There was weak evidence for  custom orthoses reducing pain and forefoot plantar pressures .
Evidence was inconclusive for foot function , walking speed , gait parameters , and reducing hallux abductovalgus angle progression .
CONCLUSION Custom orthoses may be beneficial in reducing pain and elevated forefoot plantar pressures in the rheumatoid foot and ankle .
OBJECTIVE To identify and critically appraise the evidence for the effectiveness of custom orthoses for the foot and ankle in rheumatoid arthritis .
Foot orthotics decrease pain but do not improve gait in rheumatoid arthritis patients.
OBJECTIVES Prescribing foot orthotics in rheumatoid arthritis patients with symptomatic forefoot involvement is a st and ard practice . However , limited research has been reported regarding gait and pain improvement with the use of foot orthotics . PATIENTS AND METHODS Sixteen patients ( 13 F , 3 M ; mean age : 52 + /- 12 years ) with metatarsalgia due to rheumatoid arthritis were included in this prospect i ve , r and omized with crossover study , and received foot orthotics . At 1 month follow-up , space and time gait variables with and without foot orthotics were assessed by Bessou 's locometer ; pain was assessed by visual analogue scale ( VAS ) . RESULTS Pain levels significantly decreased ( P = 0.008 ) by wearing foot orthotics . Despite a significant step length increase ( P = 0.05 ) with orthotics , there was no significant improvement of stride length , cadence , or walking speed which was the main assessment criterion . CONCLUSIONS Wearing foot orthotics improves pain , but not sufficiently to improve gait in rheumatoid arthritis patients with metatarsalgia .  Foot orthotics improved comfort levels because of a decrease in pain , but was not sufficient to correct gait
There was weak evidence for  custom orthoses reducing pain and forefoot plantar pressures .
Evidence was inconclusive for foot function , walking speed , gait parameters , and reducing hallux abductovalgus angle progression .
CONCLUSION Custom orthoses may be beneficial in reducing pain and elevated forefoot plantar pressures in the rheumatoid foot and ankle .
OBJECTIVE To identify and critically appraise the evidence for the effectiveness of custom orthoses for the foot and ankle in rheumatoid arthritis .