Special Aspects of Foot Orthotics in the Treatment of Patients with Rheumatoid Arthritis

Over time, rheumatoid arthritis leads to foot deformities in most patients, accompanied by typical symptoms and restrictions in mobility. In addition to medication, physical therapy, physiotherapy and local infiltration techniques, one focus of conservative treatment is on orthotic therapy. As a consequence of inflammatory alterations, the pathophysiological processes in the rheumatic foot initially include increased laxity of the capsuloligamentous complex with instability and typical deformation. This unstable situation can be corrected and consolidated through custom-fit insoles. As the disease progresses, we see disturbances in the biomechanical function of the rheumatic foot. These symptoms can be relieved through special orthotics and insoles. Severe deformations of the foot seen in the final stage with contractions and a fixed fore foot and hind foot make it necessary to fit custom-made orthopaedic shoes based on a shoe last to preserve mobility and quality of life for patients with rheumatoid arthritis.