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Feet

I wonder what problems other people have with their feet. I developed bunions at about the same time as I was diagnosed with RA, five years ago. I am on Leflunomide (DMARD) and Golimulab (biologic) injection. My rheumatologist dismisses my bunions as if they are unrelated to RA, but I had no sign of them before and was unaware they were developing gradually, so I'm sure they are related to RA. I can no longer bend my big toes. I find buying shoes that are and remain comfortable difficult. Since ditching my sandals a couple of weeks ago and returning to shoes and trainers, my feet feel as if someone has hit them with a rod, across the top from the bunions sites. I do keep active and walk daily. I am generally fairly unrestricted physically as the treatment described, which I have been on for the past 3 years, (I have had RA for 5 years) has been effective. I am reluctant to take painkillers as I feel I am already taking medication which has side effects which are not fully known and do not really want more drugs in my body for as long as I can avoid it.

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Hi I can relate to that because exactly the same happened to me. The only shoes I can wear now are sketchers slip on. the have been an absolute god send but miss wearing my heels. Hope you get sorted soon.

Take care

Trish

I certainly developed them with RA and on right foot big toe has crossed over adjacent one. Definately RA and whilst mt Rheumy doesnt disagree on the cause he ignores them i think because as i cant walk or weightbear they bother me less than my hands and wrists packing up. But if they arnt RA related then what are they?, i know women can get them through poor choice of footwear but i found as a 6'3" bloke i looked a little strange in killer heels, but each to his/her own.

Ah yes Leon, but wot about winklepickers eh?!!

Or maybe you're too young to remember those!!

Ha ha, im old enough to know what they are, but not to have worn them, im a child of the 60s, (by 3 months?) but tes they must have destroyed the feet of many an enthusiastic young rocker, and youth was no different then, they wouldnt listen when told "if you wear those things your feet will be in a terrible state wgmhen your older". Which has just reminded me i did once put a note on the door of both my teenage kids reading "why dont you get a job and move out and pay for your own rent and food while you still know everything??".

I think it was met with slammed doors and the usual grunts of gratitude

Yep, teenagers/fashion/gratitude - lack of! - lots of scope there for discussion!! Like, my soon-to-be aged 37 daughter who is emotionally still about 15!! But I must do a proper reply to Jackie who posted about feet, got sidetracked thinking about winklepickers! then the whole morning just went! Take care Leon

just wonder if u have flat feet too - i have baby bunions but my rheumy got my feet checked and special insoles have helped loads. i can't weight bear atm - ankles and wrists are rough so its stand shuffle scream til i get my mtx back again. thinking of getting a w/chair for bad days / holidays, too. take care. btw if you are tall watch out for knees and back, too

Thank you for the warning but i am unable to walk or stand and permanently use a powered chair. I had quite high instep when younger which flattened slightly and so shoes went up one size from 10 to 11 at 40 ish.

aaaargh....... feet..... size 28..... in it put ....... sorry x

I, too have wide feet with large "bunions" on both feet. I finally saw a podiatrist. After examination and x-rays, it turns out that my foot joint at the base of my big toe is hypermobile which has allowed the joint to shift outward and appear to be a growing bunion. I will have surgery this month to correct this and hopefully have my left one done next year!

My Rheumy pretty much dismisses nearly everything I think might be RA related so I didn't even bother him with my bunion issue.

Foot problems are known to be common with RA. I couldn't wear normal shoes within a year of being iadnosed. I had been able to wear whatever footwear I liked until then. My rheumy nurse sent me to a podiatrist which was really helpful. She made insoles for me which made my feet much more comfortable. She also gave me information about companies which make extra wide fitting footwear. I went with widefittingshoes.co.uk and have got several pairs of shoes and boots from them. They are not cheap but they look good and are comfortable.

Have a look at this article. It's very interesting.

nras.org.uk/i-have-problems...

Hi Jackie

I too have had bunions appear since being diagnosed & the consultant seemed to ignore them even tho my left one appeared over 1 weeks walking holiday...

Now, finally 6 months later my meds are settled & my hands have returned to as much as normal they are going to get, he's finally acknowledged them... & sent me to orthotics for inserts in my shoes. He's told me they are caused by osteoarthritis and there's very little that can be done bar surgery.

I've replaced all of my shoes with wide fit to accommodate my little friends but like u I am not happy having to take more pain killers on top of the 7 arthritic drugs I take everyday.

