Menu

Portland Foot and Ankle

(503) 244-7894

Battle Ground Foot and Ankle

(360) 687-3668

Vancouver Foot and Ankle East

(360) 834-3707

Vancouver Foot and Ankle West

360-834-3707

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
  • Hammertoes
  • Bunions
  • Heel pain
  • Achilles tendon pain
  • Flatfoot
  • Ankle pain

Diagnosis
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.

Our Locations


Vancouver Foot and Ankle West


Vancouver Foot and Ankle East


Battle Ground Foot and Ankle


Portland Foot and Ankle


Hours of Operation

Vancouver Foot And Ankle West

Monday:

Closed

Tuesday:

Closed

Wednesday:

Closed

Thursday:

8:00 am-3:00 pm

Friday:

Closed

Saturday:

Closed

Sunday:

Closed

Vancouver Foot and Ankle East

Monday:

Closed

Tuesday:

Closed

Wednesday:

9:00 AM-3:00 PM

Thursday:

Closed

Friday:

Closed

Saturday:

8:00 am-12:00pm (Every other Saturday)

Sunday:

Closed

Battle Ground Foot and Ankle

Monday:

8:00 AM-3:00 PM

Tuesday:

Closed

Wednesday:

Closed

Thursday:

Closed

Friday:

Closed

Saturday:

Closed

Sunday:

Closed

Portland Foot and Ankle

Monday:

Closed

Tuesday:

7:00 AM-2:00 PM

Wednesday:

Closed

Thursday:

Closed

Friday:

Closed

Saturday:

Closed

Sunday:

Closed

  • "My 3rd and 4th toes on the right foot were so painful to walk for about 5 years or so. Dr Belnap clipped the tendons in the toes and clipped the nails of both feet on follow up appointments, and now I can walk without pain. I wish I had known of this procedure sooner and will surely recommend this office to friends!

    Side note: I know there has been discussion on getting access to all the x-rays from every location. Is that going to be possible in the future? It would be very helpful for surgical planning, as it is always a good idea to have a copy of the x-rays in the operating room for surgical planning purposes. The other solution I could think of is printing off the x-rays on surgical patients and scanning them into their charts as a document, so you can access them from anywhere.

    Thanks for all your help!!"
    Nancy P.
  • "Dr Belnap is very professional. He helped with my foot pain. He corrected my issues and I was pain-free by the first follow up visit!"
    Dennis B.
  • "I came to Dr Hayes from a personal referral. He has done surgery on both of my feet for bunions. It has helped me to live my busy lifestyle. I have highly recommended him to my friends"
    Susan N.