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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.

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Foreword by Ailsa Bosworth, NRAS National Patient Champion

Knowing how common joint pain and other problems with feet are experienced by people with RA, we decided to create this 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 foot deformities are likely by comparison to people diagnosed decades 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 problems.

Our feet are made up of 26 bones and 33 foot joints with a complex network of soft tissue structures such as muscles, tendons and ligaments. Normal foot function of these joints and soft tissue structures allows 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.

Some foot problems can be addressed by changes to footwear or to the way we walk, while others may require foot surgery to fix. The decision to have surgery is never an easy one, but in some cases this can be the best option to relieve pain and improve mobility.

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 Trust

Dr Simon Otter, Principal Lecturer, School of Health Professions, University of Brighton

Frank Webb, Consultant Podiatric Surgeon, Hope Hospital, Salford

And, grateful thanks of course to our Members and volunteers who have contributed.

Ailsa Bosworth
NRAS National Patient Champion

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  • 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.