Can Rheumatoid Arthritis Cause Numbness in Feet? Understand the Warning Signs

Can rheumatoid arthritis cause numbness in feet? That’s actually one of the more common (and confusing) questions I get asked in my clinic. You’d think joint pain and swelling would be the main issue with RA—and they are—but when a patient starts describing tingling toes or a “pins and needles” sensation in their feet, it can throw folks off. I’ve had many patients tell me, “I thought I had a pinched nerve or neuropathy, not arthritis!” Trust me, I get it. Rheumatoid arthritis is a systemic autoimmune condition, and it doesn’t always follow the rules we expect.

What’s Going On? Understanding the Nerve Connection in RA

As a rheumatology nurse practitioner, I’ve spent years explaining to patients how rheumatoid arthritis (RA) isn’t just about joint pain—it’s about inflammation that can impact the entire body. And yes, that includes nerves. So, when someone asks, “Can rheumatoid arthritis cause numbness in feet?” the answer is a clear yes, but it’s a little more complicated than that.

RA causes inflammation in the synovial lining of joints, but when that inflammation gets out of control, it can start to affect nearby structures—including the nerves. Think of it like this: imagine a garden hose lying next to a balloon. If the balloon starts to swell (inflammation), eventually it presses on the hose (nerve), disrupting water flow (nerve signals). That’s one way numbness or tingling might happen.

Common Nerve-Related Foot Symptoms in RA

Here’s what my patients often report:

• Numbness or tingling in the toes or soles of the feet
• Burning sensations, especially at night
• Sharp, electric shock-like pain in the arch or heel
• Weakness or a feeling like the foot is “falling asleep”

It’s easy to mistake this for diabetic neuropathy or even a spinal disc issue. That’s why it’s so important to really listen to the full picture and consider the patient’s history, not just the symptoms in isolation.

So, Why the Feet?

You might be wondering why the feet are such a target. Here’s the deal—RA often starts in smaller joints, and the feet have tons of those. In fact, the metatarsophalangeal joints (the ones at the base of the toes) are usually among the first places we see changes on imaging. But beyond joint inflammation, there are a few other reasons numbness shows up here:

1. Peripheral nerve entrapment – Chronic inflammation can cause swelling and deformity that compresses nearby nerves, like the tibial or peroneal nerve.
2. Vasculitis – This is when inflammation affects the blood vessels, cutting off nutrient supply to the nerves. I’ve seen this in more advanced RA cases or flares.
3. Medication side effects – Some RA treatments, like methotrexate or even certain biologics, can cause neuropathy in rare cases. It’s not common, but it’s something I always keep in mind.

I remember a patient, let’s call her Maria, who came in thinking she had plantar fasciitis. But she also had RA, and the real issue turned out to be nerve compression from swelling around her ankle joints. A tweak in her meds and some physical therapy helped her tremendously.

Could It Be Tarsal Tunnel Syndrome?

This is a big one. If you’re familiar with carpal tunnel syndrome in the wrist, then tarsal tunnel syndrome is its cousin—but in the ankle. It happens when the tibial nerve gets compressed as it travels through a narrow tunnel near the inner ankle. RA inflammation can easily irritate this area, leading to numbness, tingling, and even weakness in the foot.

Sometimes patients with tarsal tunnel symptoms are surprised when we link it back to their arthritis. I had one gentleman who thought he had a sports injury, but after an ultrasound and a physical exam, we pinpointed the RA flare as the true culprit. Once we adjusted his treatment plan, the nerve symptoms began to calm down.

What Should You Watch For?

If you’re living with RA—or caring for someone who is—keep an eye out for these signs that numbness might be related:

• The numbness is symmetrical (both feet)
• It started or worsened during a flare
• There’s visible swelling around ankles or toes
• You also feel stiffness or warmth in the affected joints

Of course, always talk with your healthcare provider if you notice anything new. Neuropathy is a broad symptom and can be caused by dozens of things, from diabetes to vitamin deficiencies to spinal issues. That said, RA deserves a spot on that list.

When RA-Related Nerve Symptoms Are More Than Just a Flare

Now, while numbness in the feet caused by RA can be relatively minor and temporary, it’s not always something we can brush off. In some cases, it can point to more advanced disease or even complications like rheumatoid vasculitis. That’s when inflammation spreads beyond the joints and starts attacking blood vessels, leading to damage in the nerves they supply.

