Background/Purpose: Gout frequently affects the foot, particularly the first metatarsophalangeal joint and Achilles tendon. People with gout commonly wear ill-fitting footwear that lacks cushioning and support, which may further contribute to foot pain and disability. Currently, there is limited understanding about the footwear experience in people with gout and what variables contribute to their footwear choice. The aim of this study was to understand footwear characteristics, experience of finding appropriate footwear, and factors contributing to decisions about footwear choice in people with gout.

Methods: We conducted a web-based survey of people visiting a gout patient education website. All survey participants self-reported a diagnosis of gout and were resident in the United States. The 14-item survey included questions to elicit demographic and clinical characteristics, type of footwear worn, level of difficulty in finding appropriate footwear, and factors contributing to choices about footwear.

Results: There were 83 survey respondents. Respondents were predominately European ethnicity (n=70, 84%), male (n=48, 58%), and aged between 46-75 years old (n=61, 73%). Thirty-nine percent (n=32) were newly diagnosed (<12 months), 43% (n=35) had gout for 1-10 years, and 19% (n=16) had disease for more than 10 years. Most respondents (81%) had experienced at least one flare in the past three months. Medications included non-steroidal anti-inflammatory drugs (n=24, 29%), allopurinol (n=34, 41%), colchicine (n=24, 29%), and corticosteroids (n=9, 11%). Gout flares in the feet were reported by 77 (93%) respondents, mostly in the big toe joint (n=59, 73%), and 73 (88%) reported current foot pain. Tophi affecting the feet were reported by 29 (35%) respondents. Questions about footwear were completed by 76 participants. The majority of respondents (n=49, 64%) reported that they had difficulty in finding footwear. Closed-in athletic shoes (n=66, 88%), sturdy walking shoes or boots (n=60, 79%), and casual closed-in slip-on shoes (n=48, 63%) were the most frequently worn footwear. Orthopaedic or customised shoes were worn least often (n=12, 16%). Comfort, fit, support, and ease to put on/off were the features most often rated as important or very important features when choosing footwear (Table).

Conclusion: For people with gout, foot involvement is almost universal, and difficulty finding suitable footwear is a common experience. Comfort, fit, support, and ease of donning shoes are the key features that people with gout consider important when choosing footwear.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/experience-of-finding-footwear-and-factors-contributing-to-footwear-choice-in-people-with-gout/