Foot pain--Cuneiforms bones where they meet metatarsals

Symptoms & Treatments
21

But, if it's inflammation, couldn't it just eventually go away on its own, Seenie? I'm really afraid of prednisone. It just seems that, yeah, it'll make me feel like $1,000,000 for awhile like it has in the past, but it also does some sort of harm to the body overall. I'm almost convinced that the past prednisone bursts I had (which worked great for a few weeks) made my psoriasis and PsA get worse afterwards. I sometimes wonder if I, or any of us for that matter, would be less affected by our P and/or PsA had we never taken prednisone. :-(

The funny thing, too, is that this same rheumy flatly refused to give me prednisone last March, telling me it wasn't good for me--which ultimately forced me to do something drastic (and smart)--go on Enbrel!

Gotta love having an autoimmune disease!

22

Grandma J,

My SI is inflamed, and while it waxes and wanes, it never goes away. From what I understand, some inflammation become chronic, so we shouldn't really count on it going away eventually.

And I find it really weird that when it comes to feet, doctors just WON'T look for inflammation! When I went to my rheumy about my SI pain, the first thing he asked for was an MRI, even though the bloodwork showed nothing! And there I was this month, diagnosed twice with some kind of inflammatory arthritis, and all they are willing to do is take some x-rays and scratch their heads! Hmmmm, I wonder what the cause of this pain might be... It's unbelievable!

I'm glad that you'll be seeing a podiatrist though... The only one who really believes my foot pain is my foot doctor in my hometown. And he didn't even need x-rays to point out the arthritis in my feet, and my feet were not so bad when he saw them!

23

GrandmaJ, I’m guessing that the rheum is willing to give you a burst of prednisone occasionally, but isn’t willing to do that on an ongoing basis, because prednisone can be pretty nasty stuff. I’m (blissfully) ignorant about the effect of prednisone on psoriasis, though, because I don’t have much to start with. But a very short course, to confirm that it’s inflammation and not mechanical pain might be worth it to me.



LL, I’m with you on the willingness of docs to scratch their heads about foot pain. It’s like, “Feet, oh ya, somebody elses’ department”. My rheumatologist/prof commented on that to the resident in a teaching moment on my last visit. He used my feet as a “what not to do”, and said that when people have foot pain, it tends to be blown off with “Yes, well everyone has sore feet.” The exception, he said, was in children, where foot pain triggers great concern. And he told the resident never to let this happen to one of her patients. And he pointed to my feet. My heart sank.



I’m glad your podiatrist is on the ball, LL. It was a podiatrist who did an x-ray and discovered my erosions. She said that I had damage from an inflammatory arthritis. (That was the first practitioner who had mentioned that possibility, after years of complaints.) When I said “Well then I need to go to a rheumatologist,” she countered with “Ha, what can they do, they only give pills.” Go figure. Yep, it can be hard to get good help.

24

Seenie, actually, you were on my mind the whole time I was going from one doctor to the next. You and your warnings are the reason I didn't say "oh, my rheumy thinks it's fibro, OK then.." because clearly it is something else! Of course, they didn't do any imaging for inflammation, but the first ortho I went to gave me diclofenac sodium which is used precisely for inflammation related to inflammatory arthritis, and especially AS. And it helped me. So I think we can think of it as those prednisone trials :) In fact, I quit taking it for a few days and I can feel all the pain creeping back in. But I'll let my stomach and my liver rest for a while. I just wish yours was caught before it damaged your feet so much.

Grandma J, when are you going to see your podiatrist? Please insist on the possibility of arthritis!

25

Good for you, LL. And I think you are right about a diclofenac trial being similar to a prednisone trial. If diclofenac helps, it’s probably inflammation. I was on diclofenac for a good ten years before my diagnosis. This is not good! I have tried reducing my dose, but I simply can’t – the pain and stiffness go out of control, even with my being on Enbrel. Yes, I’m a diclofenac junkie, and I’m sure my kidneys curse me. BTW, LL, do you take a stomach protector with your diclofenac?



The moral of the story? Well, I don’t know what the moral of the story is. Early and aggressive treatment before you end up at the stage I am now? Is that the moral of the story? I don’t know, but maybe tntlamb does.

26

oh boy.. I did not know that about diclofenac... and i was worried about naproxen.. geez...im even on vicodin and acetominaphen... and Enbrel... and Lyrica and Cymbalta.... im a big junkie.. huh???

What we do to try and live a normal life!!