I’ve had a couple of patients over the years where foot numbness was actually the first warning sign that vasculitis might be developing. One in particular—a gentleman in his late 50s—started noticing a creeping numbness and weakness in one foot that didn’t respond to our usual anti-inflammatory treatments. Bloodwork and a biopsy confirmed the issue. With early detection and a treatment switch, we got ahead of it. But I always stress to patients: if something feels off or different from your typical RA symptoms, speak up early.

Signs That Warrant Deeper Investigation

If you’re seeing any of the following, it might be time to dig a little deeper with your healthcare provider:

• Persistent numbness that doesn’t improve with RA medication
• Muscle weakness or foot drop
• Ulcers or discoloration on the feet or toes
• Numbness in unusual patterns (like just the outer part of the foot)

These could point to nerve damage that goes beyond inflammation and might involve structural or vascular changes. A nerve conduction study or MRI can be helpful here—we often use these in clinic to rule out or confirm deeper nerve involvement.

How We Manage It: What You Can Actually Do

Let’s talk management. The question “Can rheumatoid arthritis cause numbness in feet?” is only half the story. The other half is—what do we do about it? Thankfully, there are multiple ways to approach this depending on the cause:

Step 1: Controlling the Inflammation

First and foremost, we have to control the RA. If the numbness is due to joint swelling compressing nearby nerves (which it often is), reducing inflammation can relieve pressure and symptoms. This might involve:

• Adjusting DMARDs (Disease-Modifying Antirheumatic Drugs)
• Adding or switching biologics or JAK inhibitors
• Short-term use of corticosteroids during flares

One patient of mine responded beautifully after switching to a different biologic—her ankle swelling dropped, and within a few weeks, the pins and needles faded too. Everyone’s RA journey is a bit different, so I never do one-size-fits-all.

Step 2: Nerve-Specific Relief

Sometimes, even when RA is relatively under control, nerve symptoms linger. That’s when we look at other strategies:

• Neuropathy medications – like gabapentin or duloxetine, which help calm down overactive nerve signals
• Physical therapy – strengthening muscles and improving circulation can make a big difference
• Orthotic support – inserts that reduce pressure on the soles can help reduce nerve irritation

I always remind my patients: improvement takes time. Nerve tissue doesn’t heal overnight. But even slow, steady progress is a good sign we’re on the right track.

What About Lifestyle Tweaks?

This is where patients really have power. Managing rheumatoid arthritis—and those sneaky foot symptoms—often means dialing in some day-to-day habits that support nerve health and reduce flare triggers. Here’s what I often suggest (and even practice myself!):

1. Stay active—but gently. Low-impact movements like swimming or yoga help with circulation and reduce joint stiffness without aggravating inflammation.
2. Watch blood sugar levels. RA patients are at higher risk for insulin resistance, and high blood sugar can worsen nerve pain.
3. Anti-inflammatory nutrition. Think omega-3s, leafy greens, turmeric, and berries. I’m a big fan of the Mediterranean-style diet for RA management.
4. Daily foot checks. Especially if you’ve got numbness—always inspect your feet for cuts or blisters you might not feel right away.

One woman I worked with started doing daily gentle foot massages and warm foot soaks with Epsom salt. Not only did it help her circulation, but she said it became her little self-care ritual after long workdays. Sometimes those small routines make a big mental (and physical) difference.

When to Loop in a Specialist

As much as we rheumatology folks know about the joint-nerve connection, sometimes we need to bring in our neurology or podiatry colleagues. If someone’s numbness doesn’t respond to RA treatment, or if there’s severe weakness, balance problems, or pain that keeps worsening, I won’t hesitate to make a referral.

Collaborative care is so key here. For one of my patients with long-standing RA and persistent foot numbness, it took a combination of rheumatology, neurology, and a custom orthotics expert to get her back to walking comfortably. These things can be complex—and that’s okay. You deserve a team approach when symptoms get tricky.

Final Thoughts for Now

So yes, to answer that ever-popular question again—can rheumatoid arthritis cause numbness in feet? Absolutely. But more importantly, understanding the why behind it and taking proactive steps can make a huge difference. Whether it’s inflammation, nerve compression, or a more systemic complication, the goal is always the same: get you feeling better and keep you moving comfortably.

Living with RA and Foot Numbness: Practical Day-to-Day Tips

By now, we’ve covered a lot of ground on this whole “Can rheumatoid arthritis cause numbness in feet?” conversation—but let’s talk real life. As someone who works closely with RA patients every single day, I know how frustrating it can be when nerve symptoms mess with your routine. Numb feet can affect everything from walking your dog to simply standing at the kitchen counter prepping dinner.

