The role of the Podiatrist in the management of patients with rheumatic disease is to work in partnership with the patient; to reduce foot related pain, maintain / improve foot function & mobility and to protect skin and other tissues from damage.
A number of treatments are available and provision is based upon a comprehensive patient-centred assessment of the individuals’ foot-health needs.
The assessments may include:
- Functional assessment of the lower limb (gait and joint examination)
- Skin examination to determine areas of potential soft tissue breakdown due to high pressure / deformity / low tissue viability
- Vascular assessment
- Neurological assessment
- Footwear assessment
Types of treatment
The types of treatment available may include:
- Routine palliative foot care: attending to nail problems, treatment of corns and calluses and provision of advice regarding general foot-health maintenance.
- Prescription/provision of ‘off-the-shelf’ or bespoke orthoses (insoles). These devices provide cushioning/protection of vulnerable areas of the foot and/or joint realignment to facilitate improved foot function and mobility.
- Footwear assessment and/or therapeutic footwear prescription. The podiatrist can advise patients regarding appropriate footwear and refer for Bespoke therapeutic footwear if the foot deformity demands particular adaptations to accommodate its shape. In addition, some NHS podiatrists can prescribe Therapeutic ‘stock’ footwear if a slightly deeper, wider shoe is all that is required. The podiatrist may work with an Orthotist within a Specialist Footwear clinic.
- Assessment and management of wounds (such as ulcerations) that can occur on the feet.
- Some NHS Specialist Podiatrists may be qualified to administer intra-articular steroid injections for joints within the foot that are subject to inflammatory ‘flares’.
- Podiatrists will liaise with other members of the multidisciplinary team to ensure that the patients’ needs are met from a ‘holistic’ perspective and provide foot-health education as part of a multidisciplinary team.