Karen

27

Hi Grandma J

I think it's a kind of personal journey where each of us measures our quality of life and pain against the side effects and dangers of the meds.

When the scales tip too much in either direction, we then make decisions to even it out. And the side effects are different for each of us, so we need to make decisions on how we react individually to the meds we try. It's hard to be brave and take the next step offered when our friends have had bad experinces.

Best of luck on your journey to pain free and good quality.

28

Yes Seenie, I'm taking a stomach protector :) In fact, I went to the pharmacy and bought it myself, before the last ortho I went to finally thought about prescribing me one! Doctors are weird really, with the amount of medication they give you, you would think they would consider giving you a stomach protector so you can keep on happily swallowing your meds for the decades to come!!! I stopped taking it for a while though... But I'm thinking of taking one tonight, because I realized it was also helping with my morning stiffness when I couldn't get out of bed this morning. I'm torn apart really, take the medicine and feel stupid but move easily, or don't take the medicine and think clearly but live in pain... I think I might be becoming a diclofenac junkie as well! It was much better than Indomethacin, but the side effects were worse... As for the moral of the story... I think getting aggresive treatment is not as easy here. My thesis advisor's mom has AS and apparently she was diagnosed when she was my age, yet she was given the more aggresive treatment options when she began talking about dying of pain, when she couldn't in any way handle it anymore. And my rheumy still tells me to take my medicine "on demand". So I have a long way to go, hopefully with minimal damage. I guess I'll have to count on exercise on that front!

Karen, I have a friend who is pregnant, and two days ago when we were talking on the phone she told me she had a very bad case of a flu and she was feeling really lousy. That's when I realized that she couldn't take any medicine for nine months, suddenly the prospect of no pills was so foreign to me, and realizing that I actually needed medicine to function properly was really scary!!!

29

MamaO, I so hear ya! I have always been very reluctant to take meds--sometimes if I tough it out, things eventually get better, but sometimes, they just keep getting worse. When you have inflammatory disease, it's more often the latter, as you probably full-well know!

I just KNOW if I get some crutches and orthotics it'll get better! Especially now that it isn't my bones or joints "telescoping" or whatever they do from PsA. They were actually starting to feel less painful over the past couple of days, but today I had to go to my daughter's college campus and walked about two blocks total. That caused a nasty flare of pain!

My husband takes loads of meds--and it's been an ever-increasing diet of them since he was in his 40s. Now he's in such bad shape--bad kidney and liver, exhaustion, stiffness, morbidly obese.....I'm trying to get him to work at getting into shape, but he's so unmotivated, it's really sad. And, he doesn't have inflammatory arthritis. Just always been a high anxiety, moody person. :-( So, seeing what he's done to himself with all the various meds, I don't want to do that to me. I'm sure eventually I'll reach my breaking point--it was a huge decision for me to start Enbrel--someday I'll have to cave and do other "drugs".

Thanks for your understanding.....we all do have a unique journey!

MamaO said:

Hi Grandma J

I think it's a kind of personal journey where each of us measures our quality of life and pain against the side effects and dangers of the meds.

When the scales tip too much in either direction, we then make decisions to even it out. And the side effects are different for each of us, so we need to make decisions on how we react individually to the meds we try. It's hard to be brave and take the next step offered when our friends have had bad experinces.

Best of luck on your journey to pain free and good quality.

30

Seenie, LL and Karen: it is good to hear about those other meds....sounds like that dicl......... one is something worth looking into. But, for now, I'll stick with Ibuprofen. My stomach can't handle much, and for me stomach upset--especially when it feels like a knife is carving a hole from the inside out, is too painful and scary. Anyway, is there another name for the dicl... ?

I did take an anti-inflammatory, Relafen (Nabumetone), for plantar fasciitis when I was about 40. I was given it again last year for some of my pain and it started eating holes in my stomach so I had to stop. My stomach lining is very sensitive to meds--and taking them with food doesn't always help, either.

My nurse said there is a podiatry consult, but it usually takes the scheduler a few days to get around to it. It's okay, I'll live. The weekend is close and tomorrow I'll be at my desk at work a good part of the day. How awful it would be to have a physical job--I'm so lucky in that regard. It's understandable why some people with inflammatory arthritis need to take early retirements and medical leaves--I can't even imagine having to do physical work for any length of time with foot pain, back pain, or most any pain for that matter! At least at a desk I can use my ice packs and heating pad and keep my weight off my feet for long stretches of time. I feel for those of you who do physically challenging jobs.

