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 unnecessary 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.
Rheumatoid arthritis causes inflammation of the joints at
the ball of the foot, which loosens their ligaments and can cause the bone to
push against the skin of the bottom of the foot. This can lead to tender
calluses and ulcerations at the ball of the foot, which 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. 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 on the
toes. Nodules can ulcerate from abrasion of shoes. Sometimes, slits cut into the
shoe at the point of the nodules can help to relieve painful pressure.
Furthermore, non-tie style laces are now available, thus making it easier for
persons 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.
Occasionally, doctors will examine the shoes that a patient
has worn to find evidence of deformity (for instance, a shoe leaning to one side
or another), wear, and alignment. The independent shoe exam is like a history
book of the use of the foot over recent months. It can sometimes be used to help
define not only causes of foot pains, but also ankle, knee, or hip pains.
In general, running shoes are frequently an advantage
because of their lightweight. Proper shoes can provide welcome relief and often improved function for patients with
foot damage from arthritis. When picking out a shoe, ALWAYS try on several pair
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!
Happy Trails
Last Editorial Review: 7/6/2004
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