Anybody who can tell me what they've done for this type of pain on the top of the foot I would greatly appreciate. I've had neuropathy in the soles of my feet in the past with burning/pain in the tops closer to my toes....that's all gotten better.
But, now for the past couple of weeks, the tops of my feet, and I did some googling--the cuneiforms bones and joints where they meet the metatarsals are killing me. It's making me feel sick all over, actually, and I would sure appreciate any advice. So far, ibuprofen helps somewhat, but I can't live on that! Just getting off my feet helps a little, and applying a heated "neck buddy" helps a very little. Ice or Salonpas patches haven't helped at all. I'm limping really badly and next step is to contact my doctor, but knowing doctors only hand out pain pills I hate doing that. I suppose a stronger anti-inflammatory is going to be necessary, as this just isn't letting up.
Ugh, what we don't have to go through, even when our biologic seems to be working for the most part. I hope you're all having a good weekend--or at least an okay one!!!
I know what you're going through with the foot pain... It really sucks. As you know I was finally diagnosed with metatarsalgia, and my problem is below where you are experiencing discomfort, where my metatarsals touch the ground. I don't know if yours is nerve related, and I actually don't know if mine was arthritis related, but the drug that helped me was diclofenac sodium. But it's just another NSAID, so I don't know if it would be more helpful than ibuprofen. Oh, and I got silicone metatarsal pads, that helped a lot too, but I think you need to see a doctor to get them - I had to get so many signatures from various doctors, but maybe that's how it works in Turkey. Other than that, nothing I did seemed to help. Putting on some pain relieving gels and wrapping up tightly helps a little too, but then it too gets uncomfortable, naturally. So I think it would be best if you saw a doctor if it doesn't get better. I had to live with that excrutiating pain and the feeling of swelling before I found the doctor that finally made it somewhat better... Don't wait like I did.
Grandma J, this brings back painful memories to when my PsA first started. Looking back with the benefit of hindsight I think mine was tendonitis even though when I suggested this to my rheumy he blew the idea off. But I would say mine extended right up across the top of the foot to my ankle. It took a long time to ease off by which time all the more familiar PsA foot pain began as I have quite a bit of foot joint involvement. For me all my foot pain is best helped by wearing the 'right' footwear .... thick cushioning soles, good arch support and nothing too tight across the mtp joints.
Maybe a call to your docs office tomorrow will help you decide whether continued self-management is the way to go or whether this is something they need to see you with. Either way I hope you get some relief soon.
I agree it is so frustrating that effective treatment, especially on biologics, doesn't seem to achieve the utopia of remission for everyone. I'd still like to be better than I am now (knees take note!) but as time goes on I am much more accepting of this constant ebb and flow and that I have to live with some pain and symptoms. Today is not a good day, not good at all (it might be the cold) but tomorrow will probably be better :)
I hear ya both... I am going to live my life the way I want.. and if it causes pain... I will take what comes... I worked out in the yard today.. raking.. getting yard ready for spring... It took me 5 days to get it all done.. but Im proud of what I accomplished. Even though I know the burning pain will come.. I still go on.... I dont hurt when Im out there... just get winded... lol.... I meditate, use biofreeze.... I try to even flex my toes...
I even heard yesterday.. it helps to scream... it takes the pain away for just a split second.. but it is supposed to help with the stress we have...
I think we all need our own mountaintop.. right??
Push forward as much as possible.... do not give in.... the doctors are just as befuddled as we are!!
