Rheumatoid arthritis is a systemic autoimmune disease that has no known cause. The disease is characterized by on-going inflammation of the lining of the joints in the body. This progresses to erosion of the joint cartilage and weakening of the soft tissue structures about the joint. Over time the joints can dislocate in a deforming fashion. The most common joints affected are those in the hands and the feet. Rheumatoid arthritis can also affect blood vessels and other body organs. Soft tissue nodules can also form near joints. These are called rheumatoid nodules.
In the foot rheumatoid arthritis can present as generalized pain in the ball of the foot or ankle. This can often present in later stages as dislocation and deformity of the joints in the ball of the foot. The plantar fat pad can shift or diminish resulting in painful callouses in the ball of the foot.
Rheumatoid arthritis can be a source of pain on the bottom of the heel. This can mimic the classical heel pain caused by plantar fasciitis. It is important for the treating doctor to consider Rheumatoid arthritis as a cause of heel pain.
Presentation and Diagnosis
Early symptoms of rheumatoid arthritis are morning stiffness of the joints and joint swelling. Fatigue, a low-grade fever and weight loss may accompany this disease. Blood tests and x-ray findings assist in making the diagnosis. In the early stages of the disease it may be difficult to make the diagnosis.
A qualified family practice physician, interest or rheumatologist should treat the generalized symptoms of rheumatoid arthritis. Local care of foot related problems treated by a podiatrist include palliative care such as trimming painful callouses, padding, special inserts for the shoes as well as surgical intervention. In many instances surgical intervention can be very rewarding.