Key points 

Muscle, bone and joint conditions that affect the feet can have a great impact on daily activities and livelihood.

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 typically results from 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 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 is a common form of arthritis characterised by recurrent attacks of extreme pain, swelling and redness. In particular the big toe joint is usually affected and becomes acutely painful with the area being red, hot and swollen during an attack. Gout 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 and subsequent degeneration and permanent damage of the joint.

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.

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.

Wearing tight, narrow shoes might cause bunions or might make them worse. Bunions can also occur in people who have feet that are more likely to develop bunions due to their shape and structure, or people with an inflammatory condition such as rheumatoid arthritis.

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

• footcare: it's important to look after your feet. Wash and dry them regularly. Inspect them for any irregularities 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 the 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 it is important to 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 gait or walking. They can also provide advice on appropriate footwear. Podiatrists are also able to 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 regarding medications which may help to alleviate pain. Your doctor may prescribe a painkiller as well as non-steroidal anti-inflammatory drugs (NSAIDs) that can help with reducing pain and 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 have not helped. A referral to an orthopaedic surgeon who specialises in feet is usually required.

• Podiatrist

• Doctor

• Physiotherapist

• MOVE muscle, bone & joint health
  National Help Line: 1800 263 265

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Need medical information regarding your condition and commonly prescribed treatments? Or assistance navigating the health, disability and social services systems? Contact our nurses on the Help Line on 1800 263 265 or email helpline@move.org.au.

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• Australian Podiatry Association (Vic)

• Australian Physiotherapy Association

• Better Health Channel

• American Academy of Orthopaedic Surgeons – Patient Information