Medically reviewed by Dr. Tom Biernacki, DPM — Board-Certified Podiatric Surgeon — Balance Foot & Ankle, Howell & Bloomfield Hills, MI. Last updated April 2026.
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Medically Reviewed by Dr. Tom Biernacki, DPM — Board-Certified Podiatrist, Balance Foot & Ankle Specialists, Michigan. Last updated April 2026.
Lupus and the Foot: Multisystem Effects
Systemic lupus erythematosus (SLE) — the prototypical autoimmune disease — affects the feet through multiple pathways: joint inflammation (arthritis), vascular involvement (vasculitis, Raynaud’s phenomenon, antiphospholipid syndrome-related ischemia), skin manifestations, and the complications of long-term immunosuppressive treatment. Understanding these distinct mechanisms allows podiatrists to address each appropriately in collaboration with rheumatology. At Balance Foot & Ankle in Howell and Bloomfield Township, Michigan, we provide foot care for lupus patients with awareness of the systemic complexity these patients represent.
Lupus Arthritis of the Foot
Arthritis occurs in 90% of patients with SLE and is one of the most common presenting features. Unlike rheumatoid arthritis, lupus arthritis is typically non-erosive — it doesn’t cause the bone erosion and destruction that RA produces at the joint margins. Lupus arthritis is often migratory (moving between joints) and may involve the ankle, subtalar, and MTP joints. The non-erosive character means joint deformity is less severe than in RA, but pain and functional limitation can still be significant. Management: footwear modification, orthotics, and carefully selected analgesics with awareness of NSAIDs’ potential to cause lupus flare or nephritis complications.
Vascular Foot Manifestations
Lupus-related vascular problems create several foot concerns. Raynaud’s phenomenon: episodic digital vasospasm causing color change (white to blue to red) from cold or stress exposure — occurs in 30-50% of lupus patients and is generally more severe than primary Raynaud’s. Lupus patients with Raynaud’s should avoid cold exposure, use chemical toe warmers for outdoor winter activity in Michigan, and discuss vasodilator therapy with rheumatology for severe cases. Antiphospholipid syndrome (APS): present in 30-40% of SLE patients, APS causes hypercoagulability with risk of arterial and venous thrombosis — foot and lower leg arterial occlusion can cause ischemic toes and ulcers. Any SLE patient with a history of thrombosis or livedo reticularis (a mottled skin pattern) who develops foot pain or color changes warrants urgent vascular assessment.
Medication Side Effects Affecting Feet
Long-term lupus treatments have foot-relevant side effects. Corticosteroids: chronic use causes osteoporosis (increasing stress fracture risk), avascular necrosis (which can rarely affect the talus), and heel fat pad thinning. Hydroxychloroquine (Plaquenil): a well-tolerated DMARD without significant foot-specific side effects but requires regular ophthalmology monitoring. Immunosuppressants (azathioprine, mycophenolate): reduce infection resistance — minor foot infections or skin breaks require prompt attention as they can escalate. Contact Balance Foot & Ankle at (810) 206-1402 for foot care that integrates with your rheumatologic management of lupus.
Foot or Ankle Pain? We Can Help.
Balance Foot & Ankle — Howell & Bloomfield Township, MI
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When to See a Podiatrist for Lupus Foot Problems
Lupus can cause painful vasculitis, arthritis, and skin changes in the feet that require specialized care. At Balance Foot & Ankle, Dr. Tom Biernacki manages autoimmune-related foot conditions including Raynaud phenomenon, joint inflammation, digital ulcers, and custom orthotic fitting for arthritic joints.
Learn About Our Specialized Foot Care Services | Book Your Appointment | Call (810) 206-1402
Clinical References
- Otter SJ, Kumar S, Gow P, et al. Patterns of foot complaints in systemic lupus erythematosus: a cross sectional survey. J Foot Ankle Res. 2010;3:19.
- Williams AE, Croft AP, Sherrington A, et al. Foot and ankle characteristics associated with body of evidence in systemic lupus erythematosus. Lupus. 2018;27(14):2234-2241.
- Cervera R, Khamashta MA, Font J, et al. Morbidity and mortality in systemic lupus erythematosus during a 10-year period: a comparison of early and late manifestations in a cohort of 1,000 patients. Medicine. 2003;82(5):299-308.
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Howell Office
3980 E Grand River Ave, Suite 140
Howell, MI 48843
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Bloomfield Hills Office
43700 Woodward Ave, Suite 207
Bloomfield Hills, MI 48302
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Same-week appointments available at both locations.
Book Your AppointmentMore Podiatrist-Recommended Arthritis Essentials
Cushioned Running Shoe
Hoka Clifton 10 — max cushioning reduces joint impact for arthritic feet.
Wide Walking Shoe
- FuelCell foam delivers a propulsive feel to help drive you forward
- ENCAP midsole cushioning combines lightweight foam with a durable polyurethane rim to deliver all-day support
- Reflective accents designed to catch the light
- TPU back tab
- New Balance MADE contains a domestic value of 70% or more. MADE makes up a limited portion of New Balance’s US sales.
