Skip to main navigationSkip to main content
The University of Southampton
Institute for Life Sciences

Researchers aim to improve the feeling of ‘walking on marbles’ for arthritis patients

Published: 27 November 2012

Researchers at the University of Southampton are to undertake a new stage of a study aimed at improving the health and mobility of those suffering from the common complaint of ‘walking on marbles’ associated with Rheumatoid Arthritis (RA) in the feet.

RA is the second most common form of arthritis in the UK, affecting almost 600,000 people1, which results in the destruction of joints around the body caused by inflammation.

Forefeet often contain some of the first joints to be affected and those with the condition often say that they feel like they are ‘walking on marbles'. Mostly, people have thought that this was due to walking on foot joints that are affected by the RA.

The Health Sciences' FeeTURA study however, developed new ways of assessing the forefeet through the use of diagnostic ultrasound and magnetic resonance imaging techniques. From this work, the team discovered that some of the swellings and associated feeling of ‘walking on marbles' were related to inflamed bursae (a fluid-filled sac usually found in areas subject to friction) that had developed underneath the forefoot joints. These inflamed bursae were rarely detected by clinical examination.

The exact cause of the inflamed bursae is not known and a cure is yet to be found, however, the team is now looking at identifying inflammatory and mechanical markers to find the best ways of treating this complication in people suffering with RA. They will evaluate foot health treatments, such as targeted steroid injections, as well as medical management through the use of new drugs (called biologics).

This new stage of the study will be funded through a partnership between Solent NHS Trust and the Faculty of Health Sciences at the University of Southampton and supported by a National Institute for Health Research (NIHR) clinical academic fellowship.

During the first stage of the study, which took place between 2006 and 2009, researchers at the University of Southampton developed a technique to better evaluate the forefeet and diagnose the ‘marbles' using diagnostic ultrasound. Participants' who were assessed at the NIHR Wellcome Trust Clinical Research Facility (WTCRF), based at Southampton General Hospital, returned for re-assessment in the second stage of the study which discovered the changes that had occurred in the condition.

A third stage used an MRI scan to visualise the anatomical structures and ‘marbles' more clearly in the forefeet (see photo) and resulted in researchers developing the first ever atlas to categorise the swellings originally identified in stage one.

Led by senior lecturer for Advanced Clinical and Expert Practice, Dr Catherine Bowen, this new stage of the treatment study will be carried out by clinical academic researcher, Lindsey Hooper, who recently won a prestigious special award from Wessex HIEC for the previously completed MRI work.

Dr Bowen comments: "Although more common in the UK than leukaemia and multiple sclerosis, awareness of the severity of rheumatoid arthritis is limited. 

"Our linked study aims to significantly improve the lives of those affected by the condition in their forefeet, reducing the severity of the symptoms including pain, inflammation, poor sleep, fatigue and depression, and therefore helping improve their mobility and wellbeing."

Lindsey Hooper adds: "This is an amazing opportunity to be involved in a study that is potentially life-changing for the many people suffering from this progressively debilitating condition.

"As I am maintaining my clinical role as a rheumatology podiatrist whilst also completing the research it means the findings can be fed directly back into clinical practice, so that local patients receive the most up-to-date care options."

1National Rheumatoid Arthritis Society http://www.nras.org.uk/about_rheumatoid_arthritis/what_is_ra/what_is_ra.aspx

Notes for editors

  1. High resolution photos are available from Media Relations upon request. The first photo is an MRI of the foot. The masses between the second, third, fourth and fifth toes are the ‘marbles'. The second photo shows the ‘marbles' on the bottom of the feet. Please credit both photos to Lindsey Hooper.
  2. Professor Nigel Arden, consultant rheumatologist, Dr Christopher Edwards, consultant rheumatologist, both University of Southampton and Dr Leonard King, consultant radiologist at Southampton General Hospital, will continue as advisors on the FeeTURA study.
  3. The University of Southampton is a leading UK teaching and research institution with a global reputation for leading-edge research and scholarship across a wide range of subjects in engineering, science, social sciences, health and humanities.   With over 23,000 students, around 5000 staff, and an annual turnover well in excess of £435 million, the University of Southampton is acknowledged as one of the country's top institutions for engineering, computer science and medicine. We combine academic excellence with an innovative and entrepreneurial approach to research, supporting a culture that engages and challenges students and staff in their pursuit of learning.  The University is also home to a number of world-leading research centres including the Institute of Sound and Vibration Research, the Optoelectronics Research Centre, the Web Science Trust and Doctoral training Centre, the Centre for the Developmental Origins of Health and Disease, the Southampton Statistical Sciences Research Institute and is a partner of the National Oceanography Centre at the Southampton waterfront campus.
  4. The National Institute for Health Research (NIHR) is funded by the Department of Health to improve the health and wealth of the nation through research. Since its establishment in April 2006, the NIHR has transformed research in the NHS. It has increased the volume of applied health research for the benefit of patients and the public, driven faster translation of basic science discoveries into tangible benefits for patients and the economy, and developed and supported the people who conduct and contribute to applied health research. The NIHR plays a key role in the Government's strategy for economic growth, attracting investment by the life-sciences industries through its world-class infrastructure for health research. Together, the NIHR people, programmes, centres of excellence and systems represent the most integrated health research system in the world. For further information, visit the NIHR website (www.nihr.ac.uk).

For further information contact:

Becky Attwood, Media Relations, University of Southampton, Tel: 023 8059 5457, email: r.attwood@soton.ac.uk

www.soton.ac.uk/mediacentre/

Follow us on twitter: http://twitter.com/unisouthampton

Follow me on twitter: http://twitter.com/beckyattwood07

Like us on Facebook: www.facebook.com/unisouthampton

 

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×