If you’re living with psoriatic arthritis (PsA), you may know firsthand how PsA-related foot pain can literally stop you in your tracks. “The past 3 weeks, I have had severe pain in my right ankle — so much, it has reduced me to tears. I would give anything to be without pain every time I stand and walk,” shared one MyPsoriasisTeam member.

Choosing the right pair of shoes can be a game changer. “The right shoes for arthritis can reduce or eliminate foot pain, which has a huge impact on the body’s function and mobility,” Dr. Marian Hannan, a professor of medicine at Harvard Medical School, told the Arthritis Foundation. “People should start thinking of their shoes as a factor they can modify to help minimize pain and maximize their ability to get out and do things.”

If arthritis pain in your feet is holding you back, consider the following tips for finding the right footwear. Even if you experience only mild foot pain, be mindful of what shoes you choose: Over time, ill-fitting shoes can damage your feet and worsen your PsA symptoms.

1. Assess Your Symptoms

Getting to know your feet and how PsA affects them can help you select shoes with features that best suit your needs. PsA affects everyone differently, but here are some common psoriatic arthritis symptoms that can affect your feet:

• Dactylitis — Also known as “sausage toes”
• Other toe changes — Shortening or clawing of toes or hyperextension of the big toe
• Localized pain — May include enthesitis (swelling of the tissue that connects tendons and ligaments to bones), plantar fasciitis (pain in your sole), or Achilles tendinitis (back heel pain)
• Swelling in your ankles or feet
• Toenail changes — May include thickening or nail separation and often resembles onychomycosis (a nail infection)
• Joint pain and stiffness — May limit range of motion in your feet
• Flat arches — May cause your ankle to roll inward as you walk

Some of these symptoms may affect the shape of your feet or cause one foot to be larger than the other. A podiatrist should be able to help you identify the sources of your foot pain and advise you on what footwear features can help.

2. Use Shoe Size Only as a Starting Point

Knowing your shoe size is useful when shoe shopping, but there are some important points to keep in mind: First, shoe sizes aren’t consistent among shoe brands. You may need a size 9 for one brand and a size 8.5 from another. Your shoe size may also have changed over time.

If you’re unsure of your current size or are considering a new brand of shoes, you may benefit from shopping at a physical store instead of online. Ask a staff member to properly measure each foot for both length and width.

When trying on shoes, it helps to wear the type of socks or inserts you generally wear. If you experience swelling in your feet, try on shoes at the time of day when your feet are most swollen.

If one foot is larger than the other, choose the shoe size that fits the larger foot. If necessary, you can purchase an insole for the shoe that goes on the smaller foot.

Ultimately, shoe size should just be a starting point: What’s more important is how a shoe feels, including around your toes, beneath your soles, and behind your heels. Avoid buying a pair that feels uncomfortable in the store with the expectation of “breaking them in.”

3. Strike the Right Balance Between Cushy and Supportive

Shoes should be comfortable from the get-go — though not so soft and flexible that they don’t provide necessary support. “Adding stability and cushioning to an arthritic foot can change pain to comfort for a patient who’s just trying to walk,” Dr. Najwa Javed, a podiatrist with Silicon Valley Podiatry Group, said in an interview with Livestrong.com. “If the shoe is very flexible and soft, even though initially it can feel good, it causes more joint motion and increases pain and deformity over a period. So the best shoes have a stable sole (one that doesn’t bend easily), a forefoot rocker (to take pressure off of the big toe joint), and a good heel counter.”

4. Go Wide — Including in the Toe Box

Pay careful attention to the width of the shoes you’re considering: A wide or extra-wide option may better suit your needs. Make sure, too, that the shoe’s toe box is roomy enough to accommodate bunions and toes.

Avoid choosing a larger shoe size that’s too long. Shoe soles have what’s called a flex point, the spot designed to bend where the wearer’s toe joints bend. If your shoes bend where they aren’t supposed to, you could develop new foot problems.

