Rheumatism and feet

Do you suffer from rheumatism and burning feet, or rheumatism in your ankles? Or do you suffer from painful rheumatic toes, soles or forefoot? Then you know that your feet are incredibly important. Arthritis in the feet can cause them to change shape, meaning ‘normal’ shoes no longer fit and walking becomes painful.

Rheumatic foot complaints can be caused by osteoarthritis, inflammatory rheumatism or soft-tissue rheumatism.

• Osteoarthritis is a condition in which the cartilage breaks down. The quality of the cartilage gradually deteriorates, which can lead to stiffness and pain in the joints.
• Rheumatoid arthritis (RA) is a chronic condition characterised by inflammation and, ultimately, damage to multiple joints. In particular, the joints of the hand, wrist and forefoot are often inflamed and swollen on both sides.
• In soft tissue rheumatism, the symptoms do not occur in the joints, but in the surrounding tissue such as capsules, muscles, ligaments, bursae and tendons. Inflammation may be present, but the symptoms can also occur without inflammation. An example is fibromyalgia.

Rheumatism affects everyone differently. However, there are symptoms affecting the feet and ankles that are common to many rheumatism patients:

• Pain when standing and walking. Shoes no longer fit properly. At a later stage, permanent deformities of the foot may occur.
• Due to fusion, the metatarsal bones may shift further downwards. As a result, one may feel a sort of lump under the sole of the foot. The pressure there then becomes too high. This can cause pain, sores and calluses. It feels as though one is walking on pebbles.
• The toes grow crooked, or even overlap one another. This can lead, for example, to hammer toes, claw toes, corns and calluses.
• If the forefoot becomes wider due to a rheumatic condition, pressure points may develop on the inside and outside of the foot. This is because the foot no longer fits properly in the shoe. In response to the pressure from the shoe, extra bone may grow.
• Oedema (fluid build-up) may occur in the forefoot, the whole foot or the ankle. The joints will then be swollen.
• The ankle may become inflamed and the Achilles tendon or ankle ligaments may become irritated.
• All of this results in a characteristic condition known as ‘the rheumatic foot’. In addition, further problems with the feet may arise as a result of the condition or the use of medication. Examples include thinning skin or sores that become infected more easily as a result of medication.

Rheumatism can cause bony lumps to form on joints. These lumps can be painful and/or can restrict a joint’s range of motion or prevent movement altogether. When a joint is subjected to significant pressure and friction over a prolonged period, a bursa may form there over time.

Due to deformities or an abnormal position of the foot, shoes may not fit as well. This can lead to increased and more rapid callus formation and corns. Nails may also show abnormalities if the toes do not have the space they need. A change in the position of the foot can lead to a different gait, which may also result in problems with the knees, hips and back. The podiatrist can advise on orthotic insoles to relieve pressure on pressure points. The podiatrist can also make toe orthoses. A toe orthosis is often an excellent aid for preventing or reducing pressure points on the toes. The podiatrist can also advise you on ((semi-)orthopaedic) footwear. A foot affected by rheumatism is prone to inflammation, so it is advisable to have your feet treated regularly by a qualified chiropodist.

Rheumatic conditions can affect not only your feet and ankles, but also other parts of the body. The podiatrist focuses primarily on symptoms of rheumatism affecting the lower limbs (the legs, from the back down to the feet). Would you like to learn more about rheumatism in the rest of your body? Visit the website of the National Association for Rheumatism Care in the Netherlands.