LL, from your SI to your feet, then SI again--you are in need of something that gets all that under control. I hope if you go back to taking your meds, things improve.

Seenie, the P is so annoying and I'm so happy to only have a few small patches on my legs that if I took prednisone and the P got worse, that would be depressing. So, that's another reason for me to avoid prednisone. I'll see how it goes.

But, thanks, you guys, for your input. At least I do know the names of meds that you have used that are beneficial and apparently safe--and if you swear by them, well, that's encouraging!

31

Dear Grandma J, I gave in to the SI pain and took my medicine tonight... I wish I could've let my stomach rest some more but the pain was creeping up my back and I was shivering a little. And I could feel my foot swelling juuuust a little but I'm not going to let get bad again! Now my stomach is a little "blah" but my SI is quieting down and my foot is all right...

Anyway, I was going to say if NSAIDs hurt your stomach, don't take them, no matter how many of us swear by them! I think our stomachs are more important than our joints! Or, having gone through so many restrictive diets for my IBS which now I suspect was, again, inflamed, I'm very protective of my digestive system! As protective as I can be under these circumstances at least... I too am afraid for my stomach, I just hope it can hold on a little longer, until I have the chance to get this bloody inflammation under control!

32

I know you're reluctant to take the meds, LL, and I get you about that! Sometimes we don't have a choice, really. And most people are more brave about it than me. But, if/when my pain and symptoms get overwhelming, I will take meds. There's another thing about meds and people over 60-sometimes people my age have a tendency to get more SEs. I noticed relafen didn't bother my stomach at all in my 40s but it did in my 60s. I had a really bad reaction to lipitor for my high cholesterol. Instead of taking it, I take coq10 and extra fish oil and keep my intake of cholesterol down. I'm also convinced the Nortriptyline I took for neuropathy gave me an extreme dry mouth and I kind of wonder if it caused the early vitreous detachment in my eyes. These experiences give me more reason to be cautious about meds. I was actually amazed Enbrel didn't give me any SEs!!! I thought it surely would. So, there you go--you just don't know how meds are going to affect you until you try them....maybe I shouldn't be such a wimp about it!


ladylazarus said:

Dear Grandma J, I gave in to the SI pain and took my medicine tonight... I wish I could've let my stomach rest some more but the pain was creeping up my back and I was shivering a little. And I could feel my foot swelling juuuust a little but I'm not going to let get bad again! Now my stomach is a little "blah" but my SI is quieting down and my foot is all right...

Anyway, I was going to say if NSAIDs hurt your stomach, don't take them, no matter how many of us swear by them! I think our stomachs are more important than our joints! Or, having gone through so many restrictive diets for my IBS which now I suspect was, again, inflamed, I'm very protective of my digestive system! As protective as I can be under these circumstances at least... I too am afraid for my stomach, I just hope it can hold on a little longer, until I have the chance to get this bloody inflammation under control!

33

My doctor had ordered a referral to orthopedics for my feet, but I started thinking I didn't need to be seen because the pain was letting up. Well, we all know how unpredictable PsA is--I should have known the relief wouldn't last! Tonight my left foot feels worse than ever. The orthopedic appt. isn't until next Thursday, but I wish it was sooner. I'm almost sure it's tendonitis, and it's probably more intense than the past tendonitis I had in my wrists and shoulders because I can't stay off my feet long enough for them to get all the way better. So annoying!

I guess I need to baby myself more in order to avoid acute pain. It's so hard to do when there's always so much to do! Time for a nice hot bath--combined with 600 mg of ibuprofen that might help for a little while.

34

I think our pain cycle is synchronized Grandma J - that's so weird :/

35

GrandmaJ, wishing you much comfort. Amazing how I lives and those in it do not accommodate our disease, or is it us unwilling to stop or too afraid to. Either way it all piles up and the load gets heavy then our poor feet start up! The foot thing is new to me but have been having pretty severe pain for 2 months and had some warnings before but they were manageable. For the first time since July my back us not my main complaint. See my rheumy tomorrow, yeah! Last appt I mentioned my feet but was there to start Enbrel so she and I had high hopes it would help no biggie. Well, they have done nothing but get worse and my left hip is reacting to the hobble limp I do because of my feet at least that’s as far as I’m willing to admit to. I have been following your thread closely to see how you handle it because I admire your strength and determination. You take only what you need and refuse the rest and I love your humor! So keep on updating please.

