Rheumatoid arthritis is an autoimmune condition that can cause inflammation, pain, and degeneration of joints. In approximately 20 to 30% of cases, rheumatoid nodules can appear on the soles of the feet. They can be alarming and can leave our patients wondering what are they and will they go away?
What Do Rheumatoid Nodules Look Like?
- Nodules can vary in texture and sizes, being either soft or firm, big or small.
- They typically appear in more severe forms of rheumatoid arthritis, and in particular presentations that affect the joints.
- These nodules appear more on weight-bearing areas of the body. In our feet this is predominately on the heels or the end of the toes.
- Pain, if the nodules are on the soles of the feet or on areas such as the toes that can rub on shoes.
- Nodules can move upon pressing them.
What Causes Nodules to Form
- A protein called rheumatoid factor is thought to be linked to rheumatoid nodules. This protein is produced by many people with rheumatoid arthritis.
- Medication used to treat rheumatoid arthritis, called methotrexate.
Treatment for Rheumatoid Nodules
- Relieving high pressure areas with an accomodating insole or customised orthotics. Customised orthotics can have specific cut out where the nodules have form to further reduce pressure and load.
- Correct fitting footwear and shoes with adequate support and cushioning.
- In more severe cases, cortisone injections can reduce the swelling.
- Surgeryis an option for the more painful and swollen nodules that are inhibiting everyday life activities, where conservative methods, such as orthotics and footwear are not enough.
If you have rheumatoid arthritis the best treatment is prevention. Having a podiatrist assess your foot posture and function can determine areas of high pressure and risk of nodule formation.