Autoimmune arthritis attacks everywhere, including the feet. Fortunately, there is help.
While I’m not overly enthusiastic about putting together a team of a zillion specialists to help treat this disease, I have been very happy with my podiatrist. When I checked in for my first appointment, in addition to handing over a check for my co-pay, I also gave the receptionist the results of tests that had been done on my feet:
Before the doctor walked into the exam room, he already had pretty good background and didn’t need to order additional tests and could get right to work on developing a treatment plan.
First I tried basic PT exercises that work for plantar fasciitis and Achilles tendonitis. These exercises helped tremendously, but not enough.
Next the podiatrist sent me to a specialty store for OTC orthotics (OTC but can’t be obtained without a doctor’s note – I never did figure that one out). They cost around $40. Unfortunately, they were incredibly uncomfortable. They also slid all over in my shoes, rendering them useless. Here’s what they look like:
Nobody told me that orthotics have to be broken in. I wonder if these would have worked for me if I’d known that. Only wear them for an hour the first day. The second day, wear them two hours. Gradually increase the time, and with a few weeks you’ll be wearing them full-time. I didn’t know that, and the orthotics hurt my feet.
Next the podiatrist measured my feet for custom orthotics. He has a special pad on his floor that’s connected to a computer. I stood on the pad so the computer could measure my feet, then I walked across the pad so that the computer could measure the way I distribute my weight when I walk. It’s fascinating technology.
The orthotics came from a company in Canada and arrived in two or three weeks. Support-wise, they are very similar to the pair pictured above. They look different, though. Aside from being custom-formed to my feet (they fit like a glove), they are covered with a long, thin pad to provide some cushion and keep the orthotics in place. No more sliding around in my shoes. Here they are (I have the full-length option).
After the custom orthotics arrived, I took them (brand new, in their packaging) to a specialty shoe store and asked for shoes that my orthotics would fit (story about that here). I bought those shoes in November of 2009 and I’m happy to report that they’re lasting quite nicely, which makes it easier to have spent so much money on shoes.
One drawback has been having to move the orthotics from one pair of shoes to the other, so this fall I bought a second pair. The podiatrist re-measured my feet and sent off for the new orthotics. These are from a different Canadian company, but as far as I can tell, they’re just like the previous pair. I keep my new orthotics in my tennis shoes, and the old pair switch back and forth between my Naots.
If I walk around barefoot, my feet hurt within ten minutes. If I wear my shoes/orthotics, the foot pain is down to a barely noticeable level.
Custom orthotics cost $400. In my opinion, they are worth every penny.
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Edit to add: My mother has a different type of orthotic, more like molded cork/foam. She hates them.
∞ itis 
Thank you Socks! Well, I got run through an ortho surgery mill. I went for advice to see what if any of my foot problems were due to RA, and advice on trying to avoid surgery as long as possible. Didn’t get a quite clear answer from the doc in terms of all the various different problems I have with my feet or what exactly was due to what though, but was expecting it would lead to advice for orthotics. I DIDN’T expect a guy from a custom orthotic co. to come in during the middle of the appointment. No walking on computerised floor pads. The docs office did do quite a few xrays before I saw the doc. I would like to see those radiologist reports b/c doc wasn’t too detailed about the xrays except gave good news that he didn’t see too much erosions. Fellow seemed to say he thought (most? of my toe vs other?) was due to RA as they don’t see (whatever with OA in feet, or something like that). I guess ligament laxity? According to head doc, M-a-y-b-e I have some kind of cyst in my mid-foot, didn’t say what from or where. Is that the cause of my top of foot pain? What’s the cause of the spreading toes, do I have claw toes or hammer toes, what various other lumps/bumps are possibly due to, what about calouses in odd places, different types of pains in different areas at various times were not addressed. The big cyst on bottom of big toe might be a bursa… But other good news was he said my ankles looked good (though I have had pain/stiffness in past with those, but without swelling). I think I may have to go to a podiatrist for more detailed responses.
So in the meantime, to get the orthotics or not? The orthotic guy had me hold my foot over some memory foam? and pressed my feet into it while telling me not to assist in pressing my feet into it. Said I did that well, as most people wind up putting some pressure on. Helps to close eyes and relax. The company called later to say insurance would not cover, except for a small portion to cover some kind of metal inserts that would go into the (forefoot?) of the orthotics. The main problem these will treat is metatarsalgia from what I understand. I need to ask them if these will help prevent the plantar fascitis or help with my heel pain, neither of which was addressed at the appt. My current Dr. Scholl’s ones (their machine at Walmart was a bit similar to what your doc had you do) did help with plantar fascitis, except for some residual in my left foot mainly. Right now my toes get crunched after a few hours of working from what I’m guessing is sliding forward in my shoes which I bought bigger to accomodate the orthotics and to accomodate the wider forefoot. The Scholl’s look similar to your custom ones, but they didn’t go all the way to the toes, and a full second thin OTC on top of them don’t really cushion my toes or ball of foot enough. The scholl’s themselves don’t slide around like your first ones. If I get the new ones I’m told they are made from foam and cork, except for the metal insert. I think that is to keep the toe of the shoe from bending, as the doc said he didn’t want that part of the shoe to bend. Doc also said to get rocker soles. My work shoes are rocker, but perhaps I need a different type of rocker sole. This is all very expensive to come up with. Hope it will work to hold off or prevent any surgery, which I for sure can’t afford. Was wondering if I should consult a podiatrist before I get the orthotics made though. So what type of foot problems besides fascitis and nerve damage do you have? And how are your shoulders coming along?
Very good point. There are different kinds of orthotics for different foot problems. Given what you’ve said, I don’t think I’d spend the money until I knew a lot more about dx and why they think those specific orthotics would help. Can you carry all your test reports to a podiatrist? For that kind of money, I’d want a second (or third) opinion.
My heel pain was due to plantar fasciitis. Have you tried any of the stretches to help with that? I put a link in the post. I’ll have to dig out my notes to see the other diagnoses, because the podiatrist had a long list and I never bothered to memorize it.
My shoes allow removal of the insole, then the orthotic goes in to replace that removed insole. No need to get larger shoes. Do you like the rocker sole? The shoe store tried to sell me those, but it seemed a little odd.
Gotta head out – busy day today. I’ll look for more info and get back to you.
PS – what kind of running shoes did you get?
http://www.brooksrunning.com/Brooks-Ariel-Womens-Running-Shoe/120074,default,pd.html
Looks like they’re less expensive online than in the store, so when these need to be replaced, I’ll just have them shipped to me.
My podiatrist told me I am not to walk around barefoot anymore. I finally gave in and bought some slippers with built in supports. They are the best! Zappos on sale! I have always hated slippers but I am in love now. They are Giesswein slippers. They are not fashionable but, boy, are they comfortable and my feet are not in pain from walking barefoot. Glad you are figuring out your foot issues.