Comprehensive Management of Foot and Ankle Conditions and Their Biopsychosocial Impact on Patients Diagnosed with Rheumatoid Arthritis

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.