The feet are one of the most common parts of the body affected by psoriatic arthritis (PsA). This disease can inflame any of the 28 bones and 30 joints in each foot, as well as the ankles. And when PsA hits your feet hard, every step can be painful.
Pain, swelling of the foot and toes (dactylitis), and stiffness are common with PsA. These symptoms may be worse first thing in the morning or if you have not moved your feet for a while, like in the morning when you first get up.
In particular, PsA tends to cause pain at the back of the heel (Achilles tendinitis) or the sole of the foot (plantar fasciitis). Foot pain and swelling appear during active disease periods called flares and subside during remissions.
Psoriatic arthritis on the feet can also cause changes to the toenails. These changes can include discoloration, nail pitting, which is when the nail has small indentations, or lifting of the nail off the nail bed.
Managing your PsA with medications can help reduce foot pain and swelling. As you follow your treatment plan, here are some other tips to help you manage these symptoms.
Take your medication
Biologics and other disease-modifying antirheumatic drugs (DMARDs) act on your immune system to slow the progression of PsA. If you take all of your doses on schedule, these drugs should help manage the joint damage that causes foot pain.
Choose good shoes
Avoid high heels and shoes with a narrow toe box. They put too much pressure on sore, swollen feet. Instead, wear shoes with an open toe or wide toe box to give your feet room to swell.
Add a cushioned insert for even more comfort and support. Your podiatrist might recommend that you wear custom orthotic insoles. These inserts will:
- give you more support
- increase your comfort
- reduce pressure on your feet
A daily workout can help arthritis symptoms. Exercise helps to keep joints limber and take off the extra weight that puts strain on them.
When it comes to PsA, some exercises are safer than others. Jogging or running can aggravate soreness. Even walking may not be possible on days when your feet hurt.
Instead of pounding the pavement, try swimming. Water exercise is particularly good for arthritis, because the warm water soothes sore joints, while the buoyancy takes pressure off them.
A bike or elliptical machine is another non-impact way to work out with PsA. Also include stretches as part of your routine several times a week, especially for sore areas like your Achilles tendon and the plantar fascia on the bottom of your foot.
A physical therapist can teach you stretches and exercises that are safe for your joints.
Manage your weight
Your feet have to carry your body weight. Being overweight puts extra strain on them.
On top of that, fat tissue releases inflammatory substances that aggravate PsA and make its symptoms worse. Try working toward achieving a moderate weight with the help of a nutrient-rich diet and regular exercise. If you’re still having difficulty managing your weight, ask your doctor for advice.
When your feet hurt, give them a rest. Sit down and prop them up on a stool at regular intervals during the day to ease swelling.
Soaking your feet in warm water with some Epsom salts helps relieve swelling and pain. Just do not keep your feet submerged for too long. Too much time underwater can dry out your skin and cause a psoriasis flare-up.
Take a pain reliever
Try a nonsteroidal anti-inflammatory drug (NSAID) like ibuprofen (Advil, Motrin) or naproxen (Aleve), which are available for oral or topical use. These pain relievers bring down swelling and can help ease pain in your feet and other sore spots.
Trim your toenails
Keep your nails trimmed short to prevent them from catching on your socks and pulling them. File down each nail to keep it smooth. Be careful not to cut your nails too short, though. You do not want to cut your skin in the process, which can possibly lead to an infection.
Use an ice pack
Cold narrows blood vessels, which helps bring down inflammation and swelling. It also has a numbing effect on tender areas.
When your feet are sore, hold an ice pack to them for 10 minutes at a time, several times a day. Wrap the ice in a towel first to avoid damaging your skin.
One trick if you have plantar fasciitis is to roll the bottom of your foot across a chilled or frozen water bottle. You’ll get a soothing massage along with the cold.
Ask about steroid shots
Corticosteroid injections bring down swelling in inflamed joints. Your doctor can give you an injection in each of the affected joints in your feet during flares.
Try these home-care tips to help ease PsA foot pain. If they do not work, ask your podiatrist or rheumatologist about other treatment options. If all else fails, you may want to consider foot surgery to fix damaged joints.
Talk with your doctor to learn more about treatment options that are right for you.