The bones and joints of the legs, like the entire skeleton, are damaged in rheumatoid arthritis. Smaller joints are affected first, and as the disease progresses, the knees and hips are affected. There is swelling of the ankle joint, reduced mobility, bony deviations… The most common bony deviation is hallux valgus. This deviation implies a bone growth at the base of the thumb. It is considered to be the most common acquired deviation of the bone system in humans in general. Rheumatic foot includes deformed fingers in the form of digitus flexus. In a pinched finger, the deformation is located at the junction of the middle and proximal phalanx. Physical therapy has not been shown to be successful in the treatment of flexus digitus. Dropped arches of the feet in the sense of planovalgus also occur. The arches or arches of the feet absorb body weight and adapt the foot to uneven terrain. The arches of the foot are: the longitudinal arch of the foot (arcus pedis longitudinalis) and the transverse arch of the foot (arcus pedis transversus). In advanced stages, they are lost, which can be checked, for example, by footprints on the sand. Rheumatoid foot will be completely filled with the entire surface of the impression, in contrast to an impression without pathological changes.
The knees are affected by effusion and a hard joint capsule. The occurrence of Baker’s cyst is particularly common. It is more common in women, as is the general occurrence of rheumatoid arthritis. It is a cyst on the dorsal (back) side of the lower leg that causes stiffness and pain. The pain is aggravated by bending the joint. The cyst is filled with fluid, and patients can feel the fluid-filled formation themselves. The hips are the latest to be affected, and severe damage is observed on the head of the femur and on the articular cup. Gait can be significantly weakened in the final stages of the disease.
The importance of footwear in rheumatoid arthritis
People suffering from rheumatoid arthritis must pay special attention to the choice of footwear. As the feet get bony deformations and are generally less mobile, footwear must meet high standards. The first line of help is orthopedic insoles, and a rheumatic foot sometimes requires special medical footwear.
Orthopedic insoles can be made individually, and can be very useful in reducing pain, absorbing body weight, reducing fatigue in the legs… Their task is to support the arches of the feet, distribute the weight and reduce the load on the places of greatest pressure. In addition to supporting the arches of the feet, the insoles reduce the appearance of calluses. The heel pad helps in this, which contributes to comfort and reduces pressure on the foot. In the case of rheumatic foot problems, it works on a dropped foot, pinched toe and hallux valgus. In general, insoles used to correct deformity or relieve discomfort can be serially or individually made. They are serially made to suit most people, and their advantage is that you can buy them immediately without prior consultation with experts. Their advantage is a lower price, but if you want an individual approach to the problem and custom-made insoles, then it is better to decide to have them made in a professional workshop. By purchasing individual medical insoles, you are making an investment. Such insoles are long-lasting, since they are made of quality and natural materials such as leather, they are adapted exactly to your deformation, etc.
Footwear for rheumatic foot – orthopedic insoles can help solve the problem of a dropped foot, but in order to approach the problem holistically, the best solution for rheumatic foot is medical footwear. Since the supply of medical shoes has improved and advanced in recent years, patient cooperation is also greater. The models as well as the design of the shoes are really diverse. Dr. Luigi shoes and slippers come in numerous models, and everyone can find an acceptable shoe design. The wide range includes everything from winter shoes to flip-flops with different ornaments. In addition, DrLuigi, in cooperation with the Institute of Interdisciplinary Technologies, conducts 3D diagnostics, with which it is possible to create a 3D model of the foot and custom-made footwear. This is particularly important in rheumatic feet, as multiple deformities are corrected at the same time. In this way, using a 3D scan of the foot, it is possible to create footwear that exactly matches your needs. The model is made using a three-dimensional scanner, and then the structure of the left and right feet is compared. Based on the findings of the scan, a further consultation with the doctor is carried out. After the consultation, it is possible to create a shoe that, for example, on one foot helps to solve the lowered arch of the foot, and on the other it helps to alleviate Digitus flexus problems.
What should you pay attention to when buying shoes?
- Shoe width – shoe width is one of the most important factors when choosing footwear for rheumatic feet. The reason for this is: deformities of the base of the thumb, weakened motor and sensory due to mononeuropathy… Due to weakened sensory, i.e. feeling, people often do not notice the pinching of shoes. This leads to the development of blisters, calluses and sores. In order to avoid this, as well as pressure on bone deformations at the base of the thumb, choose comfortable and wider shoes. DrLuigi footwear is ideal for people suffering from rheumatoid arthritis, as it leaves space for the foot, does not create additional pressure, improves circulation…
- Heel – patients with rheumatoid arthritis should definitely avoid wearing high heels. Nothing can harm a rheumatic foot like excessive pressure on the forefoot. A foot in a high heel creates unnatural pressure on the bones of the front part, and the toes narrow in a tight high shoe. Over the years, this results in hallux valgus, to which these patients are far more susceptible than the rest of the population. In addition, the rheumatic foot is not so stable. Edema of the ankles, reduced mobility, etc. lead to reduced stability of the legs. The foot in a high shoe is very unstable, so it is recommended not to wear a heel higher than 5 cm. Heels above 5 cm are not acceptable for everyday wear.
- The bottom of the shoe – the bottom must be flexible so that the foot can activate the muscles when walking. You should avoid shoes with a thick bottom, since in them the foot does not activate the arches and muscles, but only wears off. The bottom of the DrLuigi medical shoe contains polyurethane which is supple and flexible. In this way, the foot is activated when walking and the progression of the disease is slowed down.
- Shoe material – nerve damage over time causes ulcers. Ulcers heal poorly due to impaired circulation, and damage to vessels in the form of vasculitis also contributes to this. It is advisable to choose shoes that improve circulation, and thus the healing of possible wounds and ulcers. DrLuigi shoes are known for improving leg circulation.
Light binding – people with acquired rheumatoid arthritis have problems with mobility in the joints of the fingers of the hands. For this very reason, footwear with a complex lacing method is not recommended. In this case, less is more and simpler solutions should be resorted to. As an example, we can mention shoes that are put on like slippers or shoes with velcro. DrLuigi medical shoes are particularly practical to put on since they do not require any bending or hand involvement at all.
S.D.
06.09.2022.