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Arthritis Footcare: It's in the Shoes

Many forms of arthritis commonly affect the feet. When they do, walking can be difficult and painful.

Osteoarthritis frequently causes degeneration of the cartilage and bony spurs at the base of the big toe. This is what leads to bunions. Wider shoes may be necessary. High-heeled and pointed shoes should be avoided since they can put pressure at the point of the bunion. Degeneration of the arch of the foot can lead to spur formation on the top of the foot. This can put pressure on adjacent nerves of sensation, which can cause burning of the foot and toes. When this discomfort occurs, patients should avoid tying the shoe tightly or wear a shoe that does not bind at the point of the spur.

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Rheumatoid arthritis causes inflammation of the joints at the ball of the foot, which loosens their ligaments. This can cause the bone to push against the skin of the bottom of the foot. The result can be tender calluses and ulcerations at the ball of the foot. These may even require surgical repair. A bar of leather attached to the bottom of the shoe behind the arch of the foot can help by displacing pressure from the ball to the middle of the foot. Another option for taking pressure off the bottom of the foot is to wear shoes with rocker bottom soles and proper arch support. Further rheumatoid deformity can cause the toes to cock up, which can lead to abrasion of the tops of the toes.

Box-toed shoes can be extremely comfortable for persons with these deformities. Lumps of soft tissues, called nodules, can form on the sides of the foot, heel, or toes. Nodules can ulcerate from abrasion of shoes. Sometimes, slits cut into the shoe at the point of the nodules can help relieve painful pressure. Also, non-tie style laces are now available. These make it easier for a person with rheumatoid arthritis to fasten the shoes.

Gout can cause hard deposits of uric acid crystals to form a lump at the inner side of the base of the big toe. Depending on the size of the deposit, there can be abrasion and even ulceration from the shoe. Wider style shoes can be helpful.

Doctors will sometimes examine the shoes that a patient has worn to find evidence of deformity -- such as a shoe leaning to one side or another, wear, and alignment. The shoe exam is like a history of how the foot was used in recent months. It can sometimes help define not only causes of foot pain but also causes of ankle, knee, or hip pain.

In general, running shoes are often an advantage because of their light weight. Proper shoes can provide welcome relief and often improve function for patients with foot damage from arthritis. When picking out a shoe, ALWAYS try on several pairs and walk around in them before purchasing. The salesperson will understand that you are interested in both function and comfort.

Great-fitting shoes are worth investing time and effort. Be kind to your feet and they will get you where you want to go!

 

WebMD Medical Reference

Reviewed by David T. Derrer, MD on December 27, 2013
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