Recognising the Early Signs of Arthritis in Your Feet

From verywellhealth.com

Arthritis can affect any of your joints, including those in your feet. Joint damage from arthritis can cause pain, swelling, and physical changes to the joints.  

Arthritis is a general term that describes more than 100 rheumatic diseases that affect the joints. The main symptoms of arthritis are pain and swelling in one or more joints. Arthritis can be acute (sudden and short-term) or chronic (gradual and long-lasting).

With most types of arthritis, the joints become worn down or damaged over time. This is one reason arthritis is common as people age, although there are types of arthritis that are related to other causes, including genetics.  

This article will cover the early signs of arthritis in the feet, arthritis conditions that affect the feet, causes of arthritis, and more.

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Early Signs of Arthritis in Feet

Each foot contains 33 joints, 26 bones, and more than 100 muscles, tendons, and ligaments. The joints are covered with articular cartilage - connective tissue that covers the surface of bones in a joint. Its primary function is to reduce friction during joint movement.  

Arthritis can affect one or more of the joints of your foot. You may have symptoms in one foot or both feet. Arthritis will cause the joints to wear down and lose their cartilage. As a result, the bones will rub against each other, causing pain.

The soft tissues in joints might also become worn. Over time, the joint will not move and work as it should.

The earliest signs of arthritis in the feet are pain, swelling, and stiffness.

• Pain: When arthritis affects the feet, you will feel pain early on. The pain might be intermittent, or it can occur after physical activity. Foot pain this early can come and go. It might be worse in the morning or at night, depending on the type of arthritis you have. Foot pain occurs while standing, putting pressure on the feet, or moving the feet and ankles.
• Swelling: The feet might be swollen and sore from inflammation - the body’s natural response to injury or illness. Inflammation in the feet might cause the skin at the affected joints to feel warm and appear red. In addition, the feet might feel tender to the touch. Pain and swelling might also occur with rest.
• Stiffness: Arthritis can cause your feet to feel stiff. You might also experience decreased range of motion of the affected joint. Stiffness often occurs in the morning upon awakening or after periods of inactivity. Stiffness tends to improve throughout the day with movement.

Arthritis symptoms in the feet can start suddenly and get worse quickly or develop gradually. Depending on the type of arthritis you have, one foot or both feet might be affected.  

Over time, arthritis in the feet can worsen, leading to advanced symptoms. More advanced symptoms of foot arthritis include: 

• Joint deformity: Arthritis will cause the cartilage in the joints to wear away. Once this occurs, the muscles and ligaments around the affected joints become weak, leading to misshapen and deformed bones.
• Bone spurs: When joint damage occurs, extra bone might form in the affected joint. These growths appear as knobby growths. In addition, bone spurs sometimes affect joint function.
• Mucous cysts: Bumpy fluid-filled sacs that present as ridges in the feet, usually occurring at the ends of the toes or under the toenails. Because of their location, these cysts can be painful, such as with walking and rubbing against footwear. Mucous cysts also can put pressure on nerves if they grow too large.

Types of Arthritis That Can Affect the Feet  

Different types of arthritis can affect the feet, including osteoarthritis (OA), rheumatoid arthritis (RA), gout, psoriatic arthritis (PsA), and ankylosing spondylitis (AS).  

Osteoarthritis 

Osteoarthritis is known as wear and tear arthritis, which is expected as people age but can also affect younger people. OA causes joint cartilage to wear away, leading to bone-on-bone pain and bone spurs.  

When OA affects the feet, it commonly affects the metatarsophalangeal joint (MTP)—the joint that connects the big toe to the foot. OA can also affect the midfoot.  

Rheumatoid Arthritis 

RA is a type of autoimmune arthritis that occurs because the immune system malfunctions and starts to attack healthy tissues, mainly the synovial linings of the joints. RA often starts in the feet, and because RA is symmetrical, it will affect both feet.

RA will cause inflammation of the small joints and soft tissues of the feet. It can cause severe pain and joint damage in the feet very early in the disease, even before a diagnosis can be made and treatment can start.

RA can affect both the ankles and feet. In addition, it can affect the hindfoot (the heel), the midfoot (at the top of the foot), and the forefoot (toes and ball of the feet).