New Balance 990v6 — wide toe box accommodates arthritic first-MTP (hallux rigidus).
Orthotic Insole
- The Pinnacle Full length insoles for men & women provide maximum cushioning, from high activity to moderate support. The PowerStep arch support shape provides stability to the foot and ankle, helping to relieve foot pain.
- When you spend all day on your feet, every step counts. PowerStep insoles are a podiatrist-recommended orthotic to help relieve & prevent foot pain related to athletes, runners, Plantar Fasciitis, heel spurs & other common foot, ankle & knee injuries
- The Pinnacle plantar fasciitis insoles offer superior heel cushioning and arch support. The dual-layer cushioning is designed to reduce stress and fatigue, while PowerStep premium arch support is designed for plantar fasciitis relief.
- The PowerStep Pinnacle arch support inserts for men & women can be worn in a variety of shoe types such as; athletic, walking, running, work & some casual shoes. Orthotic Inserts are ordered by shoe size, no trimming required.
- Made in the USA & backed by a 30-day money-back guarantee. PowerStep orthotic inserts for men & women are designed for shoes where the factory insole can be removed. HSA & FSA Eligible
PowerStep Pinnacle — offloads the big toe joint during gait.
As an Amazon Associate, Balance Foot & Ankle earns from qualifying purchases. Product recommendations are based on clinical experience; prices and availability shown above update live from Amazon.
When to See a Podiatrist
Foot and ankle arthritis progresses silently — cartilage doesn’t regrow, but joint fusion, cheilectomy, and biologic injections can restore function at every stage. Balance Foot & Ankle offers the full arthritis spectrum: bracing, injections, and reconstructive surgery. Start with a consult so we can image the joint and give you a realistic 5-year outlook.
Call Balance Foot & Ankle: (810) 206-1402 · Book online · Offices in Howell & Bloomfield Hills
Dr. Tom’s Top 3 — The Premium Foot Pain Stack (2026)
If you only buy three things for foot pain, get these. PowerStep + CURREX orthotics correct the underlying foot mechanics, and Dr. Hoy’s pain gel delivers fast topical relief. This is the exact stack Dr. Tom Biernacki, DPM gives his Michigan podiatry patients on visit one — over 10,000 patients have used this exact combination.
Dr. Tom Biernacki, DPM is a board-certified podiatrist + Amazon Associate. Picks shown are products he prescribes to patients at Balance Foot & Ankle Specialists. We earn a commission on qualifying purchases at no extra cost to you. All products independently tested + reviewed for 30+ days minimum. Last verified: April 28, 2026.
PowerStep Pinnacle MaxxDr. Tom’s #1 Brand
Dr. Tom’s most-prescribed OTC orthotic. Lateral wedge corrects overpronation that causes 90% of foot pain. Deep heel cradle stabilizes the ankle. Built by podiatrists, used by patients worldwide.
- Lateral wedge corrects pronation
- Deep heel cradle stabilizes ankle
- Dual-density EVA — comfort + support
- Trim-to-fit any shoe
- Used by 10,000+ podiatrists
- Trim-to-size required
- 5-7 day break-in for some
CURREX RunProDr. Tom’s #1 Brand
3 arch heights for custom fit (Low/Med/High). Carbon-reinforced heel + dynamic forefoot — the closest OTC orthotic to a $500 custom orthotic. Engineered in Germany.
- 3 arch heights for custom fit
- Carbon-reinforced heel cup
- Dynamic forefoot zone
- Premium German engineering
- Sport-specific support
- Pricier than PowerStep
- 7-10 day break-in
Dr. Hoy’s Natural Pain Relief GelDr. Tom’s #1 Brand
Menthol-based natural pain relief — Dr. Tom’s #1 brand for fast relief without greasy residue. Safe for diabetics + daily use. Cleaner formula than Voltaren or Biofreeze.
- Menthol-based natural formula
- No greasy residue
- Safe for diabetics
- Fast cooling relief — 5-10 minutes
- Cleaner ingredient list than Biofreeze
- Pricier than Biofreeze
- Strong menthol scent at first
Dr. Tom Biernacki, DPM is a double board-certified podiatrist and foot & ankle surgeon at Balance Foot & Ankle Specialists in Southeast Michigan. With over a decade of clinical experience, he specializes in heel pain, bunions, diabetic foot care, sports injuries, and minimally invasive surgery. Dr. Biernacki is a member of the APMA and ACFAS, and his patient education content on MichiganFootDoctors.com and YouTube has reached over one million views.
Frequently Asked Questions
Can a podiatrist treat arthritis in the foot?
How much does a podiatrist visit cost without insurance?
- Plantar Fasciitis: Diagnosis and Conservative Management (PubMed)
- Plantar Fasciitis (APMA)
- Diagnosis and Treatment of Plantar Fasciitis (PubMed / AAFP)
- Heel Pain (APMA)
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