Hello everyone, I’d love some opinions on some new pain I have. My feet are really bothering me. Seems like plantar fasciitis (bad pain on the heel daily, worse after sitting or first thing in the morning), but could it be enthesitis? Are they the same thing but one could be caused by PsA? I also recently started in with elbow pain which seems like tennis elbow, but could that be inflammation of the tendons there related to PsA? How do you find out if it’s caused by PsA or if it’s just plantar fasciitis and tennis elbow?
I’ve had psoriasis since I was a kid, but never terrible. Just a few patches here and there for years I’ve had nail issues. I saw a rheumy a couple years back and they said I probably have distal PsA because I have had a swollen finger. My inflammation numbers were elevated but not bad at all, I guess. That’s what she said at least. I also had osteoarthritis in my SI joint, Lumbar vertebrae & facets, & the balls of my feel. She wasn’t at all concerned about that because there wasn’t any inflammation present there at the time of scans. But, I was only 35, in good shape, and had no injuries to have caused that. She wasn’t concerned about any of it really and didn’t want me to have a follow up or anything. Do I bother going for this type of thing if it’s not joint pain or swelling? Any advice or help is welcome. Thanks!
PsA is seronegative, so a lot of time the inflammation markers will be normal. Foot pain could be enthesis related. I don’t swell up that much, but have a lot of the same areas as you.
Imaging like US or MRI should indicate if it is enthesis related, or a torn tendon. Check out http://www.enthesis.info/ for more detailed explanation of how it effects the joints.
I am getting a MRI this Friday of my right foot to rule out a tendon tear, probably is enthesis.
Good luck!
Bad pain in the heel usually tends to be because your Achilles tendon is inflamed. Bad pain in the sole of your foot tends to be plantar fascitis. Both can be caused by PsA. Elbow pain can be either tennis elbow or golfer’s elbow depending on which area of your elbow hurts the most. Both are caused by inflammation and both can be caused by PsA. All are caused most definitely by inflammation. Since you might have PsA, that could be its cause.
Osteoarthritis damage can also sometimes look just like the damage caused by PsA. Batting you away with ‘just osteoarthritis’ is annoying because just anyway osteoarthritis can be awful too.
PsA as you know is caused because your immune system is abnormal and then stupidly inflames bits of you. So If I were in your situtation, I’d be finding an appointment with a different rheumy, one who has more of an interest in PsA and I’d pesent all these symptoms to them. As @Jon_sparky says PsA loves to not show up in blood tests, but it can show up just fine with a proper physical exam by an experienced rheumy.
Meanwhile icing and heating all those areas might help you. Elbow straps (easily bought off any physio site) truly help all elbow issues too.
I suppose you could say the plantar fasciitis is PsA…I don’t know for sure. I had plantar fasciitis at 40, but the doctor never mentioned PsA at that time, even though I had been battling psoriasis since my early 20s. I had also gone through extensive physical therapy in my mid 30s for lower back and neck pain–it never occurred to me or any of my doctors that this could be a start of psoriatic arthritis! The first they ever put two and two together was when my nails started showing symptoms in my early 50s, plus I suppose with random aches and pains off and on through the years from 40 to 50 they finally decided it was time to make a diagnosis. By the time I was 60, everything came to a head and I was beside myself with inflammation!!! Thank goodness for Enbrel!
We all have our own unique stories about PsA.….similar symptoms typically, but coming and going in so many different ways. I feel I was lucky that mine was a slow progression. Maybe yours will be that way, too. If you can get the plantar fasciitis under control, which I did at 40 with a few months of wearing supportive shoes 24/7 (even to bed at night!) and massage with steroids and whatnot. My lower back/neck pain was remedied through P.T. and some muscle relaxers and prednisone, too, to where I wasn’t bothered by that for almost 20 years after my 30s. As the disease waxes and wanes, you might eventually need special meds such as DMARDS or biologics…hopefully later rather than sooner!!!
By the time I was 60, everything came to a head and I was beside myself with inflammation!!! Thank goodness for Enbrel!