Are orthotic devices and splints beneficial in the treatment of rheumatoid arthritis (RA)?

Updated: Feb 07, 2020
  • Author: Howard R Smith, MD; Chief Editor: Herbert S Diamond, MD  more...
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Answer

Orthotic devices play an important role in the rehabilitation management of patients with RA. These devices are used to decrease pain and inflammation, improve function, reduce deformity, and correct biomechanical malalignment.

Lower-extremity orthoses are prescribed to provide stability and proper alignment or to shift weight-bearing off the affected limb. The most common orthoses used for the lower extremity involve the foot and ankle joints.

Approximately 80% of patients affected by RA have significant foot involvement. These problems are easily accommodated by providing a deep, wide, soft leather shoe. A metatarsal pad or bar is typically used to remove weight from painful metatarsophalangeal (MTP) joints, and a rocker-bottom sole can be used to facilitate rolloff. Hindfoot pronation should be addressed with custom inserts.

Knee orthoses may be used to control the following problems:

  • Edema
  • Pain
  • Patellar misalignment
  • Hyperextension
  • Collateral or cruciate ligament instability

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