I know how awful your foot pain has been, LL, and I'm glad you're finally getting some relief. Your pain seems lower than mine, and you described a feeling of swelling, if I remember correctly. I wish I could ask my doctor for the diclofenac sodium, but I'm allergic to naproxen sodium. It tears holes in my stomach, even if I take it with food. I'm afraid of it for that reason. But thank you for your concern and I'll most likely go to the doctor this week, even though I get discouraged when they can't do something to make it better (see I'm already being pessimistic!). I'm wondering if those gel pads would help, if even just a little. :-)
Jules, thank you. I've always thought my Skechers shoes were good for my feet, but lately they seem to hurt more as soon as I take them off. About the utopia of remission--I experienced that for nearly two full months almost immediately after starting Enbrel last July. But since the end of August, it's been one pain after another. I don't want to think Enbrel is slowly wearing out, but it's not really like an ebb and flow of symptoms--it's more like a gradual accumulation of aches and pains. My neck has also been hurting again lately and more and more frequently different joints will lock up. My daughter (nurse in dermy clinic) told me lots of people go back to the temporary twice a week dosing of Enbrel if they start having more symptoms. I guess I might consider that.
Karen, I hear you about pushing through the pain. I have a very busy life with my jobs and watching grandkids a lot. Plus, my husband doesn't do housework or most yard work--and we have a big yard. I can't get out of doing these things. But, I'm 61, and I feel really worn out. The past couple of years have been crazy difficult for me--most of the past 6 1/2 months I've had either really severe pain (my back) or the kind of pain that you can push through but it wears you out, or a bad cold. Right now, my feet are somewhere in-between the annoying and the severe! I'm not a screamer, but sometimes when it gets really bad I get so frustrated I just cry (by myself). And that is not like me. I can't handle pain like I used to. A few years ago I had foot neuropathy at least a year before I told the doctor, and I'm sure I had a whiplash when I was 40 and never doctored for it. But, it's getting so hard to ignore the pain or do things that I know will cause me more pain.
I so envy my 90-year old mom. She doesn't have PsA, and when she was my age she was like I was in my 30s! And, the fact that both of my parents went into their 80s with more ambition than I have in my 60s is really disappointing for me and makes me feel like somewhat of a failure.
I feel your pain . I have severe p.s.a in my feet. It was so escrutiating pain above top middle of my footand metatarsals. I also experience neorthoprapy for the first time also a cold feeling i wasnt sure what that was all about but it sent me into depression. I spent two weeks off my feet and using a messager just to get circulation in my feet. I'm fifty five and feel. I guess i dont have to go on. I should get use to pain but, I'm on embral and methotrexate. Im not sure if i should change to humiria.
Oh my, LL, I meant your pain seems lower in your foot, not less than mine!!!!! (The way I worded that above sounded wrong and I wanted to clarify that!)
You know what, Donna? Before I started taking Enbrel I kept saying if I make it to 70, that'll be it because I couldn't imagine living with so much pain for any longer than that. I actually felt as if my heart would give out because the pain made me so weak and every day was such a struggle. Now I'm concerned that I'm going downhill again. Like you, I wonder how long it'll be before I need to switch to Humira. I'm hoping if my feet get better I'll be fine for awhile.
Sometimes I'm not the brightest light on the tree! It finally dawned on me I should use crutches for a week or two to enable my feet to heal! I'm expecting to hear from my doctor today and I'm going to ask her about this. :-)
Grandma J, the more I think about this the more I realise the impact that different footwear has on my feet. I think I was especially lucky to get a referral to a biomechanical podiatrist at a private hospital very early on in my PsA journey. In summary she told me two things, soft soled footwear/orthotics are great for inflammatory pain and harder footbeds/orthotics are great for mechanical problems.
I have Sketchers too. For me they are ok 'ish but I find FitFlops brand footwear is best for me. I was also very surprised to discover last summer, when I was having a good spell with my foot inflammation, how good Birkenstocks were. This discovery came about by accident when a friend gave me an unworn pair of hers. So the first time I put them on I was like 'what the hell/why the hell?' but I persevered around the house and once my foot was broken-in to the hard footbed and very supportive moulding (and I think with these you are breaking your foot in rather than the shoe!!!!) I actually realised how good my feet felt.
