Only one pair per person!
Yes, that’s right, just the one pair to last until you are pushing up the daisies! Surgeons can replace wrists, elbows, shoulders, knees, hips, ankles, but feet? Not a chance! You get the one pair you are born with and they have to last the distance.
The unfortunate thing is for those of us with RA the feet can be tricky items. Often RA chooses to make itself known to us through discomfort and pain in the feet. The feet contain numerous small bones and the delicate structures can easily become damaged, especially when you consider how much use they get. Foot damage may take years to actually show up but by the time it does it is likely to be too far gone for you to be able to do much about it.
No, I’m not a podiatrist, I have RA which started in my feet possibly many years before I was actually diagnosed. I have had two lots of surgery to my feet to have metatarsal heads removed. These are the knobbly lumps behind the toes on the base of each foot. In RA these small joints quickly become damaged with the resulting "walking on pebbles" dilemma. Perhaps in the future it may be possible to replace these joints but for now the only option is removal. This shortens the length of the foot and leaves the toes floppy. I have a whacking great scar across the top of each foot and cannot now move my toes which at times become extremely painfull due to dislocations and various malformations that have occurred over time..
Those ops were 11 years ago. Since then the metatarsals (the long bones in the foot) themselves have dropped, I suppose without the head the supporting structure was missing. No-one seems to have an answer to this. Having tried just about every shoe on the planet, believe me, the idea of flippers quite appeals! I have given up with expensive shoes that for some reason or another simply hurt my feet and now get expensive trainers which offer really good width and support throughout the foot and ankle. And ... my insoles fit without any trouble! Not fashionable … but immensely sensible!
If you have RA in your feet or any possibility that you may be developing RA in your feet, you MUST wear 'sensible' shoes. Yes, boring I know!! Shoes with backs are important because they provide sufficient grip to hold the foot in place (unlike flipflops where you have to grip with your toes otherwise the blighters fall off!).
Also essential is the foot arch which helps retain the skeletal structure of the foot in the correct position. What I would say from my experience is that it is always important to choose footwear with a good metatarsal arch which supports the foot from underneath. This helps to keep the long metatarsal bones in the correct position avoiding long term problems. Fashion shoes and 'cheaper' shoes and trainers tend not to have this. When the metatarsal heads suffer damage there is little that can be done other than surgery. Walking on pebbles constantly is not pleasant!!
At the first signs of RA in the feet a good option is to request referral to a Podiatrist/Orthotist, one qualified in the problems RA brings with it. He/she will be able to examine the structures of the feet and if necessary prescribe orthotic insoles or footwear to help with the realignment. These can make a big difference not just to the feet but in the support of ankles and knees which can become affected by misalignment in the joints of the feet.
So, that’s it! Feet! They do a lot for us throughout our lifetimes so give them the TLC they deserve. One pair each …. so make sure you look after them!