Foot/ankle pain...grumble, grumble

On holiday in Cabo, came down with the usual mild pain, including a bit of left ankle pain. Walked maybe too much on day one. Anyhow - for the first time bought & used crutches days 3-7 just so I didn’t miss out on things and keep weight off it. Yesterday no crutches but at the end of the day I got up from a coffee break and walked fast and got a zinger. Today - darn it but the pain is pretty bad, gonna be a crutch day. I am using the crutches because I don’t want to sit in my room all day and taking the weight off helps.

Looking for similar experience I guess - ankle pain is new to me (at least as far as actually not being able to walk). It is painful on the outside a bit right in the ‘dent’ and radiates along the top of my foot. For the most part, sitting is comfortable, it’s weight bearing that gets it going. I’ve been icing it, swelling is very mild, really only noticeable if I compare it to my other ‘bony’ ankle. My calves are also very tight, a little sore.

I am on Rinvoq so I can’t take any NSAIDS (gastritis pretty much negates this anyway). What a mess - the crutches aggravate my wrists. Anyone had something like this ? Time frame for things to get better, or, like most of this mess, is that just a shot in the dark ? Pre diagnosis I “tore” my MCL only for it to be back to normal less than two weeks later.

So frustrating !!!

That’s incredibly frustrating. Whenever possible I avoid crutches like the plague because I know that it will only aggravate my shoulders and elbows and wrists. Where you’re describing it could be tendonitis. It could be something different. You may want to use an ankle support for the moment. My rule of thumb is that if something continues beyond a week or two that I should probably get it checked out. But if it’s so bad that you can’t/ won’t put weight on it, I would encourage you to get it checked out faster.

I like to point out that I had the experience of a very bad foot pain that did not go away and I ignored it for as long as possible. I finally dealt with it months after it started because I had broken the big toe on my other foot. It turns out I had broken a metatarsal and because I had not immobilized it I wound up needing surgery months later. It’s definitely changed my perspective on my appropriate timeline for getting things checked out

I suffered right foot pain for 6 months last year. Not quite as severe as yours as in no crutches (they would murder other parts of me) but I certainly used a stick. It was all tendonitis. Over the top of my foot from my little toe and going up the outside of my calf. It made me hobble and become very grumpy. PsA loves causing tendonitis sadly. Temporary insoles from a podiatrist did help shift the weight off the tendon.

Then I ended up with left hip bursitis. Once the steroid shot went into that, both left hip and right foot decided to behave themselves better.

I know people on Rinvoq who happily take NSAIDS with a stomach protector like omeprazole and the like. I never heard of any contraindication between the two.

I was given the green light to take Celebrex with my Rinvoq occasionally but not part of a long term daily routine. Best to discuss with a physician as we all have potential other underlying conditions.

Stoney like your 2 week wait on something - so true. Before diagnosis I had an “MCL tear” that would take 4-6 weeks to resolve, almost normal in 2. Also “threw out my low back” and that magickly resolved in just over a week. The list goes on…

Currently able to walk on my heel, no crutches and still icing it. Regular walking (with foot flexion) is pretty painful so at this point I’m assuming tendonitis. Just a new spot for me I guess. Thanks for the input.

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Poo - totally get the hip bursitis, that has been with me for years, even had a shot in one hip a couple of decades ago (pre diagnosis). The foot thing is new. This PsA keeps us guessing. Can’t believe I actually bought myself some crutches - maybe I should take them home in case I need them at a later date. Sad thought.

I was dealing with calf pain in December and tried taking some ibuprofen and it gave me grief. I took one in the morning for 2 days total and my GI tract was pretty upset. I already take pantaprazole for gastritis but this was more lower GI. Sometimes I think I might have mild Crohns as GI issues have dodged me for decades. Anyway, NSAIDS are usually a no go and with Rinvoq not recommended if you have prior issues/increases chance of complications (Rinvoq website). I never found they helped me but I was never able to take them regularly either so that might be part of it.

How are you doing on Rinvoq?I?

If that was to me (I know Amos is no longer on it) then I’m not sure. I would have said great but then this foot/ankle thing. I’ve been on it since April and do have to watch my diet more - I really can’t tolerate dairy on it, though it was a bit of a thing before, just made it worse. I am active - I lift, bike/spin, hike/walk, etc. A couple of months ago we ran a 10 k race but I paid for it with wicked calf issues for some time after and haven’t ran since. I have taught fitness for over 25 years so I’m used to ‘pushing through’ and pretty fit (and stubborn). I do think it is helping me, but nothing is perfect.

FWIW, I’ve tried several biologics but had a rheumie who seemed eager to push me on to the next one if I had pain - and I wonder if we really gave some of them a real chance. From what I have read lately, pain free, esp. for someone like me who took a decade to diagnose, might be just a dream.

I was taken off of Rinvoq in October '23 as it barely reached 50% effectiveness. I was so sure that it would be my forever answer and was one of the first in Canada to be on it for PsA. It took almost a year to get going, peaked and was just sort of ok. So I am just hitting the 3 months on Simponi…already working as well as Rinvoq but I’m sort of guessing since I just weaned off of prednisone. Was doing really well with 7.5mg prednisone and thought it was the Simponi…now I’m not so sure.

Ahh it’s the type of NSAID you’re taking. The people I know take prescribed ones like Celebrex or Arcoxia/Etoricoxib. And did so long before starting Rinvoq. Some people just can’t tolerate daily NSAIDS either.

I was diagnosed with Crohn’s two years ago, it’s remained incredibly mild though, thankfully. I still take daily Arcoxia, that has zero effect on any Crohn’s symptoms for me.

The type of NSAIDS I was talking about are all prescribed ones so obviously have to pass through the physicians before you can get them.

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Ankles and wrists are my worst joints. I can’t imagine trying to use crutches. I do occasionally use a walker. I think these crazy weather fronts are making us feel worse too. I uses Votaren cream on these joints or sometimes bio freeze. Sometimes compression socks help. So sorry you are having a flare up. Oh and make sure it’s psa and not gout. We can get that too.

For 12months Ive been having right ankle snd foot pain. It comes from my PsA damaged lower spine impinge on the sciatica nerve which branches into the anterior and posterior tibialis nerve around the ankle. The calf muscle is also very tight and wasting away. Left side is also affected but not as bad. Spinal cortisone injection every 12 weeks give me some relief for about 8 to 10 weeks. Took months before a proper diagnosis.

Is spinal surgery an option to relieve nerve pressure? What med are you in?

Hi Amos.
Surgery is not feasible apparently, although a second opinion might be worthwhile. I’m still on Rinvoq which works as well as an thing else I have had. Experience says nothing will give full cover. at least I no longer have as severe fatigue or flu like symptoms. At 77 yo, I imagine I would be experiencing some pain even without PsA. I still walk, with forearm crutches, and ride my ebike.
I think I saw you have migrated from Rinvoq. Any improvement?

I’ve had my fourth dose of Simponi but it’s too early to know what it will do for me. Good to hear that you are still mobile, that’s so important ! If Simponi doesn’t work I guess I can go back to Rinvoq or just try other stuff. I’m on low dose prednisone while waiting but 5mg isn’t doing much for me right now. Oh well, it’s only pain, right? I hope your Rinvoq is $$$ covered by insurance etc.