Rheumatoid Arthritis

At Masterton Foot Clinic, we work alongside your GP, rheumatologist, and other healthcare professionals to help reduce pain, maintain mobility, protect vulnerable joints, and support your independence throughout every stage of the condition.

What is rheumatoid arthritis?

Rheumatoid arthritis is a long-term autoimmune disease in which the body's immune system mistakenly attacks the lining of the joints (the synovium). This causes inflammation that can damage cartilage, bone, ligaments, tendons, and surrounding soft tissues over time if not effectively controlled.

Unlike osteoarthritis, which is now understood to be an active disease affecting the entire joint and influenced by factors such as mechanical loading, previous injury, genetics, ageing, and biological processes, rheumatoid arthritis is driven by an abnormal immune response.

At the time of writing, the best available evidence suggests that early diagnosis and treatment with disease-modifying anti-rheumatic drugs (DMARDs) have significantly improved long-term outcomes for many people living with rheumatoid arthritis.

Despite these advances, the feet remain one of the most commonly affected parts of the body.

Symptoms

Common symptoms include:

• Pain in the feet or ankles.
• Swollen joints.
• Morning stiffness lasting longer than 30 minutes.
• Warmth around affected joints.
• Pain beneath the ball of the foot.
• Difficulty walking.
• Changes in foot shape over time.
• Fatigue and reduced activity levels.

Symptoms often affect both feet and may fluctuate over time, with periods where the condition becomes more active.

Causes

Rheumatoid arthritis develops when the immune system mistakenly attacks healthy joint tissue.

The exact cause is not fully understood, but contributing factors may include:

• Genetic predisposition.
• Immune system dysfunction.
• Environmental factors.
• Smoking.
• Hormonal influences.

Unlike osteoarthritis, rheumatoid arthritis is not caused by normal ageing or simply "wearing out" the joints.

When should you see a podiatrist?

We recommend an assessment if:

• Foot pain is affecting your walking, work, or daily activities.
• You notice swelling in your feet or ankles.
• Your footwear is becoming uncomfortable.
• You are developing pressure areas or calluses.
• You have changes in the shape of your feet.
• You have diabetes, poor circulation, or reduced sensation in addition to rheumatoid arthritis.
• You have persistent foot pain and prolonged morning stiffness but have not yet received a diagnosis.

Early assessment often allows small problems to be identified before they have a greater impact on mobility and function. If we suspect an underlying inflammatory arthritis that has not yet been diagnosed, we can recommend further medical investigation through your GP or an appropriate specialist.

How rheumatoid arthritis affects movement

Your feet and legs work as one connected system.

Almost every muscle in the lower leg attaches to the foot, helping to control walking, balance, and stability. Rheumatoid arthritis can affect not only the joints, but also the tendons, ligaments, and other soft tissues that support movement.

As these tissues become painful or inflamed, people often change the way they walk without realising it. Over time, this may increase pressure beneath certain parts of the foot and contribute to pain elsewhere in the ankles, knees, hips, or lower back.

Rather than focusing solely on painful joints, we assess how rheumatoid arthritis is affecting your overall movement and identify strategies to improve comfort, reduce excessive loading, and maintain mobility.

How we treat rheumatoid arthritis

Our role is to work alongside your rheumatology team to help you remain as active and independent as possible.

Depending on your needs, treatment may include:

• Footwear advice.
• Orthopaedic Footwear, where appropriate.
• Custom Foot Orthoses.
• Pressure redistribution strategies.
• Foot Mobilisation Therapy (FMT), where appropriate.
• Management of corns and calluses.
• High-Risk Foot Care where appropriate.
• Regular monitoring of foot health.
• Referral to your GP, rheumatologist, or other healthcare professionals where appropriate.

Our goal is not simply to reduce foot pain. We aim to help you maintain your mobility, confidence, and quality of life while supporting the wider management of your condition.