Oh My Aching Feet: Dealing with Arthritis, Part 2

You cannot put the same shoe on every foot.

Publilius Syrus

Your feet connect you to the earth. Keeping your feet in good working order is vital to maintaining your health. Unfortunately, Rheumatoid arthritis afflicts the small joints in the body, most notably your hands and feet. Your rheumatologist will usually check your knuckles and joints in your toes. She’ll probably take X-rays, but she’s not a foot doctor. She’ll treat your arthritis, but if your feet are bothering you, you’ll need to visit a podiatrist. Symptoms of arthritis in your feet include pain, bunions, hammer toes and arthritic nodules.If you have any of these, see a podiatrist as soon as you can to start treatment.

The Podiatrist

A podiatrist is a doctor of medicine who specializes in the diseases and problems of the foot and ankle. You can expect a podiatrist to do the following things:

  • Examine your feet – A podiatrist will closely examine your feet and shoes, watch you walk with and with and without your shoes, and order X-rays if necessary.
  • Measure your feet and give you your correct shoe size.
  • Work with you to create a treatment plan.
  • Recommend proper shoes for your condition.
  • Recommend a shoe vendor who knows how to work with problem feet.
  • Recommend exercises and other measures to help your feet get better.
  • Fashion orthotics tailored specifically for your feet.
  • Perform surgery as a last resort.

Podiatrists are the best option for treating your feet. The bad news is that health insurance may not cover the entire cost. When I visited a podiatrist, most of the office visits were covered by my insurance, but the custom orthotics cost me $490 out of pocket. To me, it’s been a cost well worth paying. The orthotics may need new insoles every couple of years, but the leather insert itself can be expected to last quite a while.

As with any doctor, choose your podiatrist carefully, get a referral from your physician and ask friends and family if they have any recommendations. My experience is that podiatrists love to talk about feet. Soak up their wisdom and if you’re in agreement with their treatment plan, forge ahead.

Self-Treatment

What if you can’t afford a podiatrist? Let’s look at what you can do on your own.

1. Get an accurate measurement of your feet. As we age, our feet get longer and wider. When I was a young man, I wore a 10 1/2 D shoe. That’s expanded into 11 1/2 EEEE shoe. As I’ve discovered the hard way, trying to stuff oversized feet into an undersized shoe only adds to the problems caused by arthritic feet. Visit a shoe store that you trust. Check their work. A few weeks before I visited the podiatrist for the first time, I had my feet measured by a local running shoe store. Not wise, because the salesman measured my feet wrong and the shoes I bought were too narrow. Eventually I had to return them.

2. Make sure your shoes fit properly. A good shoe sales person can help, but you need to check their work. Made sure that the toe box is wide enough for your feet. Cramped toes can only cause problems down the road.

The fabric on the top of your toes should lay flat across your foot without tugging or stretching. The heels should be snug but not tight. Your toes should have at least 1/2” of room at the end of the toe box. If possible, walk on different surfaces. If the shoes pinch or aggravate your feet, either try a larger size or a different model of shoe.

3. Buy shoes with good cushioning and stability. When I first visited my podiatrist, I was wearing one of the cheaper New Balance models. He said they didn’t offer the support I needed and recommended several different shoes for me. Here’s a brief summary of his recommendations:

Brooks Addiction

The Brooks Addiction comes in men’s and women’s models and in walkers and running shoes.

Brooks Addiction Walkers

brooks advantage

Brooks Advantage Walker–Brown

The Addiction Walkers are my everyday shoes. They’re comfortable and have a removable insole so I can insert orthotics easily. They cost $120 retail and come in several colors:  Men — White, Black and Brown  Women — White, Black and Beige. These shoes also come in  V-strap (velcro) models.

 

Brooks Addiction Running Shoes

The Brooks Addiction also is also produced in a running shoe model. They cost $120 retail and come in a variety of colors for both men and women.They are good for moderate to severe pronators. I have a pair of these, but find that they rub against my hammer toes, but if you’re a runner and aren’t bothered by bunions or hammer toes, they might be for you.

Running Shoe, Brooks

Brooks Advantage Running Shoe — Women’s Model

Brooks Beast and Ariel Models

The Brooks Beast for men and Ariel for women are Brooks’ most supportive running shoe. I haven’t tried them, but my podiatrist waxes eloquent about them. They’re pricy at $150.

You may be able to find any of these shoes cheaper either on-line or at your local shoe store. Also Brooks tends to update their shoe models on an annual or biannual basis, so you may

Brooks Beast Running Shoe

Brooks Beast Running Shoe

pick up a pair older shoes new, in the box, at a reduced price. For example I found a pair of Brooks Addiction 11 (the current model is the 14) on Amazon for $100.

These aren’t your only options, but merely the ones I’m familiar with. Be sure to get shoes that come in different widths for the most flexibility

4. Consider off-the-shelf orthotics. If you can’t afford custom orthotics, you might consider buying some stock orthotics. My custom orthotics are made of leather, so look at those first. They’re durable and will last for several years. Personally, I think custom inserts are the way to go, but if you’re on a fixed-budget you might investigate this option. These inserts commonly run from $17 to $50. WebMD has an excellent article on orthotics that you can find here.

Final Word

I hobbled into my podiatrist’s office about a year ago. He told me that my feet were some of the worst he’d seen. We talked about surgery, but he wanted to see if orthotics and better shoes would do the trick. The proper-sized shoes provided immediate relief and though the orthotics took time to break in, I can now walk long distances without pain. On the downside, I don’t walk barefoot very often and I haven’t found a suitable pair of slippers or sandals to fit my wide feet.

Good luck and I hope you invest in taking care of your feet. Your tootsies will thank you.

Next time we’ll take a look at the link between your diet and your arthritis. Will changing your diet help alleviate your condition and can you control your arthritis by diet alone?

 

 


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