Meeting the challenge for foot health in rheumatic diseases

Background: National guidelines recommend that patients with rheumatic diseases should have access to podiatry services and evidence is emerging that podiatry interventions are effective in the management of foot problems in this patient group. Despite this recognition it is generally perceived that access to podiatry services appears to be varied or absent. Objectives: To identify the nature of foot health problems presenting in a rheumatology clinic and to ascertain the availability and suitability of foot care for these problems. Method: A convenience sample of 139 patients (100 female and 39 male) was recruited. An assessment of foot health, and footwear was carried out and patients completed the foot function index (FFI). Any unmet foot care needs were identified. Results: The majority of the 139 patients presented with symptomatic callus and toenail problems and over half with foot deformity. There was no clear difference between genders. There was evidence of the effects of foot pain caused by these problems but low prescription of foot orthoses and specialist footwear. Conclusion: Overall this study indicates that poor foot health and foot pain as being common in patients with rheumatic diseases. The lack of foot care could lead to reduction in mobility and in some cases serious complications. This paper recommends that a specialist and dedicated foot care service is provided for these patients