Why is foot pain a concern in rheumatoid arthritis?

Rheumatoid arthritis (RA) frequently causes foot pain, sometimes as the initial symptom. Managing this pain typically involves methods like specialized footwear and orthotics. Assessing foot pressure is also common, using tools like force plates to measure pressure distribution. However, it's been unclear how well these pressure measurements correlate with the pain patients actually experience.

What were the key findings regarding static foot pressure in rheumatoid arthritis?

The study in *Annals of Physical and Rehabilitation Medicine* found no direct link between static plantar peak pressure and functional assessments, pain levels (using the Visual Analog Scale - VAS), or overall disability (measured by the Health Assessment Questionnaire - HAQ). This suggests that static pressure measurements may not accurately represent foot function during movement. This is important as it challenges the idea that static pressure alone can effectively guide treatment strategies for foot pain.

What exactly is static plantar peak pressure?

Static plantar peak pressure refers to the maximum pressure exerted under the sole of the foot while a person is standing still. The study focused on whether this static measurement correlates with gait alterations and foot function in people with rheumatoid arthritis (RA). The researchers also looked at the location of the peak pressure, the total surface area under each foot, and the distribution of pressure between the forefoot and rearfoot.

What are the Foot Function Index (FFI-F), Visual Analog Scale (VAS), Health Assessment Questionnaire (HAQ) and McMaster Toronto Arthritis (MACTAR) and what do they measure?

The Foot Function Index (FFI-F) measures how foot problems impact a person's ability to function. The Visual Analog Scale (VAS) is used to assess the level of foot pain a person is experiencing. The Health Assessment Questionnaire (HAQ) evaluates overall disability. The McMaster Toronto Arthritis (MACTAR) helps to gather patient preferences regarding their foot health. These tools help provide a comprehensive picture of the patient's condition, going beyond just pressure measurements.

What are the implications of the study's findings for assessing and treating foot pain in rheumatoid arthritis?

The study suggests that relying solely on static plantar peak pressure measurements to understand foot problems may be insufficient. Dynamic assessments, which capture foot function during movement, may provide a more complete picture. This is important because treatment strategies based only on static measurements might not be as effective in addressing the pain and functional limitations experienced during activity. It also means further research is needed to develop better assessment techniques.

Glowing foot pressure points fading while walking, symbolizing disconnect between static and dynamic.

Unraveling Foot Pain: Why Static Pressure Tests Might Not Tell the Whole Story in Rheumatoid Arthritis

Samir D’Costa in Health & Wellness December 2025 • 4 min read.

"New Research Challenges Common Beliefs About Foot Pressure and Gait Issues in RA Patients"

For individuals living with rheumatoid arthritis (RA), foot pain is a frequent and often debilitating symptom. In fact, for many, the first signs of RA manifest as pain in the feet. This can significantly impact mobility and quality of life. Managing foot pain in RA often involves a combination of approaches, including specialized footwear and orthotics. The goal is to alleviate pressure points and improve overall foot function.

Assessing foot pressure is a common practice in podiatry, with tools like force plates used to measure the distribution of pressure across the foot. However, there's a lack of clear guidelines on how to best utilize these measurements to guide treatment decisions. While numerous studies have explored foot pressure in RA, the correlation between these measurements and the actual pain experienced by patients remains unclear.

A study published in the Annals of Physical and Rehabilitation Medicine challenges conventional wisdom regarding static foot pressure measurements in RA patients. The research investigates whether static peak pressure under the sole of the foot is directly related to gait alterations, questioning the reliability of this measurement as a standalone indicator of foot function.

Static vs. Dynamic: Why the Type of Assessment Matters

Glowing foot pressure points fading while walking, symbolizing disconnect between static and dynamic.

The primary goal of the study was to determine if there were any correlations between static plantar peak pressure and functional evaluations of the RA foot, based on the International Classification of Functioning, Disability and Health (ICF) model. The secondary objective was to compare podo-barometric data with clinical findings to see if they aligned.

Researchers recruited patients from physical and rehabilitation medicine and rheumatology consultations. They analyzed podo-barometric data using a force plate, measuring peak pressure and its location, total surface area under each foot, and the distribution of pressure between the forefoot and rearfoot. These measurements were all taken while patients were standing still (static data) and barefoot.

Foot Function Index (FFI-F): Measures the impact of foot problems on function.
Visual Analog Scale (VAS): Assesses foot pain levels.
Health Assessment Questionnaire (HAQ): Evaluates overall disability.
McMaster Toronto Arthritis (MACTAR): Gathers patient preferences regarding foot health.

Interestingly, the study found no significant correlations between static plantar peak pressure and functional assessments, pain levels, or overall disability. This suggests that measuring foot pressure while standing still may not accurately reflect how the foot functions during movement and, therefore, may not be a reliable indicator of gait alterations or pain experienced during activity.

Rethinking Foot Assessments in Rheumatoid Arthritis

While instrumental analysis like foot pressure measurements can be appealing in clinical practice, this study highlights the importance of considering dynamic assessments that capture foot function during movement. Relying solely on static peak pressure may lead to an incomplete understanding of a patient's condition and potentially ineffective treatment strategies. Further research is needed to refine assessment techniques and identify more reliable indicators of foot pain and gait alterations in individuals with RA.