Matthew D. Neuhaus, DPM
300 Stonecrest Blvd. Suite 350
Smyrna, TN 37167
(615) 220-8788
Located on the 3rd Floor of the Physician Office Building at StoneCrest Medical Center

 

What is Rheumatoid Arthritis?

Rheumatoid arthritis (RA) is a disease in which certain cells of the immune system malfunction and attack healthy joints. RA causes inflammation in the lining (synovium) of joints, most often the joints of the hands and feet. The signs of inflammation can include pain, swelling, redness, and a feeling of warmth around affected joints. In some patients, chronic inflammation results in damage to the cartilage and bones in the joint. Serious damage can lead to permanent joint destruction, deformity, and disability.

How Does RA Affect the Foot and Ankle?

When joints become inflamed due to RA, the synovium thickens and produces an excess of joint fluid. This overabundance of fluid, along with inflammatory chemicals released by the immune system, causes swelling and damage to the joint's cartilage and bones. Foot problems caused by RA most commonly occur in the forefoot (the ball of the foot, near the toes), although RA can also affect other areas of the foot and ankle. The most common signs and symptoms of RA-related foot problems -- in addition to the abnormal appearance of deformities -- are pain, swelling, joint stiffness, and difficulty walking.

Deformities and conditions associated with RA may include:

  • Rheumatoid nodules (lumps) which cause pain when they rub against shoes or, if they appear on the bottom of the foot, pain when walking
  • Dislocated toes
  • Hammertoes
  • Bunions
  • Heel pain
  • Achilles tendon pain
  • Flatfoot
  • Ankle pain

How is RA Diagnosed?

Usually a patient has already been diagnosed with RA prior to visiting Dr. Neuhaus. However, occasionally a patient first receives a diagnosis of RA from Dr. Neuhaus. RA is diagnosed on the basis of a clinical examination as well as blood tests. To further evaluate the patient's foot and ankle problems, Dr. Neuhaus may order x-rays and/or other imaging tests.

What is the Recommended Treatment for RA?

While treatment of RA focuses on the medication prescribed by a patient's primary doctor or rheumatologist, Dr. Neuhaus will develop a treatment plan aimed at relieving the pain of RA-related foot problems. The plan may include one or more of the following options:

  • Orthotic devices. Dr. Neuhaus often fits the patient with custom orthotic devices to provide cushioning for rheumatoid nodules, minimize pain when walking, and give needed support to improve the foot's mechanics.
  • Accommodative shoes. These are used to relieve pressure and pain and assist with walking. To learn how to choose the best shoe, please watch the following video Dr. Neuhaus designed for your benefit- The Perfect Shoe Selection.
  • Aspiration of fluid. When inflammation flares up in a joint, Dr. Neuhaus may aspirate (draw out) fluid to reduce the swelling and pain.
  • Steroid injections. Injections of anti-inflammatory medication may be applied directly to an inflamed joint or to a rheumatoid nodule.
  • Surgery. Often the pain and deformity associated with RA in the foot is relieved through surgery. Dr. Neuhaus will select the procedure best suited to the patient's condition and lifestyle.

Rheumatoid arthritis in the foot and ankle can cause considerable pain and deformity, making walking difficult. Through the treatment approaches selected by Dr. Neuhaus, substantial relief can be obtained.

 

 

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“I wrote this book because too many people suffer from foot
and ankle pain unnecessarily.”
-Dr. Matthew Neuhaus