My right is in far better condition than my left as I can no longer bend it.. it's made yoga impossible...

Ask for a referral and keep asking - hopefully you will get sorted soon... good luck!

Sara

When I was about 25 I had what I thought was a bunions on both feet had X-ray and it turned out the bones were bent had op no problem until this year on right foot I now have a bunion I saw doctor in June dismissed it not being due to RA sorry but I think it is I have a lot of pain in feet since being told I have RA in 2012 it's hard finding shoes that don't hurt sketchers so far are ok take care

I had surgery for bunions about 4 years ago as my big toes were growing against the other toes & would eventually have pushed them all sideways & Iwould have been in a right pickle. My GP referred me to an orthopaedic surgeon who specialises in feet/ankle surgery.

It's not to be undertaken lightly as it takes around 6 months to get back into normal shoes. I had one foot at a time operated on & reckon it took a good 18 months to get back to normality.

When my right foot was done I couldn't drive for about 10 weeks( I have an automatic car) with the left foot I could drive straight away but struggling in & out if the car with crutches was problematic!

I am pleased I had it done, but it is a serious undertaking especially if you live alone &'live in a house with stairs!

Hi - from another aged crone with multiple foot problems - see my reply to Jackie earlier, if you can be bothered! It's all there ..! I was so encouraged by what you said about how you coped with your foot ops - becos I live alone too, and only bathroom /toilet upstairs as well!! Have convinced myself I need to move house before even think about the ops. - how on earth did you manage? I've no family or others to help, and no car either so it just seems totally impossible. Am hoping for move to all on one level house, but who knows when?! Would love to hear your tips, in case I really could consider the op now.

Thanks, Sheena

Hi Sheena.....it was a breeze ....NOT! Organisation was the name of the game!

Downstairs my little friend was my vegetable trolley on wheels! I loaded it up .....got my crutches & kicked it around full of goodies with the foot that was in plaster! Made tea/coffee in a flask so didn't spill it.

I tried going up & down stairs on the crutches but my stairs have a bend...so resorted to shuffling up & down on my rear end (not a pretty sight!) with "stuff" in a bag hanging around my neck! It was especially awkward crawling to the bed upstairs & heaving myself onto the crutches downstairs.

I had a tea tray in my bedroom (that's when I bought the Coopers hot water boiler).It's amazing what snacks you can find that don't need a need a fridge! (But I didn't descend to Pot Noodles, just the odd cuppa soup with crackers.) But remember to have a tea towel & washing up liquid ....you can't carry them up easily!

Before the surgery I loaded the freezer with bread & plated meals & kind neighbours helped out with fresh fruit & milk!Thank goodness I have a dishwasher. But everything took SO LONG!

The hospital gave me a large plastic sock "thingy" that came over my knee - it had a seal like a wet suit...popped my leg in that & I could have a shower.

At the supermarket when I was still on crutches they said I could park in the disabled bays.....I hung on to the trolley with my crutches in it! Got some very funny looks!

As I said it was quite an undertaking....but I have a friend in the USA who now can only wear Crocs as she was too afraid to have the surgery & her feet are now beyond any treatment & I didn't want to end up like that! I must admit I thought it would be much more painful than it was. I took painkillers for the first couple of days as I'd had neuromas removed as well......then didn't need anything. I was on Mtx at the time.

I now have the nicest feet I have ever had, the scars have faded & hardly any pain! Can wear little heels, but no more Jimmy Choo stilts....not that I could balance on them these days!

Good luck if you go for it!

Thanks for that....having a bit of a flare-up today....feeling yuk...so will go back and read everything properly when feeling more like it. S.

Take care...rest up & think it out & if you think you could manage - see an orthopaedic foot surgeon . Don't be palmed off with a general,surgeon who does the odd bunion!

My surgeon has patients who travel from all over the world to get their feet & ankles seen to... ....there is probably someone like him in your area.

Push to be referred to a podiatrist so you can get a proper assessment of what's wrong with your feet. It has made the world of difference to me. Personally I feel that it is the repeated inflammation caused by RA that sparks off secondary osteoarthritis - but only one doctor agreed with me, the rest said it was coincidental. Which I think is fobbing us off - after 55 years of perfect feet it is strange that I develop foot problems within months of being diagnosed with RA.....

