Hi Barbara

Wow, I have exactly the same problems with lower limbs! Arches fallen flat, ankle mobility very poor and stiff, knees ... don't get me started! I get upstairs just like you do! My physio said I look "like I'm walking on snow all the time", think she means I either trudge or plod with flat feet!! Been working on that for ages too!

Who knows Barbara, but do give the exercises a good try, if nothing else they do make you more aware of stance, posture and movement and should at least help with flexibility.

Let us know how you get on!

Lyn x

Hi Sheila

We have both done just that already!! Clearly you have much to learn about me and feet I think I drive people nuts with my seeming obsession with feet It is important that anyone with RA is referred to a podiatrist at the very earliest signs of problem in the feet. The delicate bones, of which there are many, can be very easily damaged and as yet you can't, to my knowledge, get replacement feet!!

Here's a blog I did a few months ago on, would you believe it ... feet?

Lyn x

Oh Sheila that's a lot of money! Yes, I was seen on the NHS both by podiatry and orthotics.

I was referred fairly early on although the RA did start in my feet and ankles and was very severe. At one point I had special shoes made but they didn't cut the mustard. I have had numerous pairs of insoles made which go in trainers or whatever but I still struggle to walk very far without pain. Initially the surgery (although butchery!) worked well and for a time I had no pain or even discomfort but it didn't last as further changes took place and the arches flattened and my toes clawed.

Sometimes people don't appreciate just how susceptible the feet and toes can be to RA and don't seek advice until after the damage has occurred. I think referrals through the NHS are made a lot sooner now but people still need to ask to be referred, it doesn't seem to be automatic. Likewise with Occupational Therapy.

Lyn x

Hi Barbie, Sorry to hear things are not good but glad that someone is listening to you and trying to help. Good luck at the next appointment. I thought my physio was brilliant, after seeing the limited mobility I still had after my six week course, he was the one that brought another rheumatologist to see me from the general ward. He asked her how bad I had to be before anyone considered the anti-TNFs. The doctor arranged my first DAS test that day and she had me on Humira 3 months later. Hope your physio is as good.

Julie xx

Hi Sylvia

Sorry to hear of your ongoing foot problems and the pain you are in as a result.

I have said on many occasions on here so no doubt repeating myself but you only get one pair of feet and damage done can very soon become irreversible. The small joints in the feet that carry the main body weight are easily damaged but this can equally be avoided by correct footwear and possibly orthotic insoles.

Your problems sound very similar to the ones I and many others experience due to RA. 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 (the pads you describe). 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.

You need to see the orthotist first as they may be able to offer more suitable insoles than the standard ones issued by podiatry. Your feet will be cast, so they are very much a made to measure device, and the moulds sent off for the orthotic insoles to be made. These will support your feet in all the necessary places and avoid you putting undue pressure on perhaps joints that have some damage.

Physio may be able to suggest exercises to help but will need to assess your walking with the orthotics in place.

Hope this helps Sylvia,

Lyn x

PS here's a link to a blog I wrote on Health Unlocked about 'feet'!

Hi Sylvia

I am glad you have got an appointment next week. I am sure you will find that they make a difference. Good luck.

Sheila x

Hi Sara

So glad the insoles are helping. Mine have made a tremendous difference. What! 64 weeks. That is ridiculous. I am glad I went privately now but we shouldn't have to. Obviously if people have to wait that long, irreparable damage is going to be done and they should employ more orthotists. NHS cuts no doubt. I worry about the future with staff leaving, not surprisingly, and major cuts. Where is it all going to end? We're all doomed!!!

Sheila X

Hi Sara

I wouldn't go as far as to say inevitable but if the metatarsal heads are damaged they aren't going to right themselves. Basically it comes down to how much damage is present and whether the discomfort is something you can live with. Despite surgery my feet are still bad (although I got a good few years respite!) because the metatarsals (the long bones of the feet) themselves have now dropped (I assume due to the fact there is no supporting head) and my toes are 'clawing'as a result. Good insoles are an absolute must and should be reviewed at least 12 monthly to take account of changes to the feet.

I wouldn't rush down the surgery route at this stage; if the gravel turns to pebbles then's the time to jump!

Lyn x