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Rheumatoid Arthritis

Rheumatoid arthritis (RA) is a condition that causes inflammation in many joints of the body. Unlike osteoarthritis which is caused by wear and tear, rheumatoid arthritis is a chronic inflammatory disease where a faulty immune system attacks the tissue that lines and cushions the joints, leaving them swollen, painful and stiff.

This condition particularly affects the hands, feet, wrists, ankles and knees -and tends to occur symmetrically. That is, if your right big toe joint is swollen and painful, chances are, your left one is too. But RA can also affect other organs. As well as joint pain and stiffness, symptoms include muscle aches, anaemia (a low blood count, leaving you feeling tired) and fever. The stiffness tends to be worse in the morning and after rest.

Women are three times more likely than men to get it and it tends to affect people between the ages of 30 and 50.

The severity of the symptoms vary from person to person. According to the Arthritis Research UK about 1 in every 20 will have RA that becomes progressively worse leading to severe damage in a lot of joints while around 1 in 5 will have mild RA that causes few problems, beyond a little pain and stiffness.

How does rheumatoid arthritis affect the feet? RA affects the smaller joints such as the fingers and toes first, so feet are often one of the first places to be affected. Symptoms usually strike the toes first and may then affect the back of the feet and the ankles. The joints may enlarge and even freeze in one position, so they can't extend fully. Any kind of foot deformity will cause an uneven distribution of pressure as you walk, making you more likely to develop corns, calluses and ulcers.

Your doctor can make a clinical diagnosis using blood tests (which may show changes in the blood caused by inflammation) and X-rays (which can show up damaged joints). It is likely your feet will be x-rayed because the changes caused by rheumatoid arthritis often appear in the feet before they appear in other joints.

The treatment you'll need depends on how advanced your Rheumatoid Arthritis is. Drugs available include analgesics, non-steroidal anti-inflammatory drugs (NSAIDs), which reduce pain and swelling, and disease-modifying anti-rheumatic drugs (DMARDs), which slow down the effects of the disease on the joints.

Your podiatrist can provide orthoses (insoles) to help you walk in such a way to minimise the pressure on your affected joints and advise on the best style of footwear. They can also provide protective shields or padding to relieve pressure and reduce friction.

Surgery may also be indicated to relieve symptoms.