Rheumatoid Arthritis Of The Foot

Rheumatoid arthritis of the feet accounts for a significant portion of foot deformities. Multiple joints of the feet are affected such as the metatarsophalangeal joints, which are carrying most of the load from the body weight. The forefoot is painful and stiff. On examination it is tender when the foot is squeezed across the foot (when "transverse" pressure is exerted). The hindfoot can also be a cause of foot pain from arthritis and joint inflammation in the subtalar joint.

On top of this the tendon sheaths around the ankle area can also get inflammed ("ankle synovitis"), which leads to more foot pain, ankle pain and joint stiffness. With chronic rheumatoid arthritis eventually grotesque deformities of the forefoot and toes occur, which often require some surgical treatment and/or orthotic shoes. The diagnosis of rheumatoid arthritis of the foot is based on a blood tests that is postive for rheumatoid factor as well as characteristic X-ray images as mentioned under this link to the rheumatoid arthritis chapter.

Treatment: A multidisciplinary team with a physician, surgeon, podiatrist, occupational therapist and physiotherapist will be the best approach to treat the patient. Calluses, corns, ingrowing toenails are usually taken care of by the podiatrist. Orthotic devices can take the pressure away from inflamed areas and help to make the gait healthier. These changes can lead to better tissue viability , joint mobility and improvements of circulation. Anti-inflammatories can help with joint inflammation and synovitis. A surgeon can help with foot deformities, but the least invasive procedure that will alleviate the patient's foot pain should be chosen (Ref. 1, p.23).

Alternative treatment for rheumatoid arthritis:

There is an FDA approved non-drug method available, IceWave patches from Lifewave, which will control pain. This is mentioned in the book "Breakthrough" by Suzanne Somers (Ref. 8) where newer insights of antiaging medicine are also reviewed. Although the patches are placed over acupuncture points, there are no needles involved. Nanotechnology, a newer technology, was used in the manufacturing of these patches and infrared (heat) waves from body heat are utilized to stimulate an acupuncture point, which modifies pain perception and reduces pain to half or less. Medically this would be considered an excellent pain reliever. For more info on the patches see the IceWave patches from Lifewave link above (click "products"). In the US a 5 pack of the IceWave spray is available that can be directly sprayed onto the skin in the area where the pain is located.

Many of the anti-aging physicians in Ref. 8 point out that rheumatoid arthritis is not only an inflammation of the joints, but also a problem where toxic substances such as heavy metals have accumulated over a long period of time. Intravenous chelation therapy may have a place in removing toxic substances. In addition Ref. 8 points out that hormone rebalancing may be required (special blood tests are done by an anti-aging physician who is knowledgeable in bioidentical hormone replacement).

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Disclaimer:

This outline is only a teaching aid to patients and should stimulate you to ask the right questions when seeing your doctor. However, the responsibility of treatment stays in the hands of your doctor and you.

References:

1. ABC of rheumatology, second edition, edited by Michael L. Snaith , M.D., BMJ Books, 1999. Chapter 5.

2. The Merck Manual, 7th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapter 270.

3. Wheeless' Textbook of Orthopaedics: http://www.wheelessonline.com/

4. The Merck Manual, 7th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapter 60, p.487.

8. Suzanne Somers: "Breakthrough" Eight Steps to Wellness-- Life-altering Secrets from Today's Cutting-edge Doctors", Crown Publishers, 2008

Last Modified: June 18, 2009