Well I was sent to a patient education course when I signed on with my last rheumy. One session a week for 6 weeks. I attended conscientiously because the rheumy was so good & I wanted to come across as a cooperative patient. However those sessions seriously affected my will to live, incredibly boring & patronising. The staff who organised it were nice enough & knowledgeable, they just seemed to think we patients were feeble minded.

Anyway there was one gem, a good slide show about exactly what inflammation does to joints. And yep, osteoarthritis was in there. So I waved my hand in the air & asked if they were saying that osteoarthritis can purely and simply arise as a result of inflammatory arthritis. The answer was a very definite 'YES!' The joint is 'bathed' in inflammation and that can attack the cartilage, much as 'wear & tear' does, and then you may get osteoarthritis which is, I think, basically joint damage resulting from reduction in cartilage. Additionally, reduced mobility due to inflammation can lead to muscle wasting which in turn puts more pressure on cartilage, especially in weight bearing joints. Osteoarthritis is just one of many forms of damage that can occur in joints that are affected by RA, PsA etc. I've got a link to a scholarly article explaining this somewhere, I'll post it.

Also, my rheumy accepted that the bunion I'd had corrected was associated with my PsA. As it happens I don't think I had accompanying OA in that joint, some bunions include OA (result from OA perhaps?) but some don't.

My arches have disappeared, one day I had them and the next time I noticed, they were gone!!! I also have great deal of pain where my toes join my foot and on the top of my foot is swollen. I also get a great deal of heel pain. I pretty much live in sketchers as they are about the only shoes that I don;t feel like crying in. I have had RA for about 5 odd years and it has not yet been controlled

MEDICAL OFFICER: Suffer from any illnesses?

FLETCHER: Bad feet.

MEDICAL OFFICER: Paid a recent visit to a doctor or hospital?

FLETCHER: Only for my bad feet.

MEDICAL OFFICER: Are you now or have you been at any time a practising homosexual?

FLETCHER: With these feet? Who’d want me?

I do wonder if fletcher might of had RA, my feet have hurt from day one, since this started, Yes get some good shoes Ive got HUSH PUPPIES wide and they have velcro straps, which are brilliant as I dont need to use my hands to tie the laces!

Please dont be put of because the RA specialist,thinks its not related its your body and you know what's going on,there are great RHEUMATOLOGIST are out there who do listen to us. please speak with your RA nurse if poss as they can arrange appointments with the podiatrist dept and i've got the inserts and they do help.

warmest Craig

I have also brought these and fitted them to my boots/shoes and they feel good if you look on groupon, they are on offer and they might help.Pro 11 Orthotic Insoles:

The Specifics

Full length orthotic insoles

Designed to help with most foot pains and symptoms

Supports and helps re-align an over pronating foot

Sizes 3 to 13

Warmest Craig

So many things cause bunions .... bad shoes allegedly but also pronation i.e. feet which are not perfectly balanced. I don't think any bit of me is perfectly balanced. I think inflammatory arthritis can cause bunions too & so does my rheumy (though I'm just due to see a new one, hope she's as good!). Conditions that can have many causes .... bunions, OA etc. are a bugbear for us 'cos they may well be evidence that our RA etc. is giving us a kicking but some rheumatologists prefer to focus on symptoms that are caused by inflammatory arthritis and only inflammatory arthritis. But are there any such symptoms? Many diseases cause systemic inflammation, many diseases cause fatigue, many cause joint pain. The distinctive type of joint erosions caused by RA or PsA may be 'pure' evidence of active disease but by then it's a bit late in the day ....

I've developed a bunion since PsA diagnosis too. It's on the right foot, but it's my left foot that's got the bad toes and ankle.I guess it's from being unbalanced!

I too have RA and a bunion. I have never worn shoes with narrow toes or high heels. My RA was diagnosed 12 years ago, followed closely by a bunion and crossing over toe. 9 years ago it was successfully operated on, but within about 3 years the bunion and crossing toe was back with avengence. After the operation the bunion for was a shoe size longer thaN my other foot! It is difficult to get shoes that are comfortable for my bunion foot, but stay on my narrow foot!

My arthritis started in my feet and i was told it was bunions too and as a result was ignored and then it flared up in other joints. My toes are now permanently bent. Shoes wise i wear nothing else accept FitFlops, pre these i couldn't walk anywhere now i can't without so much pain in my feet.