Today I've just stood for a couple of hours in my greenhouse sowing seeds and I now need to sit down and rest my feet 'cos they hurt. This disease is a thief and a vandal and I've had to make so many changes to my life and expectations to accommodate it but I have found myself closer to a place of acceptance within me when I fight the bigger war and not so much the smaller constant battles which are so draining. I am a self-confessed perfectionist control freak so doing less, accepting help and finding/paying for help around the house and garden has been a big one for me to deal with BUT it has improved my quality of life no end.
I'm nine years younger than you and hearing what you do exhausts me! My heart goes out to you so I'm going to risk being a little contentious as I think we must know each other well enough by now that you will know the kind intention that is behind my words ..... Is it maybe time to sit down with your husband and family and talk about what they can do for you rather than the other way round? Your needs are every bit as valid as theirs but for things to change around you, you may have to change and not be all things to all people ..... I know this is a huge ask as your amazing, caring and nurturing nature comes across every time you post here. And maybe look to see what home tasks you can outsource if you can afford it. And what about responsible teenagers in your neighbourhood, are there any that would help with your yard work for a few dollars pocket money?
Hope you get some useful help/suggestions from your doctor today. Let us know how you get on. Sending you lots of positive healing thoughts.
Dear Grandma J, I wouldn't for a second think that you were undermining my pain :D I think this forum is the only place where everyone knows what you mean when you say "it hurts"! And I would never imagine you doing such a thing so I understood exactly what you meant when I read your reply, don't worry :))
Dear Grandma J, I wouldn't for a second think that you were undermining my pain :D I think this forum is the only place where everyone knows what you mean when you say "it hurts"! And I would never imagine you doing such a thing so I understood exactly what you meant when I read your reply, don't worry :))
Thanks, Jules. I will look into better shoes. I'm on a fairly tight budget right now because I'm bent on getting my part of our daughter's very expensive wedding paid off, but in a few months I'll have money to burn again!
A little angel called me up this morning and said she was on her way to help me with my housework! She's the daughter I babysat for this weekend. She dusted, vacuumed all the carpets and cleaned both bathrooms! What a godsend she is....and as far as watching their kids, I hate to decline because I love those kids like my own. And, they're growing up so fast it won't be long and they'll not need me anymore (the twins are 11). I think I have a need to be needed! :-/
She always jokes that someday she'll be wiping my butt (she's a nurse and our kids swear they'll never put us in a nursing home). But, I say "over my dead body-nobody's wiping my butt ever--especially not my own kids!" Do you think I'll be eating those words someday? Yikes!
Jules said:
Grandma J, the more I think about this the more I realise the impact that different footwear has on my feet. I think I was especially lucky to get a referral to a biomechanical podiatrist at a private hospital very early on in my PsA journey. In summary she told me two things, soft soled footwear/orthotics are great for inflammatory pain and harder footbeds/orthotics are great for mechanical problems.
I have Sketchers too. For me they are ok 'ish but I find FitFlops brand footwear is best for me. I was also very surprised to discover last summer, when I was having a good spell with my foot inflammation, how good Birkenstocks were. This discovery came about by accident when a friend gave me an unworn pair of hers. So the first time I put them on I was like 'what the hell/why the hell?' but I persevered around the house and once my foot was broken-in to the hard footbed and very supportive moulding (and I think with these you are breaking your foot in rather than the shoe!!!!) I actually realised how good my feet felt.
Today I've just stood for a couple of hours in my greenhouse sowing seeds and I now need to sit down and rest my feet 'cos they hurt. This disease is a thief and a vandal and I've had to make so many changes to my life and expectations to accommodate it but I have found myself closer to a place of acceptance within me when I fight the bigger war and not so much the smaller constant battles which are so draining. I am a self-confessed perfectionist control freak so doing less, accepting help and finding/paying for help around the house and garden has been a big one for me to deal with BUT it has improved my quality of life no end.
