Clinical Rheumatology

, Volume 29, Issue 3, pp 255–271 | Cite as

Foot pain in rheumatoid arthritis prevalence, risk factors and management: an epidemiological study

  • Simon J. OtterEmail author
  • Kevin Lucas
  • Kate Springett
  • Ann Moore
  • Kevin Davies
  • Liz Cheek
  • Adam Young
  • Karen Walker-Bone
Original Article


Foot involvement is a major feature of rheumatoid arthritis (RA). Most epidemiological studies of the RA foot report radiological changes and results of clinical examination. This study aimed to determine the prevalence of foot symptoms, frequency of foot assessment and access to foot care from the perspective of people with RA. A questionnaire was sent to 1,040 people with RA throughout the UK enquiring about foot symptoms, their anatomical distribution (via validated mannequins) availability of podiatry services and perceived usefulness of interventions for alleviating foot symptoms. Altogether 585 useable replies were received; 93.5% of respondents reported having experienced foot pain, and 35.4% reported current foot pain as the presenting symptom. Most (68.2%) reported moderate or severe foot pain daily. Pain was most prevalent in the forefoot and/or ankle. The main predictive factors for reporting current foot pain were longer disease duration (mean 13 vs 10.3 years, p = 0.009), higher BMI (25.6 vs 24.1 p = 0.001) and the prevalent foot symptoms foot stiffness and numbness (both p < 0.0001). Age, gender and current treatment were not significantly associated. Most (82%) had discussed foot symptoms with their rheumatologist, and only 64% had seen a podiatrist. Reported current adherence to prescribed orthoses was 55.8% and to prescribed shoes was 29.5%. Foot symptoms are ubiquitous in RA and frequently severe. Most patients had discussed their symptoms with their rheumatologist, and only 64% had specifically seen a podiatrist. Despite the remarkable progress in development of new treatment modalities for RA, foot pain remains a common and disabling symptom. Our findings support the need for wider access to specific foot care services and evidence-based, patient-centred interventions.


Epidemiology Foot pain Foot symptoms Patient perspective Rheumatoid arthritis 



The authors wish to thank the National Rheumatoid Arthritis Society for their support, those who took the time to complete a questionnaire and the research assistants for their help with running the project.




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Copyright information

© Clinical Rheumatology 2009

Authors and Affiliations

  • Simon J. Otter
    • 1
    Email author
  • Kevin Lucas
    • 1
  • Kate Springett
    • 2
  • Ann Moore
    • 1
  • Kevin Davies
    • 3
  • Liz Cheek
    • 4
  • Adam Young
    • 5
  • Karen Walker-Bone
    • 3
  1. 1.School of Health ProfessionsUniversity of BrightonEastbourneUK
  2. 2.Department of Allied Health ProfessionsCanterbury Christ Church UniversityCanterburyUK
  3. 3.Brighton & Sussex Medical SchoolBrighton & SussexUK
  4. 4.Computing Mathematical and Information SciencesUniversity of BrightonBrighton & SussexUK
  5. 5.Rheumatology DepartmentNorth West Herts NHS TrustHertfordshireUK

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