Rheumatoid arthritis (RA) is an inflammatory condition which is systemic affecting several joints in the body. The lower limb especially foot problems are a common concern for patients with RA. The difficulties people can experience vary from swelling, redness, tenderness of one or more foot joints. These symptoms can lead to joint erosions, joint instability, pain and associated changing foot shape. These changes can alter the individual’s walking ability and create great difficulty resulting in a decreased of quality of life.

In some cases of RA the formation of bursa and nodules may be susceptible to friction causing repetitive trauma to areas of the lower limb and foot. Shape changes in the foot can create pressure sites that develop corns and calluses. These may develop into areas of ulceration if not treated appropriately.

The podiatrist role is to identify, diagnose and treat disorders, diseases and deformities of the feet and legs and implement an appropriate management plan. The goal of the podiatry element of rheumatology care is to reduce foot related pain, maintain/improve foot function and mobility, while protecting skin and other tissues from damage.

Treatments provided by a Podiatrist:

Podiatry advice and treatments are based on information gained from the history and assessment of a person’s foot concern. The podiatrist can perform numerous assessments related to the lower limb, these include vascular, neurological and musculoskeletal assessments. Pressure foot analysis, gait and footwear can also be addressed.

The types of treatments used will be dependent on the individual’s particular assessed concerns with reference to health.

• Palliative general foot care. This may include assistance with general nail care, which may be made difficult due to hand related problems. General podiatric treatment for areas of callus and corns.
• Specialist assessment and management of wounds/ulcers that can occur on the foot
• Prescribing customized foot orthoses for the feet. These vary from soft devices that cushion tender areas under the foot to firmer devices that realign the foot, encouraging it to function better.
• Assessment and advice about appropriate footwear options
• Advice related to the lower limb including joint protection, management of acute and chronic inflamed joints, and appropriate exercise regimes for areas of the lower limb.