Caring for Arthritis in Your Feet

You may associate arthritis with knee stiffness and inflammation, but it can affect other parts of the body as well, including your feet. Managing arthritis in the feet is complicated, however, since the right treatment depends on the specific type of arthritis and location of the pain.

Not to mention, there are 26 bones and over 30 joints in your feet, and any of them can develop arthritis. And while the affected part of the foot or ankle will feel stiff and achy, arthritis in the feet can cause other issues as well, such as problems with balance and difficulty walking.

Your ability to keep living well with arthritis depends on understanding what’s behind your foot pain and how to manage it.

What Does Arthritis in the Feet Feel Like?

“Arthritis in the feet can feel like a deep, aching pain or stiffness, especially in the morning,” says podiatrist Holly Spohn-Gross, D.P.M., a trustee of the American Podiatric Medical Association and CEO of Sienna Podiatry in Lake Isabella, CA. Early morning arthritis pain is referred to as the gel phenomenon, stiffness that results from a period of immobility. “Within the first hour after you wake up, some of that stiffness goes away,” says Dr. Spohn-Gross.

In addition to stiffness, Dr. Spohn-Gross says other classic symptoms include swelling, tenderness, and decreased range of motion. This can occur anywhere in the feet, adds Reuben Chen, M.D., a board-certified physician specializing in sports medicine and pain management in Torrance, CA. “These symptoms can happen in the toes, midfoot, heel, or ankle,” he says.

What Causes Arthritis in the Feet?

According to the Arthritis Foundation, there are more than 100 types of arthritis. The cause of arthritis varies by type. The most common types of arthritis are:

• Gout. This type of inflammatory arthritis happens when there is a buildup of uric acid, a normal waste product your body gets rid of through urine. When this buildup occurs, it causes pain and swelling in your joints, specifically the hands, feet, ankles, and/or toes.
• Osteoarthritis. In this form of arthritis, the protective cartilage that covers the ends of bones at the joints wears down from age or injury (sometimes called the “wear and tear” arthritis that happens over time). This causes the bones to rub together, leading to pain and inflammation. It can happen in one isolated joint, or more than one.
• Psoriatic arthritis. This autoimmune disease involves the body’s immune system attacking healthy tissue in the skin and joints. It typically occurs in people who have psoriasis. It’s also likely to affect joints symmetrically.
• Rheumatoid arthritis. When the body’s immune system attacks the tissues of the joints, it triggers persistent inflammation that causes pain and swelling over time. The affected joints are typically symmetric, meaning both feet will have arthritis.

How Does Foot Arthritis Affect Mobility?

“If you’re dealing with arthritis in any part of the foot, whether it’s the toes, ankle, midfoot, or heel, it’s going to impact your movement,” says Dr. Chen. “Many people will alter their gait to relieve the pain, but this is turn can end up causing issues with the knees, hips, and even back pain.”

With osteoarthritis in particular, pain is caused by repetitive motion and impact, says Dr. Spohn-Gross. There may also be improper biomechanics at play. You could have abnormal foot alignment from age, excess weight, or genetics and all that can increase your arthritis symptoms on top of adding to instability and poor balance.

Where the arthritis is in your foot dictates what mobility issues you may experience. “If you have arthritis in your big toe, that’s going to affect how you push off the ground,” says Dr. Spohn-Gross. “Whereas if arthritis is in your ankle, it’s going to impact your range of motion a little bit more than other areas of the foot.”

Ways to Care for Arthritis in Your Feet

If you’re dealing with arthritis in the feet, Dr. Spohn-Gross says a specialist will first examine the affected joint, including the synovium (soft connective tissue lining joints in the toes, midfoot, and ball of the foot), the bone, and the cartilage. Changes to any of these help determine the best treatment plan to move forward with.

Caring for arthritis in feet is generally a multipronged approach, including medication, lifestyle intervention, and supportive devices. Let’s take a closer look at some options you and your doctor may discuss.

Managing Pain and Inflammation

The first line of defense for easing the pain and swelling that comes with arthritis in the feet is to take a nonsteroidal anti-inflammatory drug (NSAID). Ibuprofen (Advil, Motrin) and naproxen (Aleve) are two common over-the-counter options that can help with arthritis symptoms. There are also topical NSAIDs like Voltaren gel, says Dr. Chen.

A combination of cold and heat can also help, he adds. “If you’re on your feet a lot during the day and notice pain or inflammation happening, try icing the area with an ice pack for 10 minutes followed by 10 minutes of heat, which will circulate blood to the area to bring the swelling down faster.” Place a towel on the top or sole of your foot, then press the heating pad or cold pack against the towel.

Give Feet Time to Rest

Exercise is important when you have arthritis in the feet, and daily movement will help strengthen the muscles and joints, improve your balance, and keep bones strong. But exercise shouldn’t be painful, nor should you overdo it. Working with a physical therapist can help you develop an exercise routine. This may be one day of low-impact exercises like swimming or walking, and an “off” day that incorporates gentle stretches. Dr. Chen adds a physical therapist can also work with your range of motion, incorporating activities that work within your limits.

