From the Guidelines
A lump on top of the foot from arthritis is most effectively managed by addressing the underlying arthritis with medications and non-pharmacological interventions, as recommended by the 2016 EULAR guidelines 1. The lump is typically caused by bone spurs or nodules that develop as a result of joint damage and inflammation, and can be painful, especially during movement. According to the EULAR guidelines, patients presenting with arthritis should be referred to a rheumatologist within 6 weeks after the onset of symptoms, and clinical examination is the method of choice for detecting arthritis 1. Some key points to consider in managing arthritis include:
- Starting DMARDs as early as possible, ideally within 3 months, for patients at risk of persistent arthritis 1
- Using NSAIDs at the minimum effective dose for the shortest time possible, after evaluation of gastrointestinal, renal, and cardiovascular risks 1
- Considering systemic glucocorticoids as a temporary adjunctive treatment, but using them at the lowest dose necessary due to their cumulative side effects 1
- Monitoring disease activity regularly, including tender and swollen joint counts, patient and physician global assessments, ESR, and CRP 1 Non-pharmacological interventions, such as dynamic exercises and occupational therapy, can also be considered as adjuncts to drug treatment in patients with early arthritis 1. It's essential to have any new foot lumps evaluated by a healthcare provider to confirm the diagnosis and rule out other conditions.
From the Research
Arthritis and Lump on Top of Foot
- A lump on top of the foot can be caused by various factors, including arthritis 2, 3, 4, 5, 6.
- Arthritis, such as osteoarthritis (OA) and rheumatoid arthritis (RA), can cause inflammation and pain in the foot, leading to the formation of a lump 3, 4, 5, 6.
- Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used to treat arthritis, but they can have varying levels of efficacy and safety in patients with OA and RA 4, 5, 6.
Safety of Nonsteroidal Anti-Inflammatory Drugs
- The safety of NSAIDs in patients with arthritis varies depending on the individual compound and the patient's underlying condition 4, 5, 6.
- Some NSAIDs, such as celecoxib, have been shown to have a lower risk of cardiovascular and gastrointestinal adverse events compared to other NSAIDs, such as ibuprofen and naproxen 5.
- A network meta-analysis found that ibuprofen was associated with the highest incidence of hypertension outcomes, rofecoxib with the highest incidence of renal events, and naproxen with the highest incidence of edema 6.