Gout  

Gout is a type of inflammatory arthritis resulting from too much uric acid in the body accumulating in a joint. It most commonly affects the feet and, frequently, the big toe. Research shows that the range of motion at the back of the foot and MTP joint is reduced in people who experience gout in their feet.

Psoriatic Arthritis 

Like RA, psoriatic arthritis is an autoimmune disease where the immune system malfunctions and attacks healthy tissues. In PsA, those attacks are directed at the joints and the entheses - the places where tendons and ligaments meet bone. It frequently affects one or both feet. Foot problems are among the earliest signs of PsA.

Foot problems linked to PsA include:

Dactylitis: This is the term used to describe inflammation of an entire toe (or finger). Also called sausage digits, it is common in people with PsA.

Heel pain: Heel pain in PsA commonly causes inflammation of the Achilles tendon, the ligament that connects the heel bone to the calf muscle.

Bottom-of-the-foot pain: PsA can cause inflammation of the plantar fascia, the ligament that stretches from the heel to the toes. If the plantar fascia is inflamed, you might experience pain in the sole (bottom) of the foot.

Nail changes: PsA can cause dents in the toenails, nail thickening, nailbed separation, and discoloration of the toenails.

Additional foot problems: PsA can also affect the MTP joints and cause swelling at the ball of the feet and hammertoe—an abnormal bend at the middle joint.

Ankylosing Spondylitis  

Ankylosing spondylitis is a type of inflammatory arthritis that affects the spine and large joints. Like PsA, AS is an autoimmune disease that affects the entheses.

AS can lead to heel pain at the Achilles tendon and sole pain at the plantar fascia. Pain and tenderness in these areas can affect a person's walking ability.

Causes of Arthritis 

Different types of arthritis conditions will have differing causes. Common causes of arthritis include:

• Wear and tear from overuse of a joint
• Age (OA is common in older adults)
• Injury
• Infections
• Being overweight
• Muscle weakness
• Genes or family history
• Autoimmune disorders

Normal wear and tear of joints with age is the most common cause of OA. Infection and injury can cause cartilage tissue breakdown, leading to OA. OA can also run in families, and your risk for the condition is higher if you have a family history of OA.

RA, PsA, and AS are autoimmune diseases that occur when the body’s immune system attacks healthy tissues, resulting in inflammation of the joints. The exact cause of why the immune system malfunctions is unknown, but researchers have discovered genetic markers related to all three conditions.

Gout is caused by too much uric acid in the body. The body produces uric acid when it breaks down purines from food. When there is too much uric acid, uric acid crystals will build up in the joints.

Risk factors for gout include being male, overweight, overconsumption of alcohol, eating purine-rich foods, and having certain health conditions (i.e., high blood pressure or diabetes).

How Is Arthritis Diagnosed?  

To determine whether arthritis is the cause of foot pain, a healthcare provider will start by asking about your symptoms, general health, and medical history. Next, you will be asked when and where the pain began and what worsens or improves symptoms.  

The healthcare provider will also examine your foot and ankle for swelling and tenderness. You may be asked about your footwear to determine if your shoes provide sufficient support while walking.  

A test called a gait analysis is generally included in the physical examination. The healthcare provider will want to observe how you walk with this test. The test also examines the line-up of the bones of the feet, your stride, and the strength of the ankles and feet.  

Additional testing for foot arthritis includes:

• Imaging: X-rays can detect joint space narrowing (a sign of cartilage loss), bone changes, joint damage, or bone spurs. Other types of imaging, including bone scans, computed tomography (CT) scans, or magnetic resonance imaging (MRI), might be done if X-rays can’t pinpoint the source of symptoms.
• Bloodwork: Blood tests can help your healthcare provider determine what type of arthritis you might have. Different types of bloodwork can help diagnose RA, AS, or PsA.
• Joint fluid test: Your healthcare provider will use a needle to draw fluid from an affected joint to diagnose or rule out gout. Urate crystals are detectable when the joint fluid is examined under a microscope. 

When to See a Healthcare Provider 

If you experience foot pain or find you are having gait problems, call a healthcare provider. Arthritis can cause severe pain, affect your mobility, and lead to joint damage.  