I'm nine years younger than you and hearing what you do exhausts me! My heart goes out to you so I'm going to risk being a little contentious as I think we must know each other well enough by now that you will know the kind intention that is behind my words ..... Is it maybe time to sit down with your husband and family and talk about what they can do for you rather than the other way round? Your needs are every bit as valid as theirs but for things to change around you, you may have to change and not be all things to all people ..... I know this is a huge ask as your amazing, caring and nurturing nature comes across every time you post here. And maybe look to see what home tasks you can outsource if you can afford it. And what about responsible teenagers in your neighbourhood, are there any that would help with your yard work for a few dollars pocket money?
Hope you get some useful help/suggestions from your doctor today. Let us know how you get on. Sending you lots of positive healing thoughts.
Ouch ouch ouch, GrandmaJ. You know, I saw this thread a couple of days ago and I couldn’t even read it until now. You know my reaction when someone says “feet”. My feet are really sore these days, and I don’t want to think why that might be. Have you made an appointment with your rheumatologist about your increased foot pain? That needs looking into, and if Enbrel isn’t doing its work well enough, you may need something different or in addition to it. Don’t mess around with your feet!
Anyway, I remember the top-of-foot pain very well. It completely stumped my GP (I was undiagnosed at the time). I also had lumps and bumps on the top of my foot. That was a real head-scratcher. I went to the best sports meds doc in the city, and she said it was metatarsalgia. (Yes, LLL!) I only wish! It was, in fact, severe inflammation in the mid-foot.
Interesting that yours is in that part of the foot too: in most people PsA attacks the joints of the toes first. But not me, mine was in the deepest darkest region of the foot. I commented to the foot surgeon that it was unusual to have mid-foot involvemnt but nothing in the toes. He commented that lots of arthritics have mid-foot involvement. I guess it’s just less obvious there, except for the pain, which too often gets shrugged off as “oh well, we all get sore feet, get orthotics”.
DonnaB, I’m sorry that your PsA has taken a shine to your feet. Miserable, isn’t it? It’s so true what they say, “When your feet hurt …” Don’t we know it!
Yes you are so not alone! I am and have been dealing with excruciating pain in my left foot with more swelling in my right toes lately. I have been reading all the posts but the positive side of me keeps erasing my responses before posting them because I have to admit I am in a very negative mindset lately. I finally took my third dose of Enbrel on Saturday and only small reaction at site but was very nervous considering my last one 2 weeks ago resulted in mass rash everywhere 5 days after the shot. I took vacation from work 2 days for a long weekend to avoid missing work for med reasons that they are not compassionate about to say the least. I feel like I am living on dead energy or the faint relief of a pain pill. I am becoming more scared everyday of what I can endure and amazed that you keep it so together Grandma J! Hoping you find answers to share because since July my main complaint was my back and ribs but the bio is working for that, hurray! Now my feet have joined in and its misery. I am actually at the beach today trying to pretend that it is pleasant ( beautiful sunny) but sadly I am barely able to enjoy it and my family is disappointed. I too wish I had my mothers energy even for one day!
What I have come to realize in this last month Seenie, with all the doctors I had to see to find just a teeny tiny bit of relief, is that it doesn't matter how early you were diagnosed, even your rheumatologist who diagnosed you won't believe something's wrong until he sees damage or major swelling!!! So the important thing is "I" know what's going on... So I can be persistent with the doctors...
Seenie said:
I went to the best sports meds doc in the city, and she said it was metatarsalgia. (Yes, LLL!) I only wish! It was, in fact, severe inflammation in the mid-foot.
You’ve already learned what I learned ten years too late. LadyLazarus, you rock!
It’s just so easy to accept the brushoff, assume it’s something you’ve done or not done, blame yourself for overreacting, talk yourself into ignoring the signs when the doctor isn’t worried etc etc etc.
I’m not advocating that we need to pull the alarm every time we notice a change, but we do need to trust the signals that our body sends. And don’t take a brush off as an answer.
