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Rheumatoid Arthritis
Arthritis is a disabling disease
Rheumatoid arthritis (RA) is an autoimmune disease that causes your immune system to attack your healthy tissues and structures. This causes pain, inflammation and other symptoms. RA is classified as a rheumatic disease, alongside others like gout and lupus. Below, you’ll find information on identifying and managing both of these conditions.
Rheumatoid arthritis occurs when your body’s immune system attacks your own cells at the lining of the joints. This causes pain, swelling and inflammation. Rheumatoid arthritis affects the whole body, primarily the small joints in the hands and feet.
Disclaimer: This document is an informative guide only and is not a tool for diagnosis or management of arthritis.
Podiatrists play an important role in the effective management of arthritis in the lower limbs, but cannot diagnose arthritis. You must see your primary physician to receive an accurate diagnosis. Referrals are not required to see your Podiatrist. The images used do not necessarily reflect the condition, symptoms or treatment being discussed and are intended for illustrative purposes only.
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What are the symptoms of RA?
RA tends to present in symmetrical ‘flare-ups’. These flares come and go unpredictably and can affect many joints at once. The effects of RA progressively worsen and as the joints incur more damage, their movement capability deteriorates. Symptoms can include:
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Swelling and inflammation at the joints
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Changes to the shape of the joints and feet over time
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Pain, tenderness and discomfort
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Stiffness and limited movement in the joints
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Rheumatoid nodules
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General fatigue with a possible fever
What causes RA?
During a rheumatoid arthritis flare-up, the body’s immune system attacks the lining of one or more joint capsules, called the synovial membrane. As this lining becomes inflamed, it is no longer able to produce synovial fluid. Synovial fluid lubricates joints and nourishes the cartilage at the ends of the bones. This means the joints stiffen and movement becomes harder and painful. The more flares a person has, the more damage to the joint capsules incur and the greater the likelihood of the joint capsule no longer being able to stabilise the joint.
While the exact reason for the body getting confused and attacking its own cells is not well understood, it has been thought that hereditary factors may increase your chance of developing RA. Other contributing factors may include smoking and the female gender.
Flares often occur spontaneously and without a trigger, though some causes have been attributed to stress, illness and injury. Some RA patients affected, report that cold temperatures and weather affects their symptoms.
How your Podiatrist can help
While your GP will be able to provide medication and other therapies to help manage the symptoms of RA and slow its progression, your Podiatrist will look at ways to reduce pain to the joints of your feet and legs, and improve your day-to-day comfort and activity.
Custom-made orthotics made from soft materials are often used to increase comfort, absorb shock, and decrease the load through high-pressure areas and joints at the feet. They can be designed to accommodate any changes in the shape of the foot or rheumatic nodules, which could otherwise be very painful and pose the risk of developing corns, blisters or even ulcers.
Specialised footwear can also be recommended, or even custom-made, depending on the effects of RA on your feet, your pain levels and your needs. Keeping you comfortable and mobile allows you to continue to carry out your daily activities.
Stretching and strengthening exercises can also help you maintain your muscle strength and range of motion at the joints, slowing down the progression of symptoms. Your Podiatrist will discuss this and any other therapies they think may help you feel more comfortable and manage your flares during your appointment.
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