Seek immediate medical care to rule out infection if you have a fever and any part of your foot is hot or inflamed. 

Summary   

Types of arthritis that can affect the feet include osteoarthritis, rheumatoid arthritis, psoriatic arthritis, gout, and ankylosing spondylitis. Causes of foot arthritis are aging, injury, genes and family history, and autoimmune disorders.  

Diagnosing arthritis typically involves a review of symptoms and medical history, a physical examination, imaging, and lab work. You should make an appointment with a healthcare provider if you start experiencing foot pain that doesn’t resolve with rest or if you have problems walking.  

A Word From Verywell

Arthritis can be a painful and disabling condition, especially if left untreated. Treatment for arthritis can focus on symptom relief and maintaining joint function to reduce the potential for disability. You might need to try different treatments or a combination of treatments before you find something that works best to manage your arthritis symptoms.

FREQUENTLY ASKED QUESTIONS

• Where does arthritis in the foot start?

  The symptoms of arthritis in the foot will depend on the type of arthritis you have. For example, osteoarthritis affects the MTP joint that connects the big toe to the foot, and rheumatoid arthritis affects both feet simultaneously. It will cause inflammation of all or part of the foot in the same joints on both sides.

  Learn More: The Differences Between RA and Other Types of Arthritis
• Is walking good for arthritis in the feet?

  Walking is a low-impact activity often recommended for people with arthritis to manage their condition. It can also help you lose weight and maintain it to lessen stress on joints and improve symptoms. If you find your foot arthritis affects your ability to walk, reach out to a healthcare provider to discuss your treatment options.
  

  Learn More: Is Walking Good for Arthritis in the Knee?
• What age does arthritis typically start in the feet?

  The wearing down of the joints of the feet commonly occurs as people age. Most people notice arthritis in their feet and other joints after age 40. However, it is possible to have symptoms of arthritis earlier, especially with autoimmune arthritis conditions like rheumatoid arthritis.

• https://www.verywellhealth.com/early-signs-of-arthritis-in-feet-6260438
  

 

How Practising Yoga Can Help Relieve Your Arthritis Pain Naturally

From prevention.com By Kaitlyn Pirie

Bonus: It can calm your mind and boost your mood in the process 

If you suffer from arthritis pain, you might assume that all types of exercise are off-limits, but that’s not true. In fact, regularly doing yoga stretches for arthritis symptoms can help you feel better both physically and mentally. One study found that yoga may enhance muscular strength, flexibility, and functional mobility in people with knee osteoarthritis while a large review of research shows that it can help improve physical function, disease activity, and grip strength in people who have rheumatoid arthritis.

The key is to do yoga moves that are tailored to your individual needs. Below, certified yoga therapist Steffany Moonaz, Ph.D, the associate director of research at Southern California University of Health Sciences, an adjunct professor at Maryland University of Integrative Health (MUIH), and the founder and director of Yoga for Arthritis, explains why yoga can provide relief from arthritis discomfort—and how you can try a few yoga moves for arthritis at home.

How does yoga help with arthritis pain?

Pain is probably the biggest reason people with arthritis come to yoga —and pain is incredibly complicated. Physically, strengthening the supporting muscles around a joint may increase stability, which may reduce irritation within it. Or there could be nerve pain associated with degeneration—perhaps the spine is pressing on a nerve, leading to sciatica—and yoga may help alleviate it.

Some yoga practices affect the nervous system too. For example, research shows that deep breathing shifts us out of our stress response (which people with chronic pain are often in) and into the relaxation response, and that can reduce pain. There are also pain pathways between the body and the part of the brain where we interpret sensation; yoga may decrease pain by changing activity in those pathways.

Does yoga have mental health benefits as well?

Yes. Arthritis includes more than 100 conditions that can affect just one joint or many. Some, such as systemic lupus erythematosus, are autoimmune inflammatory diseases associated with depressive symptoms.

Plus, living with chronic pain from arthritis can be incredibly frustrating, stressful, and depressing. Fortunately, several aspects of yoga, including the deep breathing mentioned above, can boost mental health. Another approach we use, progressive relaxation, can help calm muscles and our emotional state.

So what’s the best way to start doing yoga for arthritis?

