Feet and arthritis

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The information below has been written for people whose feet are affected by arthritis. It provides general information about ways you can look after your feet and manage your symptoms. It also tells you where to find further information and advice.

How are feet affected by arthritis?
Any joint in your ankles, feet and toes can be affected by arthritis. Many different types of arthritis can affect the feet and cause joint pain, swelling and stiffness. Arthritis in the feet can make standing and walking painful. You may find your feet and/or toes change shape, making it harder to fit shoes. Here are some things that may help you manage your arthritis.

Exercise is important to keep your joints moving however you may need to try different types of exercise if you have painful feet. For example, consider exercising in water. The buoyancy of the water takes pressure off your ankles and feet and you may find you can move more freely than you can on land. For more information see the Water exercise information sheet. Strength training and cycling are also good forms of exercise that do not put extra pressure on sore feet. If you are walking or standing, make sure you wear supportive, comfortable shoes.

Weight loss
One of the best ways to take pressure off painful ankles and feet is to lose any extra body weight. Being overweight can make your symptoms worse as your affected joints need to carry more weight. See the section above for tips on exercise if you have arthritis of the feet. You may find it useful to see a dietitian for advice about healthy eating.

See a podiatrist
Podiatrists specialise in conditions affecting the feet. They can help you with advice about footwear, nail care and orthoses (inserts for your shoes that may help reduce foot pain). You will need a referral from your doctor to see a podiatrist in the public system (such as at a community health centre). These services are usually free or low cost. You can consult a private podiatrist at any time without a referral from your doctor. Find a local podiatrist at the Australasian Podiatry Council website www.apodc.com.au or look under ‘Podiatrist’ in the Yellow Pages.

The most important thing you can do to protect your feet is to wear supportive shoes that fit your feet properly. Keep these tips in mind when buying new shoes.

• Ask an experienced footwear sales person for help in choosing the right shoe and size. Remember, your shoe size may change if your feet are affected by arthritis.
• Try shoes on with any insoles or orthoses you normally wear. Some orthoses may need extra depth, particularly in the toe area.
• Your toes should not touch the end of your shoes as your toes or nails could become damaged. Make sure there is a 1cm gap at the end of your longest toe.
• Look for shoes with synthetic or rubber soles for better grip and shock absorption.
• Look for shoes that can be secured on to your feet with laces and straps. Fastenings that may be easier to do up include Velcro, elastic shoelaces and zips. There are also many devices to help you put on shoesand do up fastenings. Contact an Independent Living Centre for advice.

If it is difficult to find shoes that fit because of swollen or misshapen joints, try extra depth footwear. Contact your local Arthritis Office or an Independent Living Centre for retailers or see a podiatrist for advice.

What else can I do?
There are other treatments that may help you deal with pain and stiffness:

Medicines: many different types of medicines can help the symptoms of arthritis. Your doctor or pharmacist can help you understand which medicines are right for you and how best to use them.
Heat and cold: Applying heat, such as a hot pack (microwaveable wheat pack), heating pad or hot water bottle, to stiff, painful joints may help relieve these symptoms. If your joints are hot and swollen you may find it useful to apply an ice pack. Try applying heat or cold to the painful area for 15 minutes. Always have a layer (such as a tea towel) between your skin and the heat or ice pack. You can repeat this whenever you need to throughout the day. Make sure the temperature of the skin returns to normal in between applying heat or ice packs to prevent damage to the tissues.
Creams: Applying creams or ointments to the skin in the affected area may help control pain. In particular, creams containing anti-inflammatory medicines or capsaicin (an ingredient in cayenne and chilli peppers) may be useful. Talk to your doctor or pharmacist about these types of creams.
•Glucosamine and chondroitin: It is unclear if glucosamine or chondroitin are useful for feet affected by arthritis. See the Glucosamine and chondroitin sheet for more information.
Fish oils: Fish oils may be useful for some forms of arthritis that affect the feet. See the Fish oils sheet for more information.
Herbal therapies. There is no conclusive proof that herbal medicines are effective in treating arthritis of the feet. However see the Complentary therapies sheet for more information. See the Dealing with pain sheet for more information about managing pain.

Consider different forms of exercise to take pressure off painful feet. Make sure you have supportive, well fitting footwear.

For more information:

To find a podiatrist, talk to your doctor, see the Australasian Podiatry Council website at www.apodc.com.au or look under ‘Podiatrist’ in the Yellow Pages.
To find a dietitian, talk to your doctor, contact the Dietitians Association of Australia on (02) 6282 9555 or use the ‘find a dietitian’ service at www.daa.asn.au
Independent Living Centres are located in each capital city. See www.ilcaustralia.org.au or call the National ILC
Infoline on 1300 885 886 to find your closest centre and more information. (Note, the Independent Living Centre is called LifeTec in QLD).

Tremaine, M David & Awad, Elias M 1998, The foot and ankle sourcebook, Lowell House, Los Angeles, CA.
Salmans, Sandra 1998, Your feet: Questions you have… answers you need, People’s Medical Society, Allentown, PA.