Resource RA Foot health RA most commonly affects the smaller joints in the hands and feet and something like 90% of people with RA experience pain and problems with their feet, yet all too often the feet can get overlooked by patients and healthcare professionals. Print Foreword by Ailsa Bosworth, NRAS National Patient Champion Something like 90% of people with rheumatoid arthritis experience pain and problems with their feet and footwear is a huge issue for many. As a consequence, we have decided to create this new foot health area on our website to give a real focus to feet and footwear, which we hope you will find really helpful. We’d also like to get input and feedback from you if you have found a service or a brand of footwear for example, that has really helped you or solved a problem for you so that we can add to our links in this section for the benefit of everyone.It’s important to note here, however, that today, with earlier diagnosis and more aggressive treatment from the outset, less foot and ankle damage and deformity are likely by comparison to people diagnosed between 20 and 30 years ago when treatment regimens were very different, and of course we didn’t have the biologics available that we have today. So, today, being diagnosed with RA, one can be much more positive about the future and be able to lead a relatively normal life. Of course, the earlier you are diagnosed and treated, the better and the more chance you have of sustaining less irreversible damage. You may not experience some or any of the foot health problems described in this section. However, we have tried to capture information and recommendations which will be of help to the whole population of people with RA, whether you are recently diagnosed or have lived with RA, like me, for many many years and experienced significant foot and ankle problems. Our feet are made up of 26 bones and 33 joints with a complex network of soft tissue structures such as muscles, tendons and ligaments. The normal function of these joints and soft tissue structures is to allow your feet to move and adapt freely to the surface you are walking upon and the activities you want to undertake. The complex structure is responsible for: transferring our body weight from one foot to the other during weight-bearing activities such as walking or running, shock absorption as our feet strike the ground with each step and providing us with a ‘stable’ platform from which we can carry out our weight-bearing activities. The diagram below outlines a view of the bones of the foot. Image courtesy of Anita Williams Inflammation of the small joints and soft tissues in the feet can often herald the onset of rheumatoid arthritis and result in pain and deformity, without early treatment. We know that with earlier diagnosis and prompt treatment, people are less likely to develop joint deformity, and this also applies to the joints of the feet. Involvement of the feet in RA is common and is not just restricted to the joints. People with RA can also experience changes to the blood and nerve supply as well as skin and nail problems that require assessment and treatment by a qualified Health Care Professional known as a podiatrist. We are hugely grateful to Anita Williams and Andrea Graham, podiatrists from the School of Health Science at the University of Salford who have worked with me to create this new foot health area. We’d also like to acknowledge the contribution and input from: Robert Field, BA (Hons), PG Dip, BSc (Hons), Community Health Services, Dorset HealthCare NHS University Foundation TrustDr Simon Otter, Principal Lecturer, School of Health Professions, University of BrightonFrank Webb, Consultant Podiatric Surgeon, Hope Hospital, SalfordAnd, grateful thanks of course to our Members and volunteers who have contributed.Ailsa BosworthNRAS National Patient Champion Updated: 03/06/2019 Next review: 03/03/2022 Video Foot health online course Foot health online course Learn how to protect your feet (prevention is always better than cure) and understand how a podiatrist can help you manage foot health in RA. Article The Foot and Rheumatoid Arthritis For some people, the foot is the first area of the body to present with signs and symptoms of RA. For others, it may be months, years or they may never experience any foot problems at all. There are many ways that RA can affect the feet. Article Medications for RA and how they can affect the feet Medication, in controlling the RA can help with foot health, but some medications can also affect the skin and underlying tissues, which can make the feet more susceptible to infection. Web link Royal College of Podiatry The Royal College of Podiatry have an extensive section on foot health and arthritis. Article Who can look after my feet? Podiatrists are part of the healthcare team that can help patients with RA. They are experts in foot health and can help in many different ways to minimise the effects of RA on the feet and make the feet more comfortable. Article I have problems with shoes – HELP! Shoes are hugely important to the comfort of your feet, and a shoe with good structure and the right inserts can make a big difference to mobility. Finding shoes that offer comfort and support but also a sense of style can be difficult, but this situation is improving. Article Foot Surgery For most, foot orthotics, medication and good footwear can be enough to manage foot health in RA, but in some cases, surgery may be required, whether it’s the removal of painful bunions or more extensive corrective joint surgery. Article Body image, feet, shoes The impact of foot complaints for people with RA is not well studied, although it is becoming increasingly clear that social and leisure activities are severely limited because of foot complaints. Article Foot health case Studies/patient stories Foot problems can have a huge impact on life for people with RA. Here, people share their stories of how they have coped with their foot health and the impact that foot problems has had on their lives. Article Research into feet and footwear Taking part in research can improve care for you as a patient and also others with RA now and in the future. Article Foot health links and conclusion A number of organisations offer information and services which can be useful to help keep your feet healthy. Read more Podiatrist → The podiatrist role is to identify, diagnose and treat disorders, diseases and deformities of the feet and legs and implement appropriate and timely care.