1. Check with your doctor. Ask if there are any poses or movements you should be careful about. Then, if you’ve never done yoga before, ideally you want an instructor with experience and training in working with arthritis to guide you one-on-one (in person or over Zoom).
2. Find a yoga instructor familiar with arthritis. A yoga therapist has specialized training in working with clinical populations and developing individualized care plans, so that might be a great person to look for if you have movement limitations and/or chronic pain concerns. They can offer specific tips on adapting a yoga practice for your body, which is going to be different if you have, say, rheumatoid arthritis in your hands than if you have osteoarthritis in your knees.
3. Pick the right class. After you've taken the steps above, feel free to attend a class and let the instructor know about your condition. When choosing a class, look for descriptions like “gentle,” “beginner,” “therapeutic,” “restorative,” “adaptive,” “accessible,” and “for seniors.” (You don’t have to be a senior to take a gentle yoga class!)
4. Take it easy. No matter what, yoga should not make your joints feel worse. Remember that you are the world’s leading expert of your own body. No matter what the instructor suggests, listen to how you feel and adjust be comfortable. Yoga may be challenging, but it shouldn’t be harmful.

How long will it take to feel better?

There isn’t good research that says how much yoga you need to do, but think of yoga as a lifestyle rather than an activity. Proper posture, deep breathing, and morning stretches are things you can throughout the day, and they may help more than if you do one class a week and nothing in between. It could take a month to see physical results, but you’ll likely feel better mentally right away.

5 Gentle Yoga Poses to Try for Arthritis

While working one-on-one with a yoga therapist is ideal, Moonaz recommends trying these poses if you want to try a bit of yoga on your own at home. If something doesn't feel right, don't push it—slowly ease out of the pose and try another one or simply sit still and breathe.

SARA MONIKA

Mountain Pose

Stand with feet hip-distance apart or closer with toes and knees pointing forward. Keep shoulders relaxed over hips and lengthen through the spine so the top of your head is lengthening upward and arms rest at your sides. Find a focal point at eye height and allow the breath the deepen. Notice the weight evenly distributed between both feet and from toes to heels. Stand in this posture whenever you need to feel grounded, to calm your mind, or to reset your day.

NICHOLAS MURRALL

Warrior I

Start in Mountain Pose, holding a chair for support. Step one foot back a few feet, angling the back toes out slightly but keeping the hips squarely facing forward. Bend the front knee into a lunge, making sure the front knee doesn’t bend past the ankle. Keep your shoulders over your hips and the gaze forward. Bring hands to hips, shoulders, or up overhead if you feel stable, or keep one hand on the chair for safety. Take five full breaths and repeat on the other side.

BEE32

Seated Figure 4

Sit in a chair with feet firmly on the floor and your back away from the back of the chair so you are sitting up tall. Cross one ankle over the opposite knee or thigh. You can also put the foot on a yoga block or stool if the knee isn’t accessible. Relax the open hip. If you have more mobility available, place the hands on the thighs or hold the chair and begin to hinge forward from the hips, keeping the back long. Take five breaths here and switch legs.

VLADIMIR VLADIMIROV

Downward Dog with a Chair

Stand in Mountain Pose behind a chair with the back of the chair facing you. Hold the back of the chair and step back with both feet. Keep the back long and step as far back as feels okay for your shoulders, reaching the hips behind you. Keep heels on the floor and knees soft or slightly bent. Hold for five breaths and return to Mountain Pose. (When you become comfortable with the pose, you can turn the chair to face you and rest your hands on the seat instead of the back for a deeper stretch.)

TONY ANDERSON

Tree Pose

Stand in Mountain Pose, holding the back of a chair on your left. Shift your weight into the left foot, bending the right knee and rotate the right hip outward so your knee points to the right side. Bring your right foot up to the ankle or lower leg. Lengthen the left hip so you aren’t sinking to that side. Find a visual focus and reach your right arm up as high as feels comfortable for your shoulder. Try taking your left hand off the chair for a few seconds to test your balance. When you are ready, lower back to Mountain Pose, and try it on the other side.

A version of this article originally appeared in the April 2021 issue of Prevention.

https://www.prevention.com/health/a35843625/yoga-for-arthritis/