prescribed corticosteroids to reduce inflammation.
- Orthoses are a special type of insole that help to minimise the pressure on your feet.
- If your toes are beginning to stiffen or curl, it's important for you to wear a shoe with an extra deep toe box. Your podiatrist may refer you to have special footwear made to fit your exact foot shape.
- Protective shields for your toes can relieve pressure and reduce friction.
- Surgery can correct any bunions and hammertoes (a partial or complete dislocation of one of the joints in a toe) caused by RA. If it's extremely painful to walk, your joints can be fused together (a treatment called arthrodesis). Although it results in a loss of movement in that particular joint, it can reduce pain.
Painkillers or steroids can help the pain
OA affects joints that have been under pressure and is common in feet, especially in the joint at the base of the big toe.
- Exercising and stretching regularly can help nourish the joint cartilage and strengthen the muscles and tendons around the joint. Podiatrist Trevor Prior recommends you put your feet side by side and try to move your big toes towards each other three or four times a day. Yoga is a great exercise for all your joints, including your toes. Swimming is also good because it doesn't put pressure on your joints.
- It's a good idea to ease the pressure of weight on your feet by keeping yourself slim
- Painkillers or steroids can help the pain. There are also creams and gels that can be absorbed into the bloodstream when rubbed on the affected joints.
- You can use foot padding, orthoses and special shoes.
- Many people claim that supplements such as glucosamine and chondoitin help with relieving the pain caused by OA. But more research into such supplements is needed before their affects are fully understood. They may not be suitable for everyone, e.g. it's not advisable to take glucosamine if you have a seafood allergy as it's made from shellfish.
If your problem doesn't improve with the above measures, you may be referred to a podiatric surgeon for surgery. There is a range of procedures that can help, including removing the surface of the affected bone and fusing joints together, or repositioning bones or joint implants.
Christine Lawrence, 63, is a retired teacher and lives in Cornwall. She has osteoarthritis in her feet
“I first noticed aching in both my ankles and a stabbing pain in the joint at the base of one of my big toes about three years ago. My GP arranged an X-ray and we found I had osteoarthritis in both my ankles and my big toe, where I’d had a bunion since childhood.
"I firmly believe it’s important to keep moving as you get older. So I’ve tried everything I can to minimize the pain and allow myself to be active despite osteoarthritis.
"I use ibuprofen tablets if I’m going for a long walk, and Ibuleve gel, which reduces pain and swelling. I’ve had acupuncture and ultrasound treatment, which I’ve paid for privately through my health insurance. I make sure I choose sturdy, supportive shoes and have stopped wearing sandals. I take supplements – glucosamine and chondroitin – which seem to help.
“The pain is now under control and doesn’t stop me doing anything I want to do. I’m even off on holiday to India this month to walk the foothills of the Himalayas."
Toetoes are really comfortable. They prevent toes touching each other and seem to keep the area between the toes dry so that the skin is now smooth.
I love to wear them because they are fun. My red socks with red sandels looks as though I've painted my feet. When you've retired you are allowed to be a little mad!.
Last year in the Himalayas I lived in my woolly hiking socks and gave some of the children a bit of a fright when I removed my boots. They are now worn through and I immediately ordered replacements.
Ruth Reeves - Retired