Rheumatoid arthritis (RA) is an autoimmune disorder where the body’s own immune system attacks its tissues resulting in inflammation, swelling, joint deformity and pain. Affecting 2% of Australians, it is commonly managed through medications to relieve pain and slow the progression of the disease.

A common complaint for those suffering from RA is foot and ankle pain due to:

• the aforementioned  joint changes;

• skin and nail conditions from the inability to self care if the hands are affected, and

• increased forefoot plantar pressures due to the joint changes.

Podiatrists play an important role in the management of RA through:

  – General Foot Care: Deformed joints and nodules, commonly associated with RA, can lead to thickened nails and callouses and corns. These skin and nail conditions can be very difficult to manage, particularly if the joints of the hand are affected, leading to pain and difficulty walking. Therefore, regular appointments with a podiatrist are necessary to maintain the feet in a healthy state, thereby improving the patients quality of life.

  – Footwear Advice: Another complication of the foot changes associated with RA is difficulty finding comfortable footwear. A podiatrist can assist by modifying current footwear with offloading padding or by educating the patient on what features to look for in shoes (extra-width/extra-depth,  Lycra material and Velcro strap to accomodate swelling etc) and where to get them.

 

  – Orthotics: Orthotics are devices that act to cushion, redistribute pressure and improve foot function. Whilst their mechanism of action is not always agreed upon, they are a great way to reduce the stress/load on injured muscles, tendons and joints of the feet, ankles, knees and hips.

 

Orthotics are available in a variety of materials and are split into the following categories:

  – Prefabricated: These are pre-made devices and are available in varying levels of support that can be heat-moulded or modified to suit your needs. They typically last around 12-18 months depending on use and can be fitted at your appointment with the ability to add extra padding if needed.

  – Semi-Customised: These are a more durable option and, whilst still being a generic shape, this method gives the podiatrist more scope to modify the materials that are used and add any additional features they may require. They typically last 4 years depending on usage.

  – Customised: These are devices that are constructed from a cast or scan of the patients foot meaning the orthotic is 100% customised to each individual patient. These orthotics can be made from various materials and offer more choice throughout the whole process in regards to design features, material thickness and correction/shape.

With regards to RA, the function of the orthotic is, in most cases, to accomodate and offload the painful, deformed joints. Therefore, customised orthotics are generally the most appropriate option for sufferers of RA due to the ability to target these localised areas and offload them via more specialised design features not available with the other orthotic categories.

 

In summary, RA can be a debilitating disorder that has wide-ranging effects on the sufferers foot health. Podiatrists, through their specialised training, can help alleviate the pain these individuals experience through nail/skin care, footwear modifications and orthotic therapy.

If you feel you could benefit from a Podiatry appointment or have any questions regarding how we can assist in the management of your rheumatoid arthritis please contact the clinic on (03) 94805522 or book online via our website or Facebook page.

 

by Mark Whiteside

0