Feet and musculoskeletal conditions

Things to remember

Our feet are complex structures
Each foot has 26 bones, 33 joints, and more than 100 tendons, muscles, and ligaments
Conditions such as osteoarthritis, rheumatoid arthritis and gout can cause pain and swelling in feet
There are things you can do to decrease foot pain.

Arthritis and musculoskeletal conditions that affect the feet can have a great impact on your daily activities and livelihood. This information will look at common conditions that can affect your feet, and things you can do to manage.

Osteoarthritis

While osteoarthritis can affect any of the joints in the feet, it commonly affects the big toe joint or the joints in the middle of the foot. It usually is the result of a prior injury or poor foot function.

Decreased movement or complete fusion of the big toe joint is quite common and there may also be an associated bunion (bony lump on the outside of the joint) present in this area.

When osteoarthritis affects the joints in the middle of the feet, prominent bony lumps called osteophytes may form on the top of the foot. Essentially osteoarthritis in the feet is a ‘wear and tear’ injury where the cartilage of the joint wears thin and the space between the joints becomes narrowed.

Rheumatoid arthritis

Rheumatoid arthritis is an autoimmune disease that affects many joints in the body. Common symptoms affecting the feet include:

pain, swelling and stiffness of the joints
clawing of the toes
bunions
in the later stages of the disease, the arch of the foot may collapse.

Gout

Gout is a common form of arthritis characterised by repeated attacks of extreme joint pain, swelling and redness. It occurs when uric acid builds up in the bloodstream and deposits urate crystals in the joint. The build-up of these crystals can lead to inflammation. The most commonly affected joint is the big toe. During an attack the joint is red, hot, swollen, and is extremely painful. While most other types of arthritis develop slowly, an attack of gout happens suddenly, often overnight.

Psoriatic arthritis

Psoriatic arthritis is not very common, however it can affect the feet and cause the toes to swell. It’s generally associated with psoriasis of the skin and nails; the skin may appear red, scaly and itchy and the nails pitted and discoloured.

Bunions

A bunion is a painful bony bump that forms on the joint of your big toe. A bunion develops when your big toe pushes against your next toe. Over time this changes the structure of the joint, causing the joint of your big toe to get bigger and stick out.

The shape and structure of your foot is something you inherit from your parents, and some foot types are more prone to bunions than others. Bunions may also be caused by inflammatory conditions such as rheumatoid arthritis.

Wearing shoes that cause your toes to be quite confined and crowded – for example shoes that are too tight, too narrow or high heeled – may trigger bunions in people who are more susceptible to developing them.

Treating foot conditions

The treatments used for foot conditions will vary from person to person. Below are some treatment and management options:

foot care: it’s important to look after your feet. Wash and dry them regularly. Inspect them for anything unusual such as cuts, blisters, changes to the nails and skin. By being aware of your feet and any changes that occur, you can seek advice sooner.
footwear: purchase comfortable, properly fitted footwear. Look for shoes that are light, flexible at the toe joints and hard wearing. Shoes made of leather are preferable over synthetic materials as they breathe better. Avoid slip-on shoes and if laces are difficult to fasten due to arthritis in your hands, Velcro or elastic laces are a suitable replacement.
orthotics: corrective insoles can help alleviate pain by redistributing pressure away from the painful area and support the arch area. You can purchase off-the-shelf orthotics or you can have orthotics made that are specifically fitted to your feet by a podiatrist.
see a podiatrist: if you have foot pain, or a condition that affects your feet, seek the advice and expertise of a podiatrist. Podiatrists assess, diagnose and treat foot and lower limb problems. These may include skin and nail problems, foot and ankle injuries, foot complications related to medical conditions and problems with your gait or walking. Podiatrists can provide advice on appropriate footwear, and can prescribe custom foot orthotics.
exercise: it’s important to keep your joints moving where possible. Non-weight-bearing exercises such as swimming can be very beneficial, particularly for foot pain, as they take the pressure away from the painful areas. A podiatrist or physiotherapist can help with this.
medications: speak to your doctor about medications that may help relieve your pain. Your doctor may prescribe medication that can help you manage any pain and/or inflammation. Depending on the underlying condition causing the problem in your feet, your doctor may also prescribe other medications – such as cortisone injection into a joint for rheumatoid arthritis or medication for acute attacks of gout.
surgery: in some cases surgery may be needed if other conservative treatments haven’t helped. A referral to an orthopaedic surgeon who specialises in feet is usually required.

Where to get help

Your doctor
Podiatrist
Physiotherapist
Musculoskeletal Australia
National Arthritis and Back Pain+ Help Line 1800 263 265

How we can help

Call our Help Line and speak to our nurses. Phone 1800 263 265 or email helpline@msk.org.au.

We can help you find out more about:

foot pain and other musculoskeletal conditions
ways to live well with these conditions
managing your pain
- read our A-Z guide to managing pain
- watch our excellent videos on pain, your brain and how you can retrain your pain system.
  - Pain, the brain and your amazing protectometer – Lorimer Moseley
  - Treating pain using the brain – David Butler
upcoming webinars, seminars and other events.

More to explore

Download this information sheet (PDF).

Watch the recording of our webinar.

Common foot problems and MSK conditions, presented by Deborah Turner, Professor in Podiatry at Western Sydney University.
This webinar provided information about common feet problems and how to manage them.
Recorded on 25 June 2019.