Are rheumatic foot complaints caused by movement or inflammation?

Rheumatic conditions can cause inflammation in tendons and joints. This inflammation can also occur in the foot and lower leg. Feet and (lower) legs are important for the body to be able to move properly. If problems arise in the feet and lower legs, this can lead to mobility issues. This is referred to as ‘impaired biomechanics’.

Inflammation in a foot joint can cause pain. To avoid this pain, a person may start walking differently. This leads to the development of an abnormal gait or abnormal foot position. As a result, other parts of the foot – and often also the lower leg, knee and hip – are subjected to incorrect strain. This excessive strain can lead to foot problems. For people with (for example) rheumatoid arthritis, an abnormal gait or foot position carries an additional risk. We explain why below.

Foot problems such as pain can also arise as a result of an inflamed foot joint. An inflamed foot joint, in turn, can be the result of an abnormal gait or abnormal foot position. This places extra strain on the joint. The joint is not designed to cope with this extra strain, making it more sensitive and more prone to inflammation. The joints in the forefoot are particularly susceptible to this.

People with rheumatoid arthritis are twice as likely to develop joint inflammation as those without rheumatoid arthritis. This is because people with rheumatism are more likely to develop an abnormal gait. Due to the rheumatic condition, these overloaded joints are even more likely to become inflamed. That is why it is important for the podiatrist to help correct the abnormal gait.

The aim of the biomechanical assessment is to determine why someone is unable to walk properly. The investigation therefore seeks to identify the cause of the impaired biomechanics. This is often also the reason for foot problems. In someone with rheumatism, inflammation of the joints and tendons can be a major cause of impaired biomechanics. The podiatrist will therefore pay particular attention to the presence of inflammation during the examination of a patient with rheumatism. In this way, the podiatrist can assess the cause of the complaint: an abnormal gait or foot position, or inflammation. A combination of both is also possible. The cause of the foot complaints determines the podiatrist’s advice.

Impaired biomechanics and inflammation in the joints are inextricably linked: when inflammation is present, a person’s gait may change. This results in impaired biomechanics, which can lead to foot problems.

However, if an abnormal gait or posture is evident, this can cause inflammation in the joints. This inflammation can, in turn, lead to foot problems.

It is therefore difficult to say whether foot problems arise as a result of movement or inflammation. However, it is clear that both contribute to foot problems. When foot problems need to be treated, therapy for both issues will therefore be initiated in most cases.

A podiatrist is a recognised higher vocational education (HBO) professional, specialising in the assessment, treatment and prevention of complaints affecting the feet, ankles, knees, hips and back. By intervening at an early stage, your podiatrist can slow down the development of foot complaints associated with rheumatism and relieve pain. Do you have rheumatism and suffer from foot problems and/or difficulties standing or walking? If so, make an appointment with a podiatrist in your area. You could, for example, contact Rondom Podotherapeuten.