Can Orthotics Help With RA?

Medically Reviewed by David Zelman, MD on March 28, 2022
3 min read

Rheumatoid arthritis (RA) can lead to issues with the front of your feet. These can include problems like bunions, claw toes, or pain under the ball of the foot called metatarsalgia. In very bad cases, your joints and bones could become deformed. Orthotics can help correct misalignments and other biomechanical problems.

Orthotics are specially-made shoe inserts and devices designed to provide support and comfort. These pads, bars, and soles are customized to match the contours and shape of your feet. Research shows that orthotics can ease your foot pain and allow you to walk and move better.

Structural and alignment problems caused by RA can affect not only your foot, but also your shin, knee, or lower back.

Orthotics can help:

  • Distribute your body weight evenly
  • Ease or reduce pressure on the feet and arthritic joints
  • Provide cushioning for the balls of your feet
  • Reduce stress on the hips and lower legs
  • Correct gait or balance
  • Improve overall posture
  • Slow down or prevent RA progression in the long term

Research is unclear on how long you have to wear orthotics for noticeable improvements. But they may help enough that you can get by with fewer pain medications or to strengthen your muscles.

One study found that orthotics made from softer materials were more helpful for foot pain than orthotics made from harder stuff like plastic, especially if your issues are at the front of the foot.

An international study surveyed 183 podiatrists from the UK, Australia, and New Zealand on the types of orthotics prescribed for those with RA. It found that softer shell-type material is also better for more moderate to severe RA rather than early-stage RA. But orthotics that have more cushioning for the top of the foot can work for all stages of RA.

If RA is causing serious pain in your feet, ankles, or lower legs, let your doctor know about it. If they think orthotics can help, they’ll refer you to a podiatrist, a medical professional who specializes in these issues.

Your podiatrist will thoroughly examine the affected area. Later on, they may do several tests to see how your feet respond to movements like standing and walking. Based on your foot’s structure and issues, they will take three-dimensional measurements and might prescribe orthotics. Unlike over-the-counter shoe inserts, orthotics are made with high-quality materials to ease foot pain.

There are two types of prescription orthotics:

Functional orthotics. This type is crafted to help you control your feet’s abnormal motion or treat any pain caused by it. If you have tendinitis caused by RA, functional orthotics can help ease some of the muscle strain that causes it. They’re usually made from a semi-rigid material such as plastic or graphite.

Accommodative orthotics. This type is usually softer and provides more cushion and support if you have painful calluses or bumps caused by RA. Generally, this type provides more support for people with RA-affected feet.

Custom orthotics are pricey and available through prescription only. But they can last up to 5 years. Depending on the type and your needs, orthotics can cost $400 to $800.

Most insurance companies won’t cover orthotics even if your doctor prescribes it. If so, orthotics are typically eligible for purchases with a pre-tax flexible spending account (FSA) if you have one. If you’re covered by Medicare Plan B and have diabetes, you may be eligible for one pair of shoes and three pairs of shoe inserts per year.

You can also check with your podiatrist for less expensive, off-the-shelf options to help with foot pain. This type can usually be modified and can run you $60 to $300.