Comprehensive Management of Foot and Ankle Conditions and Their Biopsychosocial Impact on Patients Diagnosed with Rheumatoid Arthritis
In brief
Combined care cut foot pain by 5 points in adults with rheumatoid arthritis
In a review of 21 studies, combined medication, custom foot orthoses, and structured physical therapy were associated with a 5-point average pain reduction and improved quality of life over six months. Results varied substantially across studies, so the contribution of each treatment remains unclear; long-term randomized trials are needed to confirm the benefits.
- Journal
- Medical sciences (Basel, Switzerland) (Q1)
- Published
- 28 August 2026
- Study design
- Systematic review / meta-analysis of RCTs
- Evidence level
- Level 1, High (CEBM 1a)
- Authors
- Mercedes Ortiz-Romero, Luis M Gordillo-Fernández, José Pablo de León-Linares, César O García-García
- PMID
- 42783399
- DOI
- 10.3390/medsci14050526
Why clinicians should know about it
- Picked for Pathology and Forensic Medicine (top studies of the week, 27 September 2026): Not relevant to diagnostic pathology
- Picked for Rheumatology (top studies of the week, 27 September 2026): Systematic review of RA foot/ankle interventions
- Picked for Anatomy (top studies of the week, 27 September 2026): High-quality evidence in a top journal
Abstract
BACKGROUND/OBJECTIVES: Rheumatoid arthritis (RA) affects a high percentage of people. This condition can lead to foot and ankle deformities frequently accompanied by severe pain and limitations in daily activities; together, these aspects reduce the quality of life. METHODS: We carried out a systematic search of databases such as PubMed, Cochrane, and Scopus. We compared the outcomes of treatments with conventional disease-modifying antirheumatic drugs (DMARDs), anti-TNF biologic drugs, custom foot orthoses, and combined therapies over a six-month period. This systematic review and meta-analysis synthesized evidence from 21 included studies evaluating pharmacological, orthotic, and physical therapy interventions in adult RA patients with foot and ankle involvement. RESULTS: Across pooled estimates, multidisciplinary interventions combining pharmacotherapy, custom foot orthoses, and structured physical therapy demonstrated substantial reductions in pain (VAS score mean reduction of: -5.0 points in VAS score) and kinesiophobia, alongside gains in health-related quality of life (EQ-5D increase of: +0.30 points). High statistical heterogeneity was observed across study designs (I^2 > 50\%). CONCLUSIONS: Early assessment of foot pathologies and multidisciplinary collaboration are recommended, while future long-term randomized controlled trials are needed to confirm component-specific efficacy. Recommendations include early assessment of foot pathologies, collaboration among multidisciplinary teams, and future studies including 12-month follow-ups using specific assessment tools such as the MFPDI.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.