Daily Foot Care for People with Arthritis

Simply defined, arthritis is inflammation of the joints.  When the joints are inflamed, they often become stiff, swollen and painful.  Although there are more than 100 types of arthritis, three stand out as types that are likely to affect the foot and ankle, according to the American Academy of Orthopaedic Surgeons.

Osteoarthritis is the most common type, usually due to wear and tear on the cartilage of the joints over time.  According to the Centers for Disease Control and Prevention (CDC), one in two Americans will get some form of osteoarthritis in their lifetime, and about 27 million adults currently have it.

Rheumatoid arthritis is a systemic inflammatory disease that affects joints throughout the body. According to the latest data from the CDC, an estimated 1.5 million US adults have rheumatoid arthritis (RA), but the prevalence among women is nearly double that of men.  Although the cause is not known, RA is believed to be an autoimmune disorder in which the affected person’s immune system attacks and destroys cartilage throughout the body.

Post-traumatic arthritis is similar to osteoarthritis and may develop years after a fracture or other injury.

Other common forms of arthritis that may affect mobility include:

Ankylosing spondylitis, which usually affects younger people (between the ages of 17 and 45), although it can affect older people, as well.  This type of arthritis often has a hereditary component, and produces inflammation that causes swelling between the vertebrae of the spine and in the joints between the spine and pelvis.  It may also affect the hips, knees and shoulders.

Bursitis is inflammation of the bursae—the small, fluid-filled sacs that help reduce friction between bones and other moving structures in the joints.

Gout results from deposits of uric acid crystals in the connective tissue near joints or in the joints themselves.

Psoriatic arthritis can produce symptoms similar to RA, and is associated with psoriasis, a common skin disorder that causes scaling and flaky skin.

Maintain a Healthy Lifestyle

A large body of research has demonstrated the benefits of regular physical activity for people with all types of arthritis. It helps reduce joint pain and stiffness, strengthens muscles around the joints, and increases flexibility and endurance.  Regular physical activity also helps promote overall health and fitness by providing more energy and facilitating sleep and weight control. 

If you have arthritis, it’s also important to have regular checkups with your doctor, including a foot exam. Take medications only as directed and follow any dietary recommendations.  Following a healthful diet can also help (see My Plate at http://www.choosemyplate.gov/).

Preventive Foot Health and Footwear

• See a foot health professional for regular foot examinations and proactive/preventive foot care. Follow your doctor’s or foot care specialist’s recommendations or prescriptions for footwear, and use IPFH’s integrated approach to proper footwear selection and fitting.
• Buy shoes that are shaped like your feet.  Look for shoes with a square or round toe box so that toes have room to move around.  Avoid pointed-toe shoes as much as possible. You may need special accommodative footwear to prevent damage to vulnerable areas of the feet, especially if you have any irregularities in foot shape or size.
• Choose shoes that provide a good heel counter and arch support.  Avoid slip-on shoes such as mules, loafers or flip flops, and avoid high-heel shoes.
• Look for shoes with extra cushioning in the mid soles and outer soles.
• Never depend on shoes to fit better after they are “broken in.” Your feet should feel comfortable in new shoes when you buy them. 
• IPFH suggests wearing only properly selected and fitted, as part of an integrated approach, padded socks with shoes with non-slip outsoles and any inserts or orthotics prescribed or recommended by a doctor or foot health professional.  Peer-reviewed, published studies have shown that wearing clinically tested padded socks can help prevent injuries to the skin/soft tissue of the foot, and can help reduce pressure and foot pain in people with rheumatoid arthritis. 

Foot Self Care

• Inspect your feet daily. Use an extended mirror to see the bottoms of your feet, especially if you cannot reach them or see them without assistance.
• If you have any coexisting conditions such as neuropathy (loss of sensation) or compromised blood flow in your legs or feet, be extra cautious. Check inside your shoes for sharp or rough edges that can hurt your feet.  Also check for foreign objects, including nails, sticks, rocks, etc., that may enter or become embedded in your shoes during activity.
• Wash your feet daily using lukewarm water.  Never use hot water, or you may burn your feet (use your elbow to test water temperature). After washing, dry your feet thoroughly (remember to dry between the toes) and keep them supple by applying lotion only to the tops and bottoms of the feet (never between the toes, since this may promote a warm, moist environment that is conducive to fungal infections).
• Avoid exposing your feet to temperature extremes, and avoid walking barefoot, especially if you have neuropathy.
• Do not attempt to cut toenails if you have neuropathy, joint deformation or other foot problems related to arthritis. See a foot health specialist regularly for toenail care and foot examinations. Never attempt to cut or file calluses, corns or other protrusions on your feet.
• Avoid using wart removers or other harsh chemicals on your feet.
• Stay as active as possible to maintain circulation in the feet and the rest of your body, to help improve function and for overall health and wellbeing.

Reviewed by: Robert P. Thompson, C.Ped, IPFH Scientific Advisory Board
Last updated: March 31, 2016