36

Hi Nana L. Thanks for the kind words. Wow, you’ve had a lot of problems with your feet over the years! What is parasthesis? Are you able to walk without assistance? My biggest fear at this time is not being able to walk…either from extreme pain in my feet or from something wrong with my spine, or damage to my spinal cord. Ever since my back went out my legs are weaker and I get a lot of numbness and tingling in my lower back and down one leg or the other. I’ve changed my lifestyle somewhat–I avoid doing certain things, which for me is disappointing, especially because my parents and other family members went strong way into their 80s and my mom now 90.

But, I feel like I shouldn’t complain because it could be WAY worse and I’m probably in as good of shape as most 61-year olds without a disease. (Don’t forget Enbrel is helping A LOT.) Also, I’m not overweight, which is a blessing–I don’t have a tendency to gain extra weight. I know there are plenty of things worse than what I have. It’s just that I have a hard working mentality and love to be busy–possibly a little hyper! My mom’s that way, and at 90 she still drives a car and goes somewhere every day. We always say we hope when she dies it’s sudden because she could never accept being unwell and unable to get around!

It sounds like you’re doing better now in your 70s…? That’s encouraging! I’m adjusting to my feet and if I wear shoes all day they aren’t too bad.

37

Thanks, Nana L, you sound like a great person, too. There are so many nice people here who really understand and provide so much support and understanding!

Oooops, I did read that wrong–I thought you were 70ish! Haha, sorry!!! We don’t want to rush birthdays once we get into and beyond middle-age!

My lower back gave me problems in my 30s and I got p.t. and practiced good posture so it was good for a lot of years–I was always cautious because standing or sitting too much would give me bachaches. Then it started getting really stiff in my mid-50s, it was hard to get out of bed or a chair. When I started Enbrel last July the stiffness disappeared–it was unbelievable! But in late August I started having some weird unusual back pain down by my sacrum. I started p.t. and it got worse–I left the clinic crying!!! Had MRI, which showed inflammation, a protruding disc which was impinging my spinal cord, a couple bulging discs and some other degeneration–all contributing to the pain in my sacrum, right butt and down my leg. On laying on my back I couldn’t lift my right leg at all-it just wouldn’t respond to my brain asking it to raise! The pain was horrible! A lot of ice, heat, ibuprofen, p.t. and exercise over several weeks helped. In December, something else went wrong and I had bad pain in my left SI and down left leg! That was a burning and a knife slicing along my calf!!! All the p.t., ice, heat helped again, except that’s where the weakness and occasional numbness and tingling come in…to top it all off, I hurt my feet making like 100 trips up and down our basement stairs around March 1 (carrying small amounts of our Xmas decorations to store down there). --since my back went out I won’t lift over 20 lbs ever, so…I’ll tell you, next year our kids are gonna have to do the decorating and un-decorating!!! Or we just won’t decorate for Xmas, and I can’t envision that!

Thanks for the information about Callenetics–I’ll check that out.

After you said what parasthesia is–that sounds like what I have or had. I feel lucky that most of the pain is gone and for sure, 75% of my PsA and psoriasis is gone since I started Enbrel! Our p.t. clinic has great equipment to strengthen muscle, but they have a monthly fee. It has helped in the past and could sure do me some good again.

Congrats on your 30th anniversary–sounds like a great way to celebrate, minus the aches and pains, tho! Have you tried icing it? Enjoy the rest of your time in Liverpool–keep smiling!

38

Sounds like you need a little more rest, Nana L. That vacation to Liverpool was hard on you in some ways! :-) We got home from our vacation to the lake yesterday evening, and I woke up this morning with pain from my neck to my mid-back. I took some extra ibuprofen to get through the day, and right now I'm laying on the heating pad. (It's 12:15 a.m. here--I should be sleeping!) My other back pain is minimal at the time, but ever present are the tingling down my leg(s) and some numbness and weakness, too. That's just a good reminder for me to be careful.

Vacations wear you out, don't they? For me, it's the pulling/lifting of suitcases, etc., I'm sure.

The pain you have on top of your feet sounds exactly like mine. I've had the painful big toes recently, too--was even wondering if it was gout, but it went away. I let out a sudden scream this evening going down our stairs. I accidentally bent my foot (I try to always walk without bending them when I'm barefoot) and the sudden, unexpected intense pain of bones rubbing together made me scream. Geez, I hope that never happens in public! My general foot pain now ranges between a 1 and 8-it's actually usually at about a 3 or 4 lately, so that isn't too bad. A "0" would be nice, though! :-)