Foot Issues, Jaccoud’s, Raynaud’s, & Lupus

Many Lupus Warriors experience foot issues like swelling and pain. While they can make it difficult to work, move around, and sleep, they can often be dealt with easily.

Foot problems are a common symptom of lupus. The foot issues can take many different forms, including:

• Swelling
• Numbness
• Pain
• Cold or chilly feet.

Like many other symptoms that Lupus Warriors have to deal with, foot issues can range in severity from agonizingly painful, to mildly uncomfortable. They can also involve any part of the foot, from the ankles to the toes, including the middle and back of the foot.

For people with lupus, foot issues can make walking and movement uncomfortable and make activities, both work and fun, challenging. Foot issues can also make sleeping more difficult as they can be painful even when not being stood on. And, a lack of sleep can really impact overall health, lower quality of life, and make other lupus symptoms worse.

What causes foot issues?

Lupus is an autoimmune disease, which means that (in systemic lupus) it attacks tissues throughout the body, including the feet. When it attacks the muscles, blood vessels, tendons, and skin around joints in the feet, it can cause these joints to deform, or become the wrong shape – even bending a different way.

This is called a “deforming arthropathy.” The most common form of deforming arthropathy is Jaccoud’s type arthropathy, which is a severe deformation that can happen in the hands and the feet of lupus warriors. You can see it easily in the hands, where it can cause twisted fingers and bent joints, known as “swan necks.”

When Jaccoud’s type arthropathy occurs in the hands, it can cause pain there, too. However, the feet have to bear a lot more weight than the hands, and the deformed joints can make it hard for them to adequately support the body. This can make these deformed joints a major source of pain.

Other types of joint inflammation and damage, such as polyarthritis, can be involved, too. Erosion – damage – of the joints from inflammation might also add to the pain symptoms, but Jaccoud’s type arthropathy is much more likely.

Other causes of foot issues

Inflamed and constricted blood vessels and nerves can lead to Raynaud’s phenomenon, which is responsible for a lot of the foot swelling that people with lupus experience. This swelling, as well as the pressure it puts on the nerves of the feet, can also cause pain.

Raynaud’s phenomenon and the inflammation that causes it may also be responsible for cold feet and numbness, since it effects circulation. Raynaud’s phenomenon affects up to 1/3rd of people with lupus.

This type of pain is often triggered by stress or cold, so if flares occur during times of stress or rapid temperature changes, it may be because of Raynaud’s.

Sores and blisters can also happen and cause pain. People with lupus find these wounds, as well as other cuts and abrasions that come with normal physical activity, to be slow to heal. This can be due to both the disease and the immune system suppressing drugs that keep the disease at bay.

These sores and blisters can remain open for a while, leading to a lot of pain or to more serious problems, such as infections.

Your lupus team may take an X-ray to determine the cause of any foot issues and pain.

Living with foot issues

Foot deformity and pain can pop up in any Lupus Warrior, as a part of their symptom flare ups. Fortunately, the normal treatments for lupus work well here: reducing lupus activity with your normal meds will reduce the chaos throughout the body, including in the foot. The New England Journal of Medicine recommends non-hormonal anti-inflammatories for treating foot problems related to lupus.

Because Raynaud’s phenomenon is affected by temperature, heating up feet with a warm water bath can help. Use this strategy when the first feelings of pain or swelling start. Wearing warm clothes and avoiding rapid temperature changes (such as walking into an air-conditioned room from a non-air-conditioned room) may help keep it at bay, too.

Additionally, cigarette smoke, heavy tools, and major vibrations can stress out the body and trigger inflammation.

Surgery for foot pain

Surgery may also be an option for treating foot pain, removing or repairing the damaged and deformed tissues of the foot. Surgery in the feet and hands usually has a good prognosis, but it can have complications.

Bring up soft tissue correction surgery to your lupus treatment team if you are having foot issues.

Learn more

This article at Lupus.org talks about Jacklyn Cantu’s experience with lupus-related foot issues. The article also goes into Raynaud’s phenomenon. It’s an informative story about the treatment process for foot issues. 

for more information on Raynaud’s, check out the National Institutes of Health page.