Rheumatoid Arthritis in the Foot and Ankle
- Each foot has 26 bones
- There are more than 100 ligaments in each foot
- Diabetes is the #1 cause for lower extremety amputation
- A toenail takes 4-9 months to completely grow out
- Pain in the feet is NOT normal
Surgery: YES OR NO????
- Deciding whether or not to have surgery is a big decision.
- Our foot and ankle surgeons are skilled in both surgical and conservative options.
- We will present the options most suitable for you and help you with your decision.
How much pain should I be in before I make an appointment?
- Foot pain is not normal.
- Foot pain is a signal that something is not right.
- Any degree of foot pain warrants an evaluation to determine the source of the pain and possible treatment options.
- Most foot pain left untreated will get worse and become more difficult to cure.
- If you have foot or ankle pain, make an appointment, do not wait.
Will soaking cure my ingrown toenail?
- Soaking an ingrown toenail will often make it feel better, but it will not cure it.
- The symptoms of an ingrown toenail include pain, redness, and swelling.
- An ingrown toenail is easily cured with a simple in office surgical procedure.
- The toe is anesthetized so that pain is not felt during the procedure.
- The ingrown nail, or portion of the nail, is removed.
- Most people feel no pain afterwards and return to normal activities the next day.
What are orthotics?
- Custom made foot arch supports designed to hold the foot in its optimum position
- Can alleviate the discomfort caused by a number of foot conditions such as heel pain, bunions, and flat feet.
Happy Feet...Happy Bride
Comfortable footwear can help make the perfect day even better. Many times foot or ankle discomfort can be alleviated with appropriate shoes. It is not unusual for people to buy shoes that are too small for their feet. If your foot problem has an easy solution, our podiatrists will gladly provide you with that information. Sometimes the right shoe is not enough and custom-made orthotics is necessary to help the feet maintain the best position. Our podiatrists can utilize a three dimensional digital scan to have custom made inserts (orthotics) fabricated for your shoes, made from the scan of your feet to correct your specific foot abnormality and fit your feet only. If your foot or ankle problem can be resolved with conservative treatment, our podiatrists will advise you of the best treatment for you. There are times when the best solution for a foot or ankle problem is surgery. If you require foot or ankle surgery, our podiatrists can provide you with the latest state of the art surgical techniques. They will take the time to explain to you what to expect before, during and after surgery and will try to answer all your questions. Whatever your foot or ankle problem may be, our podiatrists will explain the various treatment options available to you. Everyone is happier when their feet are happy!
Thoughts on Celebrating 30+ Years
Some thoughts from Dr. Jacoby:
On April 30, 1984 I took over this podiatry practice. Elgin became my professional home as well as my personal home. I am forever grateful to Dr. Roger Hess who started this practice 50 years prior. Dr. Hess was a gentleman whom I admired and emulated both professionally and personally. I am forever honored to continue caring for the patients who initially trusted Dr. Hess.
My first office was at 860 Summit on the East Side of Elgin. I remember painting the office myself. I moved twice into larger space at 860 Summit. Eventually we outgrew the space there and moved to larger space at the Sherman Hospital Medical Building and then finally here to 750 Fletcher. I am grateful to the multitude of patients we have had the privilege of treating and that have kept us growing. I am also grateful to the multitude of other physicians in the area whom I am so privileged to work with.
Not only has this practice grown in physical space, but we have grown technologically as we offer many state of the art alternatives. My staff has been and continues to be essential. To all my staff, both past and present, I say a most sincere Thank You.
I look back on the years with much pride and sentimentality. I look forward to the future with the same enthusiasm and joy I felt on April 30, 1984. I love what I do and every day I realize how blessed I am to be in this wonderful profession!
What is Rheumatoid Arthritis?
Rheumatoid arthritis (RA) is a disease in which certain cells of the immune system malfunction and attack healthy joints.
RA causes inflammation in the lining (synovium) of joints, most often the joints of the hands and feet. The signs of inflammation can include pain, swelling, redness, and a feeling of warmth around affected joints. In some patients, chronic inflammation results in damage to the cartilage and bones in the joint. Serious damage can lead to permanent joint destruction, deformity, and disability.
When joints become inflamed due to RA, the synovium thickens and produces an excess of joint fluid. This overabundance of fluid, along with inflammatory chemicals released by the immune system, causes swelling and damage to the joint’s cartilage and bones.
Symptoms Affecting the Foot and Ankle
Foot problems caused by RA commonly occur in the forefoot (the ball of the foot, near the toes), although RA can also affect other areas of the foot and ankle. The most common signs and symptoms of RA-related foot problems, in addition to the abnormal appearance of deformities, are pain, swelling, joint stiffness, and difficulty walking.
Deformities and conditions associated with RA may include:
- Rheumatoid nodules (lumps), which cause pain when they rub against shoes or, if they appear on the bottom of the foot, pain when walking
- Dislocated toe joints
- Heel pain
- Achilles tendon pain
- Ankle pain
RA is diagnosed on the basis of a clinical examination as well as blood tests.
To further evaluate the patient’s foot and ankle problems, the surgeon may order x-rays and/or other imaging tests.
Treatment by the Foot and Ankle Surgeon
While treatment of RA focuses on the medication prescribed by a patient's primary doctor or rheumatologist, the foot and ankle surgeon will develop a treatment plan aimed at relieving the pain of RA-related foot problems. The plan may include one or more of the following options:
- Orthotic devices. The surgeon often fits the patient with custom orthotic devices to provide cushioning for rheumatoid nodules, minimize pain when walking, and give needed support to improve the foot’s mechanics.
- Accommodative shoes. These are used to relieve pressure and pain and assist with walking.
- Aspiration of fluid. When inflammation flares up in a joint, the surgeon may aspirate (draw out) fluid to reduce the swelling and pain.
- Steroid injections. Injections of anti-inflammatory medication may be applied directly to an inflamed joint or to a rheumatoid nodule.
When is Surgery Needed?
When RA produces pain and deformity in the foot that is not relieved through other treatments, surgery may be required. The foot and ankle surgeon will select the procedure best suited to the patient's condition and lifestyle.