The truth is Seenie, I have been brushed off so many times, I had honestly began thinking that the whole problem was in my head… And I could’ve easily thought the same about my arthritis… if it wasn’t something that was SO UNBEARABLE when it gets bad and MAKES YOU go to a different doctor everyday (I don’t know if you have seen it but I went to another ortho the next day about the shadow thing)… I don’t know if I would do the same for something else - after all, I ignored my back pain for years - but I just had to find relief for my foot! In the last week of my misery, I didn’t even care if the doctors believed me or not, I didn’t even care if I really was crazy, I just wanted relief!!!
You had mentioned your feet giving you more trouble again, and all I can say is, that sucks! With that, I'll say ttyt because I'm dozing off right now. :-(
Seenie said:
Ouch ouch ouch, GrandmaJ. You know, I saw this thread a couple of days ago and I couldn't even read it until now. You know my reaction when someone says "feet". My feet are really sore these days, and I don't want to think why that might be. Have you made an appointment with your rheumatologist about your increased foot pain? That needs looking into, and if Enbrel isn't doing its work well enough, you may need something different or in addition to it. Don't mess around with your feet!
Anyway, I remember the top-of-foot pain very well. It completely stumped my GP (I was undiagnosed at the time). I also had lumps and bumps on the top of my foot. That was a real head-scratcher. I went to the best sports meds doc in the city, and she said it was metatarsalgia. (Yes, LLL!) I only wish! It was, in fact, severe inflammation in the mid-foot.
Interesting that yours is in that part of the foot too: in most people PsA attacks the joints of the toes first. But not me, mine was in the deepest darkest region of the foot. I commented to the foot surgeon that it was unusual to have mid-foot involvemnt but nothing in the toes. He commented that lots of arthritics have mid-foot involvement. I guess it's just less obvious there, except for the pain, which too often gets shrugged off as "oh well, we all get sore feet, get orthotics".
DonnaB, I'm sorry that your PsA has taken a shine to your feet. Miserable, isn't it? It's so true what they say, "When your feet hurt ..." Don't we know it!
I wish I had time to reply to everyone's comments because I so appreciate all your help and it's always nice to know what other people have done for similar pain.....but, I'm off to work in a few minutes. First, I'm stopping at the clinic and having x-rays of both feet, so hopefully the results will be available by tomorrow.
Haha, funny thing happened yesterday. I was planning to use my husband's crutches but they were covered with coal dust. So, I gave them a shower and made sure they were sparkling clean. When I set out to adjust the height, I found out they were only adjustable from 5'10" to 6'6", so boohoo, I don't have any crutches to use today!
Okay, here are the x-ray results. Left foot: mild joint space narrowing of the first metatarsophalangeal joint. No evidence for inflammatory arthritic changes. Right foot: moderate to marked joint space narrowing of the first metatarsophalangeal joint. No periarticular erosions are evidenced with inflammatory arthritic changes at this time. There are no pencil-in-cup deformities noted. There is osteoarthritic change at the bases of the big toes.
They offered me a prednisone burst which would "quiet any PsA disease activity". The nurse also called me and told me x-rays don't show inflammation and I could always get the prednisone later if I'm hesitant to take it now. I am being referred to a podiatrist for further opinion.
It all sounds pretty mild and there isn't much to be concerned about. Except, then I remember some people here who were told they had mild arthritis in their feet for years and it turned out to be quite severe! Plus, it seems weird that my feet can be very painful at times and other times not so bad. I'm looking forward to the podiatry visit and maybe getting orthotics or crutches or whatever else might help lessen or cure the pain. Thanks for all your input, everybody!
Well I’m no radiologist, but it sounds pretty mild to me too. You have to wonder what other peoples’ feet would look like if they ever had reason to have a foot x-ray. But if there’s nothing extreme there, Why do your feet hurt so? My guess would be inflammation, which, of course, the x-ray won’t show.
If you decide to take the offer of a prednisone burst, it will be interesting to see whether the pain goes away. If it does, that’s a sign that you’ve got inflammation going on. One of my rheumatologists suggested a prednisone trial as a diagnostic strategy. And inflammation it was.