Introduction of Practical Strategies for Foot Care, Shoes and Orthotics for Patients with Rheumatoid Arthritis

YABE Yuichiro

doi:10.18970/footcare.74

<p>Rheumatoid arthritis of the foot is frequently overlooked. Therefore, it is important to carefully observe patients' feet, shoes, and walking patterns, and listen to their complaints while considering their lifestyles. Points of observation include: nail-cutting; patients' movements, including their lower limb, upper limb, and trunk functions; the type of lower limb edema: bilateral or unilateral; symptoms, such as the presence of Raynaud's phenomenon, vasculitis, skin ulcers, calluses, and dry skin; shoes, including the method to put on shoes, scratches, and the ability to tie shoelaces; and medications, including whether oral/topical drugs can be used. Foot care teams (comprising patients, their caregiving families, persons involved in community-based medical care, doctors, nurses, physical/occupational therapists, prosthetists/orthotists, shoe retailers, care managers, and others) should share problems, promote interactive communication, and obtain consensus among members to resolve such problems. Approaches should be illustrated in detail. In the case of plantar calluses around the MTP joint, a metatarsal bar or pad is placed slightly toward the heel from the callus. The area for insoles is also prescribed, as necessary, which are provided by prosthetists/orthotists and shoe makers. As for toe joints, the upper vamp is tanned to expand the part of the leather touching the foot in cases of PIP joint arthritis and MTP disorders similar to hallux valgus. In foot care for rheumatoid arthritis, it is necessary to manage foot disorders from overall perspectives and to provide continuous care.</p>

Introduction of Practical Strategies for Foot Care, Shoes and Orthotics for Patients with Rheumatoid Arthritis

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