Podiatry plays an important role treating rheumatology conditions such as rheumatoid arthritis, psoriatic arthritis, gout and connective tissue disorders. Several guidelines from Australia and overseas recommend patients with rheumatoid arthritis see a podiatrist for an appointment once a year. The podiatrists at Fitzroy Foot and Ankle Clinic are leaders of the management of rheumatoid arthritis and other rheumatological conditions.
Dr Glen Whittaker (PhD) is a leader in podiatry and rheumatological conditions. He is currently the Professional Development officer for the Rheumatology Health Professional Special Interest Group (RHPSIG) and has given several presentations to rheumatologists. In 2020, he was awarded the ‘Best Allied Health Paper’ by the Australian Rheumatology Association.
Rheumatoid arthritis
How does rheumatoid arthritis affect feet?
Rheumatoid arthritis is a systemic inflammatory condition that has an affect on multiple body systems. This condition causes inflammation of the joint lining that leads to pain, reduced function, impacted ability to work and exercise. Given the foot comprises several joints, between 70-90% of people with rheumatoid arthritis will experience foot complaints. In addition, rheumatoid arthritis has an affect on the blood flow and nerves to the feet, foot deformity, foot ulceration, and problems fitting footwear, therefore, there is an ongoing need for assessment, education and treatment from podiatrists.
What treatments do podiatrists provide for rheumatoid arthritis?
Podiatrists have an important role to keep people active and mobile in the community. Given rheumatoid arthritis affects the joints of the feet, podiatrists can:
Provide education and information about how to care for your feet with rheumatoid arthritis
Provide exercise and strengthening programs
Discuss footwear to protect or reduce stress the foot joints
Use orthotics to protect or reduce stress the foot joints
Perform assessments to monitor for changes to nerves and blood flow
Manage callus that can occur on the bottom of the foot due to joint changes
Spondyloarthritis
Spondyloarthritis is an umbrella term for conditions including axial spondyloarthritis and psoriatic arthritis. These conditions can affect different types of tissue in the body. Axial spondyloarthritis mostly affects the spine and pelvis, however some people will have pain where tendons insert onto bones (which is called an enthesis). Psoriatic arthritis affects joints in the feet, different entheses in the feet (particularly the heel), and also the skin and nails of the feet. These issues can have a significant impact on function, work and exercise.
What treatments do podiatrists use for spondyloarthritis?
Podiatrists have an important role keeping people with spondyloarthritis active and mobile in the community. Given spondyloarthritis, particularly psoriatic arthritis, affects the joints of the feet, the entheses (where tendons insert to bone), and the skin and nails, podiatrists can:
Provide education and information about how to care for your feet with spondyloarthritis
Provide exercise and strengthening programs to limit stress to the foot joints and entheses
Discuss footwear to protect or reduce stress to the foot joints and entheses
Use orthotics to protect or reduce stress to the foot joints and entheses
Manage nail thickening that can occur for people with psoriatic arthritis.