Nonsurgical management of the foot and ankle affected by rheumatoid arthritis

Rheumatoid arthritis frequently affects root and ankle function, leading to pain, difficulty with ambulation, and disability The purpose of this article is to describe common root and ankle deformities associated with rheumatoid arthritis and present state-of-the-art nonsurgical management strategies. Physical impairments thought to be commonly associated with limitations or function and practical interventions for alleviating those impairments or reducing the impact of the impairment on ambulation are identified. Examples of rehabilitation interventions discussed include prescription footwear, custom and premolded root orthoses, hindfoot orthoses, ankle-foot orthoses, shoe modifications, therapeutic exercises, and patient education. Early and aggressive attempts at prevention, delay or correction of foot and ankle pathomechanics related to rheumatoid arthritis may play a key role in helping patients maintain an active ambulatory lifestyle.