Arthritis patients in new “walking on pebbles” research
More than 100 rheumatoid arthritis (RA) patients suffering from pain in the balls of their feet similar to “walking on pebbles” are to take part in new research at Leeds University.
Heidi Davys, a specialist rheumatology podiatrist at Chapel Allerton Hospital in Chapeltown, has been awarded a £171,000 five-year part-time training fellowship by the Arthritis Research Campaign to find out why RA patients develop this particular foot deformity, and to investigate what can be done about it.
“Around 90 per cent of RA patients, including those who are newly diagnosed, frequently complain of pain under the balls of their feet, often describing the sensation as ‘walking on pebbles’,” explained Miss Davys. “According to previous research, similar problems arise in other groups of patients when damage occurs in a ligament in the ball of the foot called the plantar plate, but no-one has yet explored why this occurs.”
Miss Davys and colleagues in the Leeds Academic Unit of Musculoskeletal Disease believe that a combination of factors, including inflammation caused by RA, change in foot shape and the way a patient walks may be responsible for the pain and deformity.
She now plans to recruit 120 rheumatoid arthritis patients from the rheumatology clinics at Chapel Allerton Hospital who will be followed up for two years. Patients will have six-monthly foot examinations, as well as having foot pressure measurements undertaken in the gait analysis laboratory and detailed ultrasound studies.
“We will be looking at patients at different stages of their disease from the early stages through to longer disease duration to try and work out why this damage occurs and to pick out what factors lead to the ‘walking on pebbles’ sensation,” added Miss Davys. The ultimate goal of the research will be a clinical trial aimed at reducing foot pain and deformity.
Leeds is a leading centre for the provision of foot care for patients with rheumatoid arthritis, and has an acclaimed university programme of research into foot and ankle disorders allied to arthritis called FASTER, largely funded by the Arthritis Research Campaign.
“We are very lucky to have a full-time rheumatology foot service here in Leeds, which is something that is not available in most other parts of the country,” said Miss Davys. “Foot care services for people with arthritis are very important, and yet they are often neglected or not regarded as a high priority. We hope that this fellowship, along with the rest of the foot programme in Leeds will provide valuable new information and help raise the profile of the foot in arthritis.”