5. Avoid High Heels

High heels (heels taller than two inches) simply aren’t good for anyone’s feet. Among their drawbacks, they’re hard on the arches and put extra stress on joints. High-heeled shoes — as well as shoes that pinch your feet — can lead to deformities such as bunions or hammertoe.

In contrast, low heels can prevent damage to your toes, back, and knees. Flat, wide heels also offer cushioning and can help with balance.

6. Choose Finger-Friendly Fasteners

If your PsA affects your hands, you may prefer slip-on shoes or those with a Velcro hook and loop to those with laces. If your feet are prone to swelling, consider shoes with adjustable fasteners that you can loosen or tighten as needed.

7. Consider Adding Extra Foot Support

Some people with foot arthritis need a little extra support beyond what shoes can provide.

One option is custom-made orthotics, which a podiatrist can prescribe. These are special medical devices built specifically for your feet, based on factors such as your gait, activity level, and foot type. Orthotics can be expensive, starting at $400 — and they aren’t covered by most insurance.

Another option is over-the-counter shoe inserts. Made from materials such as foam or gel, they can deliver added arch support and cushioning for your heel, arch, or entire foot. Look for inserts specially designed for people with arthritis.

Importantly, wearing the wrong type of orthotics can worsen your condition. Consider consulting with a podiatrist to help select an insert that best meets your specific needs.

Recommended Brands for PsA-Friendly Shoes

There’s no shortage of brand options for PsA-friendly shoes, and despite some of the limitations noted above, there are plenty of styles from which to choose. MyPsoriasisTeam members frequently discuss their favorite brands. Here are some of their recommendations:

• “I have found Skechers to be one of the few brands of shoes that I can wear now!”
• “Some of the best shoes I’ve found are New Balance and a company out of Canada called Propet. Their ortho-level shoes are available in various widths, last well, and cost a fraction of SAS shoes with a much wider variety of style.”
• “My foot pain is the worst pain I have for psoriatic arthritis. I wear Born shoes a lot with a wide toe box and never any shoes with backs.”
• “Summer, I find Birkenstock sandals to be the best! Winter is either comfortable flat boots or comfortable walking Nike shoes, sandshoes, etc. — no high heels for me anymore. 😢”
• “The shoe brand FitFlop out of Europe and Ohio works excellent for plantar fasciitis. I have been wearing them for 7 years. I get instant relief when I put them on. They are pricey but for me, it is money well spent because of how much pain I had.”

Some shoes (and other foot products) carry the American Podiatric Medical Association (APMA) seal of approval. These are shoes that undergo review by the APMA to ensure they allow for normal foot function, promote foot health, and are safe and useful. Shoes on the list come from many different brands, including:

• Dockers
• FitFlop
• Hoka
• MediFeet
• Therafit
• Vionic (formerly Orthaheel)

Consider the above list of brands as a starting-off point, not a definitive guide to the best shoe brands for PsA.

There are many other brands that may have specific features that work best for you. For example, if you’re looking for a sneaker you can easily slip on without bending or using your hands, you may be interested in Kizik or Zeba shoes.

The Bottom Line

If PsA-related foot pain is slowing you down, the right footwear can significantly improve your quality of life. On the other hand, the wrong shoes may end up doing more harm than good. Make sure the shoes you choose fully fit your feet and are comfortable from the get-go. Consider speaking with a podiatrist for some guidance in determining specific shoe features (and possibly orthotics) that can give you the comfort and support you need.

Find Your Team

MyPsoriasisTeam is the social network for people with psoriasis and psoriatic arthritis and their loved ones. On MyPsoriasisTeam, more than 113,000 members come together to ask questions, give advice, and share their stories with others who understand life with psoriatic arthritis.

What shoes would you recommend to help with PsA-related foot pain? Share your experience in the comments below, or start a conversation by posting on your Activities page.