Whatever you do, don’t stop moving entirely! Exercise is important for maintaining flexibility and range of motion, so reduce the impact on your feet by switching to swimming, water aerobics, cycling, or gentle yoga, per the Mayo Clinic, but don’t see arthritis pain in your feet as a reason to quit moving altogether.

Maintain a Healthy Weight

Carrying excess weight puts extra stress on your joints, including the feet. “Too much pressure from weight can start to cause tiny tears in the cartilage,” says Dr. Spohn-Gross. When you walk on level ground, tthe force on your knees and lower body is significantly greater than your body weight, meaning every extra pound counts when it comes to stressing your ankles and feet.

Consider a Mobility Aid

Dr. Chen says that with arthritis in the feet, having pain in one part of the foot can have you compensating in other areas, impacting your gait and balance while possibly causing pain in other joints in the body. Dr. Spohn-Gross adds that the biggest goal in arthritis management is preserving mobility.

If you find walking painful, or that your gait or balance is compromised from inflammation and pain, assistive devices like rollators can help keep you safely moving.

Ask About Pain-Relief Treatments

Both Dr. Chen and Dr. Spohn-Gross suggest trying conservative pain relief treatments for arthritis in the feet first, such as NSAIDs, using ice and heat, and working with a physical therapist for a safe exercise routine.

If you’re still experiencing pain and swelling, talk to your health care provider about pain relief treatments. Dr. Chen says there are prescription anti-inflammatory medications that may help or getting a cortisone shot in the area of the foot that has arthritis can reduce pain.

What Are the Best Shoes for Arthritic Feet?

“A lot of times, people with arthritis in the feet wear shoes that are too narrow,” says Dr. Chen. This can restrict the foot, causing pain and limited range of motion. “If you have arthritis in the feet, you want a shoe that has a wide toe box so that there’s more space, instead of something that crunches your toes together,” he adds. “A shoe with a soft sole can also help reduce pain and provide support.”

“A rocker bottom will help to reduce some of the pain through certain arthritic joints,” adds Dr. Spohn-Gross. “If you need more relief, orthotics may be recommended, which is a custom cast of your foot. This will take pressure off certain areas and help to create a more stable foot.”

Finding the best shoe for you will depend on what area of the foot has arthritis. For example, stability sneakers with cushioned midsole and heel will take pressure off the ball of the foot. Have a podiatrist look at your gait, arches, and specific part of the foot being affected by arthritis; this will help with a recommendation on the best shoes and/or orthotics for your feet.

As for what to avoid, for obvious reasons, the Arthritis Foundation says high heels are a no-go for women, as they will put a lot of pressure on the feet, especially in the toes. Flip-flops lack arch support and cushion and may increase foot and ankle swelling if you’re dealing with arthritis.

Exercises for Arthritis in the Feet

When arthritis affects the feet, it is a balancing act between exercises to help make your feet stronger, and avoiding movements that will lead to even more inflammation and pain. Exercises that may be recommended to you include:

• Ankle alphabet (raising your foot off the ground and writing the ABCs with your big toe)
• Ankle circles
• Calf stretches
• Calf raises
• Heel and toe taps
• Toe curls
• Toe stretches
• Standing heel to toe raises

Medical Treatments for Foot Arthritis

Medical treatment for foot arthritis includes oral or topical NSAIDs like Advil, Motrin, Aleve, or Voltaren gel, says Dr. Chen. Your healthcare provider can also prescribe a stronger NSAID for pain and swelling. If that still doesn’t help with symptoms, your health care provider may recommend a cortisone injection to get relief. Non-invasive options may be offered as well, such as shockwave therapy or laser therapy, says Dr. Spohn-Gross.

Supportive shoe gear is often one of the first things a specialist will look at to help with your symptoms, says Dr. Spohn-Gross, who also recommends physical therapy for early-stage arthritis in the feet. This will target the area of the foot that has arthritis and you’ll get personalized stretches and exercises you can do at home to help strengthen the surrounding joints and muscles to preserve your mobility.

In cases of severe arthritis in the feet, surgery may be required. Surgical options include a debridement, which clears out pieces of cartilage, ligament, or bone affecting joint movement of the big toe, or a fusion that fuses two or more bones in the toe or foot to eliminate friction caused by damaged cartilage.

There’s another emerging area of medical treatment for foot arthritis, says Dr. Spohn-Gross. “Regenerative medicine is a new tool in our toolbox, using stem cells or platelet-rich plasma (PRP) injections,” she says. While it’s not an option for everyone, Dr. Chen adds that regenerative injections can be beneficial to foot arthritis because the joints are so small, providing concentrated and effective results like less swelling and stimulating tissue repair.

When to See a Doctor About Foot Pain

“If you have persistent or recurring pain that is progressively worsening, that is not normal and you need to talk to a health care provider,” says Dr. Spohn-Gross. “Swelling or stiffness that doesn’t resolve is another red flag. If you’re limping or changing the way you walk because of this, it’s important to take note of that, too.”

Feet that are red, hot, swollen, and painful can also be a sign of inflammatory forms of arthritis, Dr. Spohn-Gross adds. Don’t try to treat any of these symptoms at home. Make an appointment with a podiatrist or your general practitioner to get a diagnosis so you can get the proper treatment your feet need.