Pain in the Feet As a Symptom of Rheumatoid Arthritis

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Rheumatism Arthritis (RA) can attack any part of your body, including your feet. In fact, inflammation and pain in the feet is an early symptom for many people.

Foot symptoms in RA can take many forms. You may have joint pain or constant aches and pains. You may also have pain in your ligaments, which are bands of tissue that connect your bones together. Symptoms are often worse after prolonged standing, walking, or running.

For some people with RA, leg pain begins slowly. For others, it is instant. However, at some point, most people with RA find that foot joint pain makes it very difficult for them to walk.

This article will discuss foot pain as a symptom of rheumatoid arthritis. It will also describe some strategies you can use to manage leg pain with RA.

Verywell / Tim Liedtke

How does RA affect the feet?

Rheumatoid arthritis is an autoimmune condition. When you have RA, your immune system tries to destroy the lining of your joints, called the synovial bag. It also attacks the fluid in your joints, called synovial fluid. It does this because it mistakes these parts of your body for disease-causing invaders.

RA causes damage and inflammation that causes your joints to swell and feel hot. Small joints, like those in the feet, are the most common target of these attacks.

Finally, long-term inflammation thickens the synovial membrane. This causes cartilage and bone to wear down. In the feet and toes, the joints can become deformed. This leads to poor range of motion and significant pain. Walking, standing, and even wearing shoes can become difficult.

Proper treatment can help reduce damage and inflammation to your foot joints. It can also prevent or delay deformities and other problems.

Is it RA or osteoarthritis?

When you first notice foot pain, you may wonder if it’s osteoarthritis (OA). Arthritis is also known as wear-and-tear arthritis and is more common than rheumatoid arthritis.

There is no clear way to tell if you have arthritis or rheumatoid arthritis without a medical diagnosis. But OA and RA have some key differences.

Deformity of the RA and Legs

In the feet, rheumatoid arthritis often affects metatarsophalangeal (MTP) joint of the toe. These are the joints that connect your toes to your feet.

RA can cause serious foot deformities. This is especially true if it is left untreated.

  • Side drift: Over time, the toes can “drift” outward, toward the little toe. This is sometimes called lateral deviation or lateral deviation. Looks like the toes are tilted.
  • Bunion: Feet may develop bunion (hallux valgus). These are painful lumps on the side of the foot with the big toe.
  • Contract: RA can also cause your front foot to shift. This can lead to a contract. Spasticity is a permanent shortening of the muscles or tendons in your toes. A well-known type of contract is the hammer. In this condition, the toe is permanently bent and flexed. Contractions can lead to calluses and pain under the ball of the foot.
  • Flat feet: The pelvic joint, which is part of the arch of the foot, can become unstable. When this happens, the arch can collapse.

All of these changes to the structure and shape of the foot can make it harder to find a comfortable shoe.

Other foot problems in RA

People with RA may have leg symptoms that are not related to the deformity. This is because the disease can affect almost any joint in the foot.

Heel pain

This is a recurring problem for people with RA. It can occur on the back or underside of the heel.

Inflammation in the feet can lead to conditions associated with heel pain, including:

  • Plantar fasciitis, also known as heel spur syndrome, causes pain in the heel and lower part of the arch
  • Achilles tendonitis, an inflammation of the tendon that connects your calf muscle to your heel
  • Back of the neck bursitiswhen a fluid-filled sac (bursa) behind the heel bone, becomes inflamed and causes pain and swelling

Nervous disorder syndrome

When RA inflames the synovial membrane, the swelling can compress nerves. An example of this is carpal tunnel syndrome. This causes burning, tingling, or soreness in the arches of the feet and soles of the feet.

Low note

Rheumatoid nodule is a lump underneath the skin. It usually appears on tendons or bones located just below the surface of the skin.

Read More:   What Can Cause Mucus in Stool?

In the foot, a rheumatic nodule may appear over the Achilles tendon. If a bunion is present, it can also appear on the side of the big toe.


Inflammation from RA can affect small blood vessels. This can lead to rashes or sores on the legs and feet.

Debris bleeding is also possible. These are small areas of broken blood vessels on either side of your toenails or fingernails.


RA can cause foot deformities and other forms of foot problems, including heel pain, nerve pain, nodules on bones and tendons, and skin rashes.

Foot pain management in RA

Treating RA can help relieve foot pain and prevent deformity. This usually involves prescription medications to prevent the immune system from attacking your joints.

You may also need to find other ways to manage your foot pain and deal with the deformity.

Popular strategies include:

The success of these strategies will depend on which joints are affected and to what extent. If these approaches don’t work, you may need to consider surgery. Deformities such as bunion and hammer can often be treated with surgery.

In some cases, the doctor may fuse the bones to form a joint. This involves permanently connecting the bones together, which limits movement and reduces pain. Depending on which bones are fused, you may or may not notice a loss of motion.


Treating RA can help improve foot-related symptoms and prevent deformities. Other strategies include pain management with NSAIDs, steroid injections, therapeutic footwear, occupational therapy, and sometimes surgery.


People with RA may have symptoms that include pain in the foot joints and ligaments. If left untreated, RA can lead to foot deformities.

RA can also cause heel pain, burning and tingling pain in the arch or sole, nodules, and a rash on the skin.

Treatment for RA can help relieve foot pain, and additional strategies such as wearing special shoes, anti-inflammatory medications, and occupational therapy may also be helpful. In some cases, surgery may be necessary.

A very good word

Not everyone with RA will develop foot problems. However, the majority of people with RA have at least some foot-related symptoms.

The most important thing to remember is that you have a lot of options. Medicines can be helpful, and conservative treatments can make a big difference in controlling all aspects of the disease.

Your rheumatologist will work with you to reduce pain and inflammation, prevent joint damage, and improve your sense of well-being. Having a good relationship with your rheumatologist will ensure the best possible outcome over the course of your disease.

frequently asked Questions

  • How does RA affect the toes and feet?

    Rheumatoid arthritis affects the tissues that cover the joints, making them swollen, painful, and warm to the touch. Small joints in the feet are common targets. Over time, chronic inflammation can cause cartilage and bone to wear down, leading to foot and toe deformity.

  • How can you tell the difference between rheumatoid arthritis and osteoarthritis in the feet?

    The key difference is that osteoarthritis usually affects only one foot, while rheumatoid arthritis affects both feet. In both arthritis and RA, the pain and stiffness is greatest in the morning. While arthritis pain usually goes away within half an hour of getting out of bed, morning RA pain lasts longer.

  • How do you relieve RA leg pain?

    Rest, ice, and over-the-counter anti-inflammatory medications are often used to relieve pain early in an RA episode. As the disease gets worse, prescription medications and steroid injections may be needed to control the pain. Occupational therapy, orthotics, splints, or therapeutic shoes can also help relieve pain.

    In more advanced cases, surgery may be needed to correct deformities from the RA or fuse the bones together to reduce motion that causes pain.

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