Around 400,000 people in Australia are affected by rheumatoid arthritis. This is an autoimmune disease where the body attacks its own tissues, leading to widespread inflammation, which affect a range of joints, including those of the feet. Research indicates that more than 90% of people with arthritis experience symptoms in the joints of their feet, which include pain and swelling, as well as a change in foot shape that can lead to instability and difficulty walking. Although day-to-day activities can be affected by this, with early interventions, including the use of foot orthotics to provide support, the impact of rheumatoid arthritis can be significantly reduced, benefiting both physical health and quality of life.
Benefits of orthotics in rheumatoid arthritis
As a rheumatoid arthritis sufferer or someone who cares for a person affected by this, you will want to know more about what can be gained through the use of orthotics to manage associated foot problems. You will therefore be pleased to hear that orthotic inserts are designed to:
Reduce plantar pressure (the pressure between the sole of the foot and the surface beneath) and redistribute this when taking part in weight-bearing activities. This is beneficial as a reduction in plantar pressure is associated with diminished feelings of pain, providing an adjunct to other forms of pain relief. There is certainly evidence in the scientific literature that use of a variety of foot orthotics reduces pain and by easing pain in rheumatoid arthritis this can help in a number of ways. Firstly, this promotes better functional ability. Pain is also one of the main barriers to activity in arthritis, which is actually beneficial to its management, so by removing this pain this allows people to participate in physical activity and exercise, which offers wider health benefits. This includes a reduced risk of heart disease and other circulatory problems, which are more common in people with rheumatoid arthritis, and improved mental well-being, with sufferers of rheumatoid arthritis more prone to low mood. By reducing pain this in itself can also directly promote better mental health, as pain commonly contributes to a depressed mood in rheumatoid arthritis, either through the negative emotional response that it triggers or the reduction in quality of life that it brings through reduced functional ability. Seeking orthotic inserts may well improve the quality of life of someone with rheumatoid arthritis, but further advice and support is available for sufferers and their carers with regards to other strategies that may help when mood is low. This is an important issue to be tackled, as depression has been shown to worsen the progression of rheumatoid arthritis.
Stop the advancement of deformity within the joints of the feet. While orthotics cannot correct changes in foot shape that have already occurred, they may prevent further changes from taking place and by doing so walking should become easier, as should the completion of everyday tasks. However, the use of orthotics to slow the progression of foot deformities has not been as well-studied as their benefits for pain reduction. The most frequent foot deformity seen in rheumatoid arthritis is what is termed as hallux valgus, which is more commonly known as a bunion. One study that did investigate the ability of foot orthotics to slow progression of hallux valgus in rheumatoid arthritis found that sufferers using these were 73% less likely to see any further deformity than those who did not use these inserts, though a more recent study hasn’t demonstrated such beneficial results. While this promising study did have its limitations and further work is needed, if you suffer from bunions as a result of rheumatoid arthritis, particularly if pain is also problematic, you could well benefit from using foot orthotics, as they may help with both symptoms.
Types of orthotics in rheumatoid arthritis
Although a number of types of orthotics are available – including hard, soft, semi-rigid and custom orthotics – the form that provides most benefit to people with rheumatoid arthritis is unclear. Research indicates that all types of orthotics have the potential to provide pain relief for sufferers, though the results with those that are custom-made appeared to be more variable, which may reflect their differing designs. Similarly in relation to which orthotics are best for slowing the progression of changes to foot shape, a hard foot orthotic was used in the study where further deformity was 73% less likely, while custom orthotics were used in the study from 2013 where no benefit was found. Further work into this area is needed to provide clarity on the best orthotics for rheumatoid arthritis, but this should not dissuade you from trying the range of these available in the meantime.
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