So what does managing this actually look like in the day-to-day? Here’s what I typically recommend (and what my patients swear by):

1. Prioritize Footwear That Supports and Protects

This one’s big. A surprising number of patients come in wearing shoes that don’t support their joints—or worse, shoes that actually make their symptoms worse. Numbness makes it harder to feel if a shoe is too tight, rubbing, or pinching. I always tell patients: if your feet are numb, your shoes need to do even more work for you.

• Choose wide-toe box shoes that don’t compress your toes
• Consider orthotic inserts for arch and metatarsal support
• Avoid heels and hard soles—opt for cushioned soles with good shock absorption

One of my long-term patients, Sandra, swears by her rocker-bottom shoes. “They’re not the cutest,” she laughed once, “but I can actually get through a grocery run without crying.” That’s a win in my book.

2. Try Gentle, Nerve-Friendly Movement

We talked a bit about this in Part 2, but it’s worth reinforcing—movement is medicine. Gentle stretching, resistance bands, or even water aerobics can help improve blood flow to the nerves and maintain mobility. I’m a big believer in consistency over intensity.

Just a few suggestions:

1. Toe wiggles and ankle circles first thing in the morning
2. Daily foot massage (self or partner—it all counts!)
3. Simple calf and hamstring stretches to reduce nerve tension

If you’re unsure where to start, ask your rheumatology clinic if they have a physical therapist who specializes in joint conditions. Trust me, those folks are worth their weight in gold.

3. Keep Track of Symptom Patterns

This is one that not enough patients do. I always recommend journaling when the numbness happens, how long it lasts, and what else is going on that day—diet, stress, medication changes, sleep. Over time, patterns start to appear. I’ve had more than one patient realize their foot symptoms flared up right before a big RA flare—or even just after a particularly salty takeout meal. 🤷‍♀️

When Numbness Lingers: What Else Could Be Going On?

Here’s the tough part. Sometimes the numbness doesn’t go away, even when RA is controlled. That’s when we start exploring other possibilities. As much as we don’t want to think about it, people with RA can also develop secondary conditions that affect nerves:

• Diabetic neuropathy – especially if steroids or weight gain have contributed to insulin resistance
• B12 deficiency – surprisingly common and treatable!
• Spinal issues – like lumbar disc herniation that mimics or worsens RA symptoms
• Fibromyalgia – which can amplify sensations of numbness or burning

This is where collaboration is key again. A full workup—including labs, imaging, or a referral to neurology—might be needed to get the full picture. I always remind patients: just because you have RA doesn’t mean every symptom is from RA. Keep that differential diagnosis list open.

Hope, Healing, and Patient Empowerment

If there’s one thing I want you to walk away with from this entire article, it’s this: you’re not imagining it. That weird tingling in your feet, the numbness that makes you stumble, the nighttime burning that messes with your sleep? It’s real. And you deserve to be heard, evaluated, and supported.

Over the years, I’ve seen many patients improve with the right blend of treatment, education, and self-care. RA may be chronic, but numbness doesn’t have to be permanent. And knowledge—especially understanding what’s really going on in your body—is such a powerful part of healing.

So next time someone asks, “Can rheumatoid arthritis cause numbness in feet?” — I hope you not only say yes, but feel equipped to explain the how, the why, and the what-to-do-about-it. That’s what this journey is really all about—taking back control in a body that often feels unpredictable.

Resources I Trust and Recommend

• National Institutes of Health (NIH)
• Health.com
• Arthritis Foundation
• Mayo Clinic

Disclaimer

This article is for educational purposes only and is not intended as medical advice. Always consult with your healthcare provider regarding any symptoms, treatment decisions, or changes to your care plan. As a rheumatology nurse practitioner, my insights are based on clinical experience, but each patient’s journey is unique.

Tarra Nugroho

Tarra Nugroho is a health writer and wellness researcher specializing in autoimmune conditions, with a particular focus on rheumatoid arthritis (RA). At Healthusias, Tarra combines scientific research with a conversational approach to help readers navigate the complexities of chronic inflammation and joint health.

In articles like “Best Supplements for Joint Health in Rheumatoid Arthritis: A Casual Guide,” Tarra explores evidence-based natural remedies and lifestyle strategies to support mobility and reduce flare-ups. Her work reflects a commitment to empowering individuals with practical tools for managing autoimmune conditions.

Whether you’re newly diagnosed or seeking holistic ways to manage RA, Tarra’s insights offer clarity and encouragement on the path to better health.