Rheumatology

Rheumatology is a specialist area of podiatry. It involves the treatment and management of patients who have been diagnosed with autoimmune disorders, connective tissue diseases and/or chronic inflammatory conditions such as rheumatoid arthritis.

Because of the way that these conditions can affect the small joints in the feet, this speciality aims to:

  • Help reduce foot-related pain
  • Maintain/improve foot function
  • Maintain/improve mobility
  • Prevent tissue breakdown and ulceration

Specialist podiatry clinics in rheumatology are hospital-based. Patients must be referred by a speciality consultant.

All newly diagnosed rheumatology patients are eligible for an initial podiatry appointment. This will include the assessment of foot function and structure. Subsequently, the podiatrist will then decide on an appropriate treatment plan, based on a patient’s individual needs. This may include:

  • Simple insoles/orthotics or devices
  • Exercises for stretching and strengthening
  • Foot care advice

At this point, it may be appropriate for an onward referral to be arranged to other services. This could include community podiatry for routine care, musculoskeletal (MSK) podiatry or referral to an orthotist for bespoke footwear or adaptations.

Patients are seen as an outpatient at the following locations:

Self-care can help reduce pain. This can include:

  • Heat packs, such as a hot water bottle or warm water can help ease the pain. Do not apply heat to already warm-to-the-touch inflamed joints. Do not apply heat directly to the skin. Heat treatments can be applied for up to 15 minutes at a time.
  • Ice packs or a bag of frozen peas can help reduce swelling. Do not apply ice directly to the skin. Wrapping an ice pack in a towel will avoid damage and irritation to the skin. Ice treatments can be applied for up to 15 minutes at a time.
  • Raising your affected limb above your heart height (elevation) or changing your position by using cushions in a chair (positional technique) can help to reduce swelling. Elevation may help with swelling experienced in specific joints such as the knees or feet. Supporting joints with pillows can make them more comfortable, such as a pillow behind your back or neck.
  • Soles from podiatry may help to rest affected joints.

You should seek urgent help if you are experiencing any of the following:

  • High fever with rash.
  • Red, hot, swollen joints.
  • Unusual pain and swelling in a joint, especially with a fever, that could be septic arthritis.
  • Severe and sudden abdominal pain.
  • A severe, atypical disease flare.
  • Sudden spine pain, which may signal a vertebral fracture. Rheumatoid and psoriatic arthritis are risk factors for both osteoporosis and fractures; corticosteroid use raises the risk.