What is Rheumatoid Arthritis?
Rheumatoid Arthritis is one of the most common types of arthritis. The Arthritis Society defines rheumatoid arthritis (RA) as “a systematic inflammatory disease that can affect multiple joints in the body.” While the true origin of RA remains unknown, it is believed to result from a malfunctioning immune system. It has been suggested that the joints of the foot are affected in approximately 16% of patients with early RA and may rise as high as 90% with progression of the disease.
What do people Symptoms of RA?
Symptoms may be isolated to one joint or spread to many joints and can include:
- Redness or warmth to the touch
- Joint damage or deformity
- Difficulty walking or performing activities of daily living
- ‘Flare-ups’ or periods of heightened symptoms are common
- Arthritis is incredibly common. About 1 in 4 (54 million) adults have some type of arthritis and more than half of adults with arthritis (32 million) are of working age (18-64 years).
Arthritis can be debilitating, which is why it’s important to seek care and actively manage it. The number of adults limited by arthritis has increased by an estimated 20% since 2002. Daily activities of 24 million adults are limited by it, such as holding a glass, lifting a bag of groceries, or walking to a car. More than 25% of adults with arthritis report severe joint pain. As a result of pain and discomfort working-age adults report lower employment than those without arthritis. Additionally, adults with arthritis are more than twice as likely as adults without arthritis to report a fall-related injury.
Risk factors for Rheumatoid Arthritis
Risk factors for discomfort include:
- Poor fitting or worn out footwear
- High impact exercise
- High volume or intensity of exercise during periods of heightened symptoms
- High weight or obesity may increase the pressure placed on your feet and force transmitted through your joints
- Life stress and worry (anxiety) have been shown to worsen symptoms (arthritis.org)
- Depression or anxiety
Make sure to use:
- Good relaxation and coping strategies
- Assistive devices such as canes, walkers, reach-and-grab type devices
- Conducive environment – limit elevation changes and stairs, soft surface floors (carpet instead of ceramic or hardwood)
What can you do to manage your joint pain?
- It is important to stay active with RA. Mild to moderate intensity, low impact exercise is commonly recommended to preserve joint function. During times when your joints are swollen and hot, low impact and light range of motion exercises are more appropriate. Always consult with the appropriate heath care professional before starting a new exercise program. Physical activity programs can reduce yearly healthcare costs by about $1,000 per person. And, by being physically active, adults with arthritis can decrease pain and improve function by about 40%.
- Cushioned footwear and custom foot orthotics have been shown to help reduce foot pain scores. Reducing impact forces and distributing pressure evenly across the bottom of the foot can work to reduce areas of high pressure.
- Use heat and cold therapy. Using a warming pack or taking a warm shower may help reduce joint stiffness or pain. Never apply heat to an inflamed or swollen joint. Likewise, using a cold pack or ice bag may be helpful during periods of swelling or pain. Always use a barrier, such as a towel, between the skin and the hot/cold pack.
- Healthy eating and weight control are also important factors in day-to-day health when living with RA. Consult a dietician or your family physician for more information.
- Talk to your SoleScience Pedorthist or other care provider about local or digital educational programs and materials to gain confidence and skills on managing arthritis.
What are my options for treatment? Who can help?
There are a number of treatment options available to those living with RA. Options range from medication and lifestyle modification to footwear prescription and pressure offloading. Your family physician or rheumatologist will be more than happy to discuss appropriate medications and life style alterations.
Exercise prescription and pain management can be discussed with physiotherapists, kinesiologists, pedorthists and other health care professionals. Occupational therapists can help with lifestyle and household modifications to assist with activities of daily living.
Pedorthists are rigorously trained in the assessment and treatment of various types of arthritis, including RA. Through footwear prescription and modification, custom or off-the-shelf foot orthoses, basic range of motion exercises and stretches, life style modifications, and various other modalities, your pedorthist can help with concerns relating to the foot and lower extremity.
Prevention/Prehabilitation of Rheumatoid Arthritis
Currently, there is little known about the prevention of RA. There are however, a number of measures that can be taken to limit flare-ups and to manage your symptoms.
- Exercise and diet play a large role in the maintenance of joint and muscle function.
- Take care to select an appropriate exercise routine. Level of intensity is important and should take into consideration factors such as current level of fitness, age, current level of joint and muscle function, comfort etc.
- Diet is based on a number of factors and should be managed with the assistance of a registered dietician or physician.
- Maintaining a health body weight is important. Being overweight or obese may increase both the pressure on the bottom surface of your foot and the force transmitted through your joints.
- Footwear selection is important to consider. Proper fitting shoes are vital in the prevention of foot pain. Width, length, depth, level of support, and cushion are all factors to consider. Consult your pedorthist for more information.
- Foot orthotics can play a pivotal role in the prevention of foot discomfort. With appropriate support and cushion for the arches of your feet, research has shown custom foot orthoses are effective at limiting the occurrence and reducing the severity of foot pain.
- Modifying or limiting activities that cause discomfort can be an effective way to reduce symptoms. Riding a bike or roller blading instead of running, swimming instead of high impact exercise, and using assistive devices can limit discomfort and optimize ability.
Staying active with joint pain
Day-to-day discomfort can be managed, and in many cases improved, with moderate intensity and low impact exercise. During times of heightened symptoms or flares, low intensity range of motion exercises may help preserve joint function and improve comfort. High impact and high intensity exercise should be avoided at times when your joints are painful, hot to touch, or swollen. An appropriate warm up and cool down should always be performed before and after exercise to ensure optimal muscle function. If you are new to exercise or have questions regarding appropriate exercise selection, consult with your kinesiologist or physiotherapist.
Appropriate footwear with adequate support and cushion is important during periods of exercise. Consult with your pedorthist regarding footwear that is appropriate for your foot type and selected activities.