Hi, I think its the RA ask your gp to refer you to a podiatrist. I am still wearing sandles as I can't wear built in shoes even the sketchers as I also have very painful soles. The good news is I saw a podiatrist within a week of referral who examined me and said there wasn't much she could do as I have" rheumatoid feet" along with all the other problems,bunions and little toes crossing under the next toe. She referd me on to a Orthotist by phone and I saw him 3 days later. What happens is rheumatoid can effect any muscles and tissue and the soft cushioning on the soles of our feet get pushed under our toes causing the toes to get cramped up together and as there's little room it causes them to get squashed and pushes the bunions out. If you find it painful to walk its because as the cushioning is now under the toes your pushing down on your feets bones . The orthotist can make individual foot supports which I now have, if its really bad they can make shoes for you.

I hope this makes sense as I had a bad night so very tired. Linda

Hi Jackie, I haven't read thru all your replies at length, but I do sympathise becos my feet seem to be the only area affected by RA - weird, but then that's me all over! BUT I have always had sore, awkward feet - now in my 60s, I was never really able to wear high heels even when young, and my mother had dreadful bunions. Though she didn't have RA, and she never had bunions operated on. So I wasn't really surprised when I too developed bunions, and soldiered on with them until I couldn't get wide enough shoes any more, plus the pain was getting to me.... so I had the left foot one done about 6 years ago. The recovery time was the worst aspect, as I live alone. But I got thru it, and there was no trace of RA at that time. Then, in 2013, I was suddenly in agonising pain on BOTH feet, mostly in the midfoot area, on the top. Walking was, and still is, out of the question. Went through all the tests, the long drawn out frustrating process that we're all familiar with, until my Rheumy decided it WAS seronegative RA. But only inflammation which showed in scans, was in my feet joints. Midfoot, and also at base of toes. No medication has helped, so far. We may yet try Tocilizumab, but the fact that none of the other DMARDS or even the first biologic helped at all, has put me off. Plus the severe side effects. Been referred to a foot specialist surgeon, who is keen to operate to fuse 2 joints, but so far I'm stalling on that. Seems my foot joints have been so damaged that an op is only answer. I've also developed bunions on my smallest toe joint, which I didn't know could happen - but do now! Can only wear the softest, MaryJane-style shoes, in the widest possible width. Special insoles do help a little but not much. But as the bunion on my right foot was never operated on, that foot is a good bit wider than left. None of which helps you much, but at least you know you're not alone! I too would like to know whether having 'ordinary' foot problems pre-RA, sort of opened the door to RA? If you see what I mean. The even weirder thing is that although I gave up believing astrology-stuff a long time ago, I have a book which goes into great detail and even gives which parts of the body are most vulnerable to illness, for each sign. I'm a Pisces, and yes - Pisceans can apparently expect foot problems !!!

Do you need a wide shoe? - if so, Wider Fit Shoes, or Cosyfeet may be of interest to you. Am impressed that you can still do walking, by the way! All the best, Sheena. xx

Hey HallJackie - That is one of the weird things about feet in RA. I don't know about bunions, but my big toes started turning in toward the other toes, and created a lump on the top of each foot. I told my rheumatologist about it and like yours, mine said they were not related, but she sent me to my orthopod. He took x-rays and said that they clearly WERE RA related. So I'm not sure about the bunions, but feet definitely get involved in the RA process...

I have had to wear insoles for years. I kept spraining my ankles. The final straw was when I stepped off a first aid unit, was taken to A&E in the ambulance that I drove in and sat there for 4 hours in full St John uniform (I think they then hurried me through as I was going to damage the next person who said "you shouldn't be in here, you should be bringing us in here!). Well I got referred to a lovely man with a foot fetish who had loads of X-rays taken. Upshot was that my ankles turned my feet out. That was the end of heels and the start of medically designed insoles. I now have to wear PPE shoes for work (why I don't know, if a bus runs over my feet they won't safe me). Haven't had bunions (don't really know what they are), but I have been complaining about my feet longer than my hands.

As I said earlier, my so-called bunions were caused by hypermobility of the big toe base joint. I have researched a little and found that there may be a connection between hypermobility and connective tissue disorders (which makes sense, I guess). See a podiatrist to get to the bottom (haha) of your problems. My surgery is in 2 weeks and the podiatrist is using screws to correct the issues. He said that because he is using screws, I could bare weight almost right away and be back to work the following week AND